Managing a child’s food allergy can put parents on high alert.

The first step in dealing with an allergy is to seek the expert advice of an allergist who can help parents identify what their child is allergic to, how serious the allergy is and how it can be treated. Once that has been established, some families can benefit from meeting with a dietitian to develop a plan for their child to eat well and eat safely.

“One of the most important things for parents to learn about is reading labels,” Katrina Waters, outpatient dietitian with Bon Secours St. Francis Health System, said.

Waters said a federal law requires food manufacturers to list if their product contains one or more of the most common food allergens: milk, eggs, fish, shellfish, tree nuts, peanuts, wheat or soybeans. She advises parents to use apps and websites to be sure products are free of their child’s allergen.

“It’s also important to note that sometimes manufacturers change their ingredients,” she said.

The cookie that was safe last week could have a new – and potentially dangerous, if your child is allergic – recipe this week.

“The second thing is watching out for cross contact,” Waters said. “How do we keep these foods safe for the person with allergies?”

Cross contamination can occur when, for example, a knife is used to spread peanut butter and then it is wiped off and used to prepare food for a person allergic to peanuts.

“Some families have separate utensils or color-coded plates,” Waters said. “It’s a good idea to make the safe foods first. They have the cleanest utensils and there’s not other food around it.”

In some cases, the food allergen should not be in the home at all.

“Some people are allergic even if it’s in the air,” Waters said.

Waters recommends putting safe foods in a separate cabinet or on their own shelf in the refrigerator. Be sure to wash all kitchen items and hands with warm, soapy water.

“Some parents use non-latex gloves when making safe foods as another precaution,” Waters said.

When dining out, Waters recommends downloading a chef’s card that can be filled out at home and given to the server or chef at a restaurant to ensure the kitchen staff is aware of any allergies. Apps are available to determine which restaurants have the most options for those who are allergic.

“Ask how foods are prepared,” Waters said. “If they are cooking more with fresh ingredients, sometimes you have more say.”

Managing allergies at school requires a team effort.

“If the kids are in school, be sure the school has an allergy action plan in place,” Waters said. “Make sure, if the child has an Epi-pen, that it is available in case of an emergency.”

As children get older, apps and online support groups can help them understand and deal with their allergies.

“Sometimes it can feel excluding,” Waters said. “Knowing they have a support group to go to and those apps available, it does come down to parents educating them.”

Especially when children are too young to advocate for themselves, Waters said it is important for parents to make friends and caregivers aware of the child’s allergy.

“Tell everyone you can,” she said. “The more people that are aware, the more people who can look out.”

Peanuts are a special case

New guidelines supported by several medical organizations, including the American Academy of Pediatrics, support the early introduction of peanut products in some children. The decision to introduce peanut products should always be made with a pediatrician or an allergist.

“It has to do with infants who are already at a higher risk,” including those who have severe eczema or an egg allergy, Waters said.

In those cases and under the supervision of a doctor, Waters said parents may introduce a bit of peanut butter smoothed into pureed fruits or vegetables for babies who are 4 – 6 months old and tolerating solid foods. Waters said that past recommendations held off on giving children peanut butter or other peanut products until age 3 or later.

Once this introduction is supervised by an allergist, Waters said a plan can be made.

“After you consult with the allergist, they may say it’s OK to continue those feedings at home,” she said.

Your child’s doctor may also suggest that babies with mild or moderate eczema have peanut products introduced to the diet around 6 months of age. Even if children have no known allergies, parents should discuss the introduction of peanut products with their doctor.

“If you find that your child is allergic to peanuts, I recommend they meet with a dietitian to discuss how they can meet their child’s needs,” Waters said. “Just because you are eliminating that one food, it is just one food — you can still meet their needs. Be very encouraging to your child. It can be helpful to make a list of everything they can still have. That puts a positive spin on it.”

Food allergy resources

Food allergy websites with resources for parents and teens:

Safe restaurant dining:

Apps for grocery shopping and dining out:

MyFoodFacts: allows users to scan barcode of products to identify if food allergens are present, and it will send an alert to the user if allergens are in the product.

Fooducate Allergy and Gluten Free Scanner: also allows users to scan barcodes of products to determine if they contain allergens, and offers healthy suggestions for alternative and substitutions.

AllergyEats: offers database of allergy-friendly restaurants organized by city, zip code or current location.

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