When a family member has a severe food allergy, the natural impulse may be to purge the household of all foods that can possibly trigger a reaction. While that is certainly an option, other options are available, and only you and your family can decide which option is best. Some families choose to evict all problem foods from the premises.

Others prefer eliminating only the riskiest foods. And some families opt for prevention and education rather than an outright ban. All these options are valid. As a family, you need to weigh the risks and benefits and decide for yourself, taking the following considerations into account:

• The severity of the allergy.
• The practical difficulty of eliminating one food versus another.
• The overall quality of life for all members of the family.
• The presence of other children in the home.
• The overall effects that a food ban may have on a child’s ability to deal with food allergy in the real world.

When someone has a severe food allergy, and a miniscule amount of the allergen can trigger a dangerous reaction, you may decide to completely ban the food from your house. Most families with peanut allergy, for example, choose to remove all peanut from the premises, primarily for two reasons:

• Peanut allergy often engenders a greater level of fear, especially a fear that tiny exposures may lead to severe reactions.
• Most families find that they can give up peanut products without suffering any great hardship.

The situation for milk or eggs is often quite different. Although severe reactions certainly occur with these foods, they are somewhat less common than with peanut. More importantly, removing these foods from the home can cause significant hardship for nonallergic family members.

Hence, few families living with milk or egg allergy choose to completely eliminate these foods from their homes. I never recommend that a family completely eliminate a food from the home. I understand why families choose to do this, but it is rarely, if ever, necessary.

I believe that implementing reasonable precautions can create a safe environment even if the problem food remains in the home. I reveal the most effective precautions later. Keeping all problem foods in the home may even offer the additional benefit of alleviating irrational fears.

When allergic children are accustomed to living around the foods that they’re allergic to, they naturally develop a more rational respect for the possible danger. It’s like having a gas stove or candles in your house. Children realize that the flame can harm them. They know not to touch the flame or play with fire, but when someone lights a match, they don’t go running and screaming out of the house.

I see children every week who are completely paralyzed by the fear of an allergic reaction. They may panic when someone opens a candy bar across the room, truly fearing that this will cause a reaction or even kill them. If the same children had lived around the foods that they are allergic to, they almost certainly would not have this irrational fear.

Other families have made the decision to ban certain foods because they always think the worst. They imagine that a babysitter will find the jar of peanut butter on the top shelf, where it is labeled with a skull and cross bones with Jimmy’s picture on it, and decide to give it to Jimmy for a snack.

As unlikely as this might be, I cannot promise them that such an event would never happen. This is exactly why the decision of whether to completely eliminate a problem food from the home is a choice that every family needs to make for itself.

When families choose to keep a problem food in their home, they provide a valuable learning experience for the person with the food allergy and for other family members. The presence of the problem food creates a real-world environment in which family members must:

• Read and decipher food labels.
• Wash their hands before and after eating.
• Scrub down counters and tables.
• Practice proper food preparation.

In addition, the person with the food allergy is required to develop some level of self control to avoid problem foods that are readily available. If you choose to eliminate problem foods from your home, and you have a young child with food allergy, provide other educational opportunities.

Teach proper cooking techniques, practice reading food labels when you go grocery shopping, and stress the need for washing hands and scrubbing down counters and tables before and after eating.

If you decide to let allergenic foods hang out at your house, you may decide to employ other strategies to protect the safety of the person who has the allergy. The following safe practices are not hard and fast rules, merely some ideas to consider implementing in your home:

• Segregate safe and unsafe foods: Designate a specific shelf in your cupboard or pantry for safe foods and be sure that everyone understands your system. You can similarly rearrange the items in your refrigerator.

• Label the problem foods: Special labels or stickers may provide an added measure of safety. You can purchase food allergy labels or use your computer or label maker to create custom labels that work best for you.

Labeling safe foods is often easier and more effective for a common food allergy, like milk. Labeling unsafe foods is often more efficient when unsafe foods are few as in the case of a peanut, tree nut, or sesame allergy.

• Designate allergen-free zones: Set rules that indicate where foods can and cannot be eaten. For example, if one child is allergic to milk, you may consider restricting the consumption of milk and other milk-containing foods to the dining room or kitchen table. Otherwise, family members are likely to spread milk all over the house.

• Designate places at the table: Consider establishing fixed seating arrangements at the table, especially if young children are involved. An allergy-free zone can reduce the chances that a child will share food or pick items off another family member’s plate and lessens the chance of exposure to scattered crumbs, spills, and splatters.

• Limit opportunities for cross-contamination: If allergic foods are kept in the home, cross contamination is always a risk. All family members need to be especially careful with utensils.

Grabbing the same spatula to serve a cookie that contains the allergen and using it to serve a cookie that’s allergen free is a simple mistake that can lead to a severe reaction. Likewise, family members must learn to never dip the knife they used to spread their peanut butter into the jelly jar and to thoroughly clean the cutting board after preparing any allergenic food.

Maintaining an allergen-free diet takes care, planning, and diligence. Not only do you need to make sure that your allergic family member has safe foods and beverages on hand, but you also must consider the nutritional value of the substitutes, especially for young children.

Running out to the corner store for a quart of milk when your child relies on soy, rice, or potato milk may not be an option. Stock up on any special substitutes for problem foods, especially when substitutes are available only in certain stores. Once you get in the swing of things, living with food allergies does get easier.

Ask and shop around for the stores that best serve you needs. A trip to a specialty store that has foods that you cannot find at your usual grocery store once or twice a month may be a great help in keeping your shelves stocked with nutritional goodies.

Before you head out to the grocery store, be sure to review earlier article, and consider copying and packing the field guide for each food that you or your family member is allergic to, so you are well-prepared to decipher the more cryptic food labels.