Going Venture With Food Allergy

Eventually, your child is going to venture out on her own, leaving the allergy safe house you call home. This may begin with something simple like a sleepover at a friend’s house, but over time may include summer camp, vacation with a friend’s family, travel to a foreign land as an exchange student, moving off to college, or hiking the Appalachian Trail.

Venturing out presents both a challenge for your child and an opportunity for him to experience more freedom and assume more responsibility for managing his food allergy. A week or two before your child (or teenager) heads out to a friend’s house, camp, college, or some other venture, check the food allergy medications to ensure the following:

  • Your child has sufficient supplies to last the duration of the sojourn.
  • Medications are in their original prescription bottles and are clearly labeled with your child’s name. (Many camps and other institutions refuse to administer medication that’s not in its original prescription bottle.)
  • Expiration dates indicate that the medications are not to expire until after your child returns home.
  • Detailed prescription information that describes how much of the medication to take and when your child should take it.
  • At least two epinephrine (EpiPen or Twinject) autoinjectors, if prescribed. Check the expiration dates on the injectors, too.
  • If plane travel is needed, be sure you have a letter from your doctor permitting you to carry medicines on the plane.

When your teenager decides to study abroad for a semester or seek his fortune in college or in the more real world, arrange for a doctor’s visit soon after your teenager arrives at his new destination. Most colleges have an oncampus clinic complete with doctors and nurses, but your teenager must know exactly who to contact in the event of an emergency or when he’s running low on his medications.

Ask your child’s allergist for a recommendation. Allergists have access to board-certified allergy specialists around the country through their specialty societies. This information may be of use in identifying an appropriate provider in another part of the country if the travels are within the U.S.

At home, where the kitchen is well-stocked with allergen-free foods and snacks and everyone is well-versed in proper food preparation, remaining reaction free is manageable, if not always easy. On a trip, try your best to recreate the controlled situation of your home, by taking the following actions:

  • Speak directly to the head of the food service at the camp, school, or other institution. Ask the head honcho to explain policies regarding food allergy and how they educate the kitchen staff about food allergy.
  • Inquire about how they use the specific foods that concern you. Some camps and schools, for example, have a self-serve peanut butter bar that can create a real mess.
  • Ask to see the menu before you arrive. This may help you to identify other red flags.
  • Ask about food in the bunks, dorm rooms, and other areas where your child may come into contact with others. Consider arranging for a single room, or at least obtain assurance that your child will not have to room with a peanut-snack addict.
  • Arrange a visit to the kitchen. Any place you can trust should be happy to have you inspect their kitchen. Examine the foods they have on their shelves, and ask questions about food preparation and risks of crosscontamination.
  • Once you have sorted out the menu and the kitchen set-up, you and your child can select safe foods for her stay. After the initial inspection, however, your child will need to remain vigilant about any changes in the menu or food preparation.

For longer stays, such as spending the school year on campus, intermittent calls or meetings with the food service manager can keep you in the loop, as well.

  • Have your child pack enough snacks to last him for the duration of his trip plus a few extras, just in case. On a trip, allergen-free snacks may not be as readily available as they are at home.

Most summer camps have a camp store or canteen where the campers can purchase snacks. Consider having your child’s snacks stored in the camp store, so he doesn’t eat them or give them all away on his first day. This can also help your child feel more like one of the gang when everyone lines up in the camp store to buy snacks.

People working the camp store should know your child has a food allergy and that they need to read the label every time before dispensing any snacks to your child. Prompt, well-trained, and well-coordinated action is essential to properly deal with allergic reactions, especially severe reactions.

Like CPR, if you have to teach someone what to do during the emergency, the lesson may already be too late. No matter how long your child plans to be away from home, send emergency information and instructions to your point person.

You may include allergy information on a health form, application, or (preferably) as a separate document that can be copied and distributed to key personnel. Instructions should include the following:

  • List the foods that your child is allergic to. Include specific foods along with common names that appear on labels.
  • Describe the specific symptoms that your child typically experiences, along with symptoms that your child may experience.
  • Provide step-by-step instructions on how to administer medications. You can find instructions for using EpiPen. Instructions for using Twinject. Provide trainers (an EpiPen or Twinject look-alike that is used to familiarize people with the device) and make sure everyone who might need to is fully familiar with this device. (Trainers are typically provided along with your prescription.)

The support network you built at home and in your community does your child little good when she hits the road. Before she sets out, create a new support network at the planned destination.

Begin by identifying and contacting your point person — a responsible adult, preferably one who knows about food allergies, who communicates directly with you and distributes essential information to all those who need to know.

