Raising children and teenagers who have food allergies is even more challenging than living with your own food allergy. Not only do you have to steer clear of problem foods in grocery stores and restaurants, but as a parent, you have to protect your child at school and after school.

Educate your child to protect herself and eventually take ownership of her food allergies. Moreover, you need to pull off this juggling act in a way that doesn’t instill unnecessary fear and anxiety.

One of the most frequently lodged childhood complaints is this: “That’s not fair!” Parents, grandparents, teachers, and babysitters drill the fairness rule into kids from before the time the kids even learn the language. The rule is one of the critical lessons to learn in the socialization process.

Without it, total chaos would certainly ensue. Adults would be wrestling in the streets, intentionally smashing into one another on the roads, and strangling their co-workers. By about 5th grade, children slowly experience the epiphany that life isn’t always fair.

Children who have allergies often pick up on it much sooner — typically around the age of 3 or 4 years — when they realize that they can’t eat everything that their friends and siblings are eating. As a parent, the most you can do to overcome your child’s frustration is to let your child realize that he’s not alone.

Following are some tips on how to help your child find comfort in numbers:

• Tell your child that nearly 12 million people in the United States alone have food allergies. That’s a lot more people than she can count on her fingers and toes. Three million children in the United States have food allergies — that’s about 1 in every 25 kids.

• Connect with parents in your neighborhood who are struggling with food allergies in their families. The more you network with other parents, the more you realize that you and your child are not the only people struggling with food allergies.

• Join a local food allergy support group or create a mini-support group at your child’s school. In a support group your child has contact with other children in the neighborhood whom life is treating not so fairly. In the process of finding support for your child, you also gain support for yourself, along with some practical information and tips, allergist recommendations, and suggestions concerning other useful resources.

• Encourage your child to visit FANKids (the Food Allergy & Anaphylaxis Network’s Web site for kids) or FANTeen (Food Allergies in the Real World).

You can track down a local food allergy support group by asking your allergist, searching the Web, contacting FAAN, or talking with your allergist. Your county or city health agency may also be able to provide you with a list of local support groups.

Children are often much more capable of taking on additional responsibility than we, as parents, give them credit for. From birth, they struggle to control their environment. As teenagers they often mutiny in an attempt to take control of your house.

You can empower your children and teenagers to take more control of their food allergies by providing them with the information and tools they need to do the job:

• As soon as your child can read, teach her how to read food labels. Make a game out of it to see who can spot the hidden foods on a candy bar label or a box of cereal. Advise your child to read the label every time before unwrapping a food — manufacturers sometimes change the ingredients in a food, so just because a food was safe doesn’t mean it’s always safe.

• Foster a sense of curiosity about food allergies by encouraging your child to ask questions. By learning to ask questions, your child becomes less dependent on you for the answers. When she eventually ventures out on her own to a local eating establishment, she is better prepared to grill the cook and restaurant manager for information about what’s in the food.

Treat your child’s food allergies matter-of-factly, with the detachment of a scientist. Children can quickly spot your fears, whether you express them verbally, in your tone of voice, or through your facial expressions or body language. I know that suppressing your own fears and concerns can be a monumental task, but do your best to keep them in check.

Your child doesn’t have to stand up in front of the entire second grade class and give a PowerPoint presentation on food allergies, but he may be able to gain acceptance and support by teaching classmates and friends about his food allergy. Encourage your child to engage her friends and playmates in discussions about her food allergies.

Friends often prove to be great protectors, both medically and socially. Sometimes simply stating that you have a food allergy and that eating a particular food makes you sick is sufficient to spark a healthy dialogue with playmates.

Allergens, including peanut protein are easily cleaned from cafeteria tables with common household cleaning solutions. Not all school cafeterias, however, follow strict cleanliness guidelines, especially when they have multiple shifts of students shuffling in and out.

Encourage your child to sit at the cleanest table in the cafeteria or ask one of the kitchen crew to wipe off the table before lunch. To maximize safety without having to draw too much attention, consider packing wet wipes and a small placemat in your child’s lunchbox, just in case.

