DD has nut allergy- what precautions can I implement with family/friends?

[cdlamis]

My 4 yr old just failed her in office peanut challenge so now we are looking for permanent guidelines to live by- especially when visiting friends and family. We can be assured that our home is 100% peanut free but am at a loss when at other people's homes.

For example, we were at MIL's house yesterday and my nephew wanted a PB&J sandwich. I felt like such a nag not letting my DD sit next to him and making sure he washed his hands afterwards. I got the sense that my BIL/SIL thought I was overreacting (maybe I am?). DH and I realized that was have not made things clear with family members and its only fair to everyone else to let them know what is expected when around DD.

What do you do if someone eats a nut product around your DC? Is it different around family/friends?

If someone eats something with nits, what do you make sure happens after? Wash hands? Sterilize the table?

Am I being way over protective trying to come up with "rules" since I can't control everything? I feel bad controlling the menu at my MILs house but not thinking twice when I take DD to a playground that could contain germs/remains of a number of allergens.

Any thoughts? I would love to hear from both sides. I feel like I could possibly overreact with this and alienate family/friends if I don't take the right approach. BUT, I also feel that only we (as her parents) can protect her so I need to care less about feelings of others.

TIA!

[AnnieW625]

I would call your MIL/FIL and your BIL/SIL directly and let them know the seriousness of your daughter's nut allergy, and let them know that since she is 4 she may not be outgrowing this allergy. I don't think you are over reacting.

I don't have a child with nut allergies, but do have a cousin with walnut allergy so much easier to control than say peanuts but my grandparents and my parents have never had a cross thing to say about her allergy. We also have a friend whose son is allergic to peanuts and I am not offended when asked not to make them a meal with peanuts or have no peanuts when he is around.

I bet the ILs will appreciate the personal phone call. In the future for play dates/birthday parties, school etc. just let the parents know as soon as you know DD is going over there that peanuts need to be removed from the area when DD is around. I think parents are pretty understanding about those things now. One thing that does irritate me (and this mainly comes from reading things on message boards) is the parents assume that everyone should know just what to do about all food allergies and assume that everyone who serves something allergic is in the wrong all the time when they simply just may have not known the seriousness of the issue because they didn't explain it well.

[Katigre]

How serious was her reaction? There are different levels of peanut allergy. Two of my friends' children have them and they don't need any special precautions, they just can't eat peanut products themselves.

Unless the reaction in the office was extremely severe (i.e., immediate anaphalactic after eating) I would just have her not eat peanut products but wouldn't be concerned about other people's homes/random exposure.

[Laurel]

How serious was her reaction? There are different levels of peanut allergy. Two of my friends' children have them and they don't need any special precautions, they just can't eat peanut products themselves.

Unless the reaction in the office was extremely severe (i.e., immediate anaphalactic after eating) I would just have her not eat peanut products but wouldn't be concerned about other people's homes/random exposure.

Whoa, wait a second! I have always heard any nut allergy has the potential to be life threatening with repeated exposures, even if past reactions have been mild/limited to ingested nuts.

BBB nut allergy parents, can you clear this up?

[deenass]

I think that the difference between your MIL house and the public playground is that MIL / FIL / BIL etc. you would expect to have REASONABLE concern over the potential LIFE THREATENING aspect of your child's allergy.

I also think it's fair that you ask family members not to consume nut products around your child - again, TO SAVE HER LIFE. Your nephew/niece, etc. is not going to DIE if they can't don't have a PB&J at grandma's house. Your daughter might if she accidentally ingests some (or comes into contact with it depending on the severity of ehr allergy). And with allergies, continued exposure can cause the reaction to worsen over time. So, while now she may only get hives, repeated exposures can cause the reaction to get much worse.

I think this is a case where research is your friend. I think you should talk to those close to you and your child and your family and explain to them the severity of the allergy. You are not the "crazy paranoid" one here. No one would fault you for not letting your child walk around the perimeter of a deep swimming pool. Sam logic applies here.

Hope I don't sound too preachy, I'm just SUPER sensitive to allergy issues (and have little to no tolerance for those who try to "poo poo" parents with allergic kids).

[Katigre]

Whoa, wait a second! I have always heard any nut allergy has the potential to be life threatening with repeated exposures, even if past reactions have been mild/limited to ingested nuts.

BBB nut allergy parents, can you clear this up?
These are both close friends who we share meals/houses with frequently (and both their kids are in elementary school so have also dealt with school issues). I'm going off of their experience and what they've asked us to do - and just like with any allergy, I believe that peanut allergies can be super severe (can't even be in the same room as nut products) to less severe (can't eat them, but others around them can without an issue).

Here is a NIH study on managing nut allergies that seems to support the idea that levels of severity can vary (they graded them 1-5 for the purposes of their study, and not all were anaphalactic) - http://www.ncbi.nlm.nih.gov/pubmed/11197398.

ETA: You're right that kids who test positive for nut allergy shouldn't eat them - my friends' kids don't eat nuts. But it's not a problem for others to eat nuts around them. Their friends can eat peanut butter sandwiches at the same table without my friends' kids reacting, and the friends aren't asked to wash hands afterward either. If one of their friends eats peanut products before coming over to play that's not a problem either. Simply avoiding eating the offending foods is enough to prevent reactions (and these are kids who are over age 5, so you don't have the toddler issues of sharing food/cups/sticking fingers in each other's mouths that could be problematic - at that age I'm sure they'd have requested no peanuts around their child just to prevent accidental ingestion).

