It’s like the first smile and first steps, but more terrifying — every parent of a food-allergic child remembers the first allergic reaction.
For Chris Huppin’s then 4-year old, it was a fancy fish entrée.
“Jacob had told me, ‘I don’t want to eat it,’ so I asked him to give me a ‘No, thank you’ bite. He did,” she recalls, and within seconds, “He threw up, broke out in a rash, and started having problems breathing.”
After having him treated at the emergency room, Huppin took her son to an allergist to be tested. “He came back allergic to tree nuts, peanuts, fish… the list is long. But the hardest thing for me was holding the Epi-pen [a portable injection of adrenaline] and being told he could die.”
Jacob is one of three million American children diagnosed with a potentially deadly peanut allergy. The number of children diagnosed has doubled in the last 10 years.
There is no clear answer about why the numbers are rising, but the most commonly cited theories stem from “The Hygiene Hypothesis” — the theory that American kids are growing up too clean. Regular use of antibiotics, immunizations and antibacterial cleaners have left their immune systems with no diseases and germs to attack, settling instead on foods.
After misidentifying a food protein as a threat, confused immune systems create antibodies, releasing massive amounts of chemicals (including histamine), triggering reactions in the gastrointestinal tract, on the skin, and in respiratory and cardiovascular systems.
Spokane allergist Kerry Drain explains that overreacting immune systems often led to false positive allergy test results in the past, but improved technology makes today’s results comprehensive and reliable.
“There’s a lot more out there. Pediatricians have better diagnostic tools to order. That has definitely helped,” she says.
Dr. Drain has lived through 32 years of food allergy trouble-shooting, and emergency treatment of reactions — not just as a doctor, but as a patient.
Since she was diagnosed at age 6, she has avoided nuts, yet she has still had to self-administer an Epi-pen multiple times. “My last three issues were all caused by cross-contamination,” she explains. Cross-contamination is when a food she thought was safe has been close to a food that was not.
“I’m an interesting case study,” she admits. “The day after I have an anaphylactic reaction, my body tests almost negative to peanuts. Within 6 to 12 hours, it’s back up, and within four days, it’s a higher level than ever,” she muses. “I am 38 years old, and I run a razor’s edge between a normal life and paranoia.”
And if you think a doctor who diagnoses allergies and trains other people to use Epi-pens borders on paranoid, you can imagine the tendencies of non-professionals.
Like most parents with food-allergic (FA) children diagnosed as toddlers, Anne-Scott Ettinger carefully controlled what her daughter ate for meals and snacks at home. But when it came to grade school, there were too many unknown variables, so Ettinger got involved.
“The most effective thing is to go in before school starts, train teachers how to use the Epi-pen, let them use it on an orange,” she suggests, “ and make sure there’s not a peanut butter pine cone bird feeder.”
Her daughter Kristen is now 14, but for years Ettinger sent a letter to parents in grade school classes explaining her daughter’s food allergies, and suggesting ways to discuss food allergies with their families. Ettinger showed up at classroom parties and field trips, encouraging nonfood-related activities.
And she has always packed her daughter’s lunch.
“We’ve never been people who insist their child has the same lunch as everyone else. We have chosen to bring food from home rather than push places to be 100 percent safe,” says Ettinger.
District 81’s Coordinator of Health Services, Kathe Reed-McKay, would appreciate Ettinger’s flexibility and understanding. She says that although it would be ideal to create a safe space for every child with a food allergy, it’s unrealistic.
“We really discourage the use of ‘peanut-free zone’ because it gives a false sense of security. We’re trying to better identify areas as allergy zones,” says Reed-McKay. She explains that lunchrooms going “soy free” would be even more challenging than peanut-free.
“We wouldn’t be able to serve more than four items if we were soy-free,” she says, “so we deal with [children’s health issues] on an individual basis.”
Children with severe food allergies are coded in the computer and as they go through the lunch line, they’re given a bright green card to alert the lunchroom staff. “Knowing that it’s impossible to control many environments, our Allergy Task Force members want to promote awareness, prevention, and the ability to act in an emergency,” says Reed-McKay.
“The emergency action plan is fluid — it can change at any time on the parents’ notice. We depend on them to keep doctors’ orders updated,” Reed-McKay emphasizes. District 81’s EAPs offer an opportunity for not only parents to advocate for FA students, but also school nurses, teachers, and other students.
“The PAL [“Protect a Life” elementary lunchroom procedure for fellow students] program just fits in so well,” she adds.
Huppin would like to see teachers encourage this kind of partnership among students, but she hasn’t seen it yet. “They’re growing up with this generation of kids who are actually in the same room dealing with them on a daily basis,” says Huppin. “They’re required to learn about stranger safety — why not food safety?”