In a camp situation, this may be the camp director or nurse. In college, the campus medical center and the resident assistant in the dorm may be good choices. Educate your point person so he knows the foods that your child is allergic to, potential symptoms to watch for, and emergency procedures.

Make sure that this person is comfortable with the epinephrine injector and that she completely understands your emergency action plan. Have your point person pass this information to others who are responsible for your child. In a summer camp situation, for example, the following people need to know what to look for and what to do in the event of a reaction:

  • Counselors
  • Camp nurse
  • Drivers
  • Cooks and cafeteria workers
  • Camp store workers
  • Lifeguards
  • Volunteers who may visit the camp

Your existing emergency plan may be foolproof at home, but when your child travels, that plan is often useless. Tweak your emergency plan to fit the situation. A solid emergency plan contains the following items:

  • Immediate treatment in the form of medications, including epinephrine autoinjectors.
  • Name of the person or people who are best equipped to deal with a severe reaction, including how to contact them immediately. Location and contact information for the nearest emergency care facility.
  • Transportation to the emergency care facility. Find out whether the ambulances that service the area carry epinephrine or not, and if you can request that a unit capable of administering epinephrine be sent.
  • Communication on the way to the emergency care facility — a cell phone.

Everyone who cares for your child should know the emergency plan details well in advance of any possible reaction. If the people who are caring for your child or teen are not well trained in dealing with food allergies, consider holding a brief training session. This is especially useful for summer camps that have little or no experience with food allergies.

Your training presentation should include a description of food allergy, the fact that even small exposures can be deadly, and instructions on the use of all medications. Make it clear that they really do not want your child to die on their watch.

Practicing a “mock” reaction scenario can be very useful for the people who will be caring for your child or teen with food allergy. Work with your point person to schedule your presentation, so that everyone who’s going to care for your child can be present.

You can find plenty of free training materials at the Food Allergy and Anaphylaxis Web site. FAAN also has specific programs on camps and colleges to help train both you and them. Although your child’s new support network may need to get up to speed on food allergies, your child shares responsibility for her own care and safety.

Remind your child of the following key precautions:

  • Never share food or drinks.
  • Read the labels, and don’t eat any unlabeled foods.
  • Ask your counselor or the cook if you’re unsure of the ingredients in a particular food.
  • Follow the rule of thumb, “If in doubt, don’t take chances with a food.”
  • Seek help if you suspect the beginning of a reaction, even if you don’t have any noticeable symptoms.

In many cases, your child chooses the camp he wants to attend based on one single criteria — where his friends are going. In other cases, you, as a family, make the choice. Whether your choice is already made for you or you’re shopping for an appropriate camp, gather the following essential information:

  • Has the camp had other campers with food allergies and how has it handled these cases? (You may be able to have the camp contact parents of children with food allergies who attended the camp and are willing to talk with you.)
  • Who’s the medical person in charge and who’s second in command (for when the primary medical person is unavailable)? Ask about their credentials and their knowledge and experience in dealing with food allergies.
  • Where will your child’s epinephrine and other medications be stored and how readily available will they be? Can your child carry her own medications? How many people at the camp will be trained in giving the epinephrine shots?
  • How far away is the nearest emergency medical treatment? Onsite emergency care may be insufficient in a case of very severe reaction.
  • What outings may the camper be going on during her stay? How accessible are medications and emergency treatment on these outings?
  • Does the camp have a system in place to keep all camp personnel well informed?

In most states, the camp cannot provide medicines or just keep epinephrine on hand. Each family must provide the medications for their child. You can never depend on others even if they are supposed to have it. Bunkmates and roommates can play a key role in intervening when a reaction begins.

Oftentimes, people with food allergies are too embarrassed or confused to seek help themselves or ask if a particular food is safe. Someone with a clearer mind who can spot the early warning signs may be better at sounding the alarm. Encourage your child to talk about his food allergies with bunkmates and roommates.

If a counselor is involved, perhaps she can introduce the topic of food allergies and present a brief training session that covers prevention, common symptoms, and emergency procedures. Whether a child or teenager is at camp, college, or on a field trip, she typically clicks with one peer more than others.

The duo may become inseparable and do everything together. This person should know about your child’s food allergy, be well-trained in spotting the early warning signs of a reaction, and know how to respond in the event of a severe reaction.

When our clinic works with a family to send a patient off to a new situation, many families bring along the best friend or future roommate to get them a special lesson on what their friend is allowed or not allowed to do. I love these visits. In college particularly, having a food allergy buddy to pal around with is very helpful.

Especially if your friend has a tendency to wander off with the first babe or hunk that saunters past. The friend can not only assist you in the event of a reaction, but also help spot dangerous situations and support you emotionally if you have to leave when the party was just starting to rock.