[DrSally]

I think the problem with eating peanut products around a child with a peanut allergy is the possibility of skin contact. With milk, I was told that strict avoidance increased DS's chance of outgrowing the allergy. We strictly avoided all cross contamination and he did outgrow it. I know that a child is less likely to outgrow peanut allergy, but that's one factor to consider. Another is that peanut exposure through the skin *could* be worse b/c at least when it's ingested, the body's GI system has a chance to break it down, KWIM. There is some thought out there that early exposure to peanuts though lotions can sensitize a baby to peanuts and increase risk of developing an allergy.

The oil in pb sticks around for a long time. I'm not comfortable with someone eating pb around DS, let alone not washing hands/table afterward. Also, peanut proteins stay in the mouth for up to 2? hours, so I don't want relatives kissing DS after eating PB. DS got hives just from sitting on the carpet where a dog had played with a toy with PB *inside* it. He also got hives and his eyes swelled shut from being licked by a dog who had prob eaten food with pb in it. While he's prob not going to have a severe reaction everytime he has a skin exposure, why risk it or the theoretical effects of having multiple, incidental exposures?

[bubbaray]

How serious was her reaction? There are different levels of peanut allergy. Two of my friends' children have them and they don't need any special precautions, they just can't eat peanut products themselves.

Unless the reaction in the office was extremely severe (i.e., immediate anaphalactic after eating) I would just have her not eat peanut products but wouldn't be concerned about other people's homes/random exposure.


This is contrary to our instructions from our pediatric allergist for both girls (DD#1 is allergic to tree nuts, DD#2 is allergic to peanuts, fish and all-but hidden egg). He says that you are either allergic or not, period.

We have been told that you can never know when a formerly mild reaction can turn severely anaphylactic. Having experienced severe, rapid anaphylaxis with DD#2 (fish), I can tell you that there is no freakin' way I want to play roulette like that.

When your dr tells you that "emergency rescucitation must be available at all times", you tend to take note.

I'm definitely on the more relaxed end of the spectrum for parents dealing with FAs (I belong to an IRL support group) but I definitely don't take risks. If I think someone won't take the FAs seriously, we just don't visit. Period. If I'm not sure about the food, I take our own with us. I'm actually finding most parents IRL here are reasonably good about it.

[DrSally]

... you are either allergic or not, period.

We have been told that you can never know when a formerly mild reaction can turn severely anaphylactic. Having experienced severe, rapid anaphylaxis with DD#2 (fish), I can tell you that there is no freakin' way I want to play roulette like that.

.

Exactly. I really don't like when people talk of "severity" of peanut allergy. We toured a preschool that allowed kids to bring in peanut products for lunch. I told the director about DS's peanut allergy and she asked how severe it was. That told me that she didn't have a proper understanding of peanut allergies. That place was immediately scratched off our list. DS had an anaphalactic reaction to milk at 6 months and there is no way I want to repeat that experience. His only peanut exposure has been through accidental skin contact and possibly traces in foods or my BM before I knew of his allergy. His numbers on his RAST doubled last year and the allergist said it was prob from trace exposures. FWIW, having your numbers go up is not a good sign.

[jk3]

My DS's nut allergies have become increasingly more severe over time. I was less concerned initially because he had mild reactions. Not so anymore. I would explain the severity of the situation. If they think you're overreacting, fine. Better safe than sorry. Peanuts + peanut butter are especially dangerous because of the residue. Even if your child has not had a contact allergy before, this can crop up at any time. It's not easy.

[cdlamis]

Thanks for the replies so far. I have decided to politely email all family members and line out our concerns and expectations.

I would still like to know what you do for precautions. Do you ask other children not to eat the offending food around your child, do you move your child, do you clean around the area?

[AshleyAnn]

Have you sat down with them and explained to them how much protection DD needs? I agree with the PP who that she finds it flusterating that people with kids who have FAs expect others to know what they need to do and how important it is to protect DD. If this is the first time they've dealt with someone who has a peanut allergy they probably don't realize that DD could react from contact or trace elements and I bet they really don't understand that reaction could be deadly and fast.

[bubbaray]

Kinda depends on the situation, KWIM?

Daycare and school are peanut/treenut/fish free. School is technically peanut "aware", but seem to be pretty on the ball with the whole peanut/nut thing (DD#1 has only been in K for 1 month). Daycare is VERY aware and fabulous about it. I don't worry while they are there.

They don't often go to other kids homes. Like, almost never. I will have to deal with this more as they get older.

BIL/SIL who are otherwise idiots are fairly on the ball with this issue as one of their children is also peanut allergic. I make DH take snacks for the girls when they go there and an EpiPen.

ILs, well, I dunno. They seem fairly clueless sometimes, but othertimes are fine. sMIL is a former nurse, but I know that she does cook with nuts at other times, so they are probably in the house. I believe that she d/n have peanuts in the house, though I haven't confirmed this with her. We rarely ever go there. DD#1 spent a few days there without us in late August and took her EpiPen (along with her asthma stuff). I sent instructions, but all was fine.

So, really, as of right now, I don't take super special precautions. Basically, I'm just lazy. *I* always have at least 1 EpiPen with me. DH isn't quite as reliable, though. I generally don't wipe down surfaces at restaurants or on planes. I do wipe shopping carts (more for the germs).

If I was having regular playdates at someone's home, I would be uncomfortable if they regularly served PB or fish or nuts or did so right before we arrived.