If your child has a peanut allergy, and the school has a peanut-free table, that may be the safest option and hopefully does not result in too much isolation. To limit the isolation factor, a friend who intentionally does not bring in peanut butter can sit with your child.

Even if your child’s school has a great food allergy policy in place and an immaculately clean cafeteria, encourage your child to eat off a small plate or a napkin, both at home and away from home. If a few errant scraps of food or allergen residue remains on a table, a plate or napkin can prevent them from finding their way into your child’s meal.

Besides, eating over a plate or napkin keeps everything a little cleaner. Packing a small placemat, as discussed in the previous section, is a great idea, but if you forget to pack it, a paper plate or napkin is usually available.

You’ve been in a lunchroom, and you know that not all kids strive to achieve the same standards of lunchroom etiquette. If your child has severe reactions to peanut butter and happens to sit next to some kid who has peanut butter all over his hands and somehow can’t keep his hands off other kids, a change in seating arrangements may be in order.

Advise your child to steer clear of any sloppy eaters, but if the sloppy eater happens to be your child’s best friend, a little education may be in order. Your child or a responsible adult may need to teach the friend a thing or two, as explained earlier.

More trades occur in the average school cafeteria in an afternoon than in a day at the New York Stock Exchange. Sandwiches and snacks always look a little tastier when they’re sitting on someone else’s plate. For a child who has food allergies, however, food swapping is taboo and may be dangerous.

Your child has no way of knowing what’s in a food that’s not in its original wrapper, how that food was prepared, or what it touched between the other kid’s house and the school.

Make sure your child understands how important it is to eat only what he brings to the table — only foods that you, your child’s parents, have approved. Your child’s school should have a no-tolerance policy concerning food fights. Some kids may think they’re just having fun, but to subject a fellow student who has a severe food allergy to a food fight is borderline assault.

Up until junior high, most schools are party schools . . . at least some of the time. Teachers celebrate birthdays, Valentine’s day, Halloween, and parents send in all sorts of goodies for the class. To enable your child to participate fully in the festivities, send in some allergen-free snacks on the day of the party.

Better yet, deliver a small supply of snacks for the teacher to keep on hand, or volunteer to make treats for the whole class. I know many mothers of food allergic children who have simply become the baker for all parties.

Ask the teacher to send a letter home to parents explaining that a child in the class has a particular food allergy and informing them that when their snack day rolls around to please send in a snack that’s free of the problem food. Include a list of common names used for the food.

Asking For Help

Children are often too embarrassed to ask for help when they’re feeling ill at school, but when your child has a food allergy, the sooner she gets appropriate treatment the better, especially if she experiences severe reactions. Foster an awareness in your child of the potential early warning signs and symptoms of a reaction.

Teach your child the following three important points:

• Your symptoms may differ with each reaction, so be aware of all the potential symptoms.

• You may start feeling funny right after eating, but symptoms can occur at any time. The most common initial symptom is itching in the mouth so warn them to be on guard for this one.

• Inform your child that she is to seek assistance immediately if she notices any of these early warning signs:

• Itching, especially in or around the mouth.
• A sense that something is terribly wrong. We often refer to this as “a sense of impending doom,” which is incredibly common even before other symptoms start.
• Rash.
• Queasy feeling.
• Tightness in the throat or any difficulty breathing.

Even if your child knows what to do, he may be too embarrassed or physically unable to ask for help. Teachers and caregivers may need to intervene. Earlier articles provide additional suggestions on policies and procedures for daycare, preschool, and kindergarten through high school.

Every child should carry a health emergency card that includes her name and address, parents’ work and phone numbers, family doctor’s phone number, a list of any health conditions she has; and brief instructions on what to do in the event of an emergency. Figure below shows a sample card for a child who has a food allergy.

Make the creation of a health emergency card a fun group project. Create a custom card for each member of the family or each student in the class. Encourage your child to personalize his card with funky (but legible) fonts, wild colors, and a cool background. Most kids love to create their own publications on the computer. Wearing a medical ID bracelet is another option.