By KATHERINE J. IGOE
IT WAS A STANDARD WEEKNIGHT: my daughter, Isabelle—10 months old at the time—munching delightedly on some peanut butter. Me, watching at a distance, my husband monitoring. I have many, many allergies, but peanuts are by far the worst. Even the slightest contact will give me a rash, and accidentally getting it in my mouth will send me to the hospital.
After a vigorous wipe down, bath, and toothbrushing, I picked her up for our nightly bedtime story. After a brief debate between The Very Hungry Caterpillar and There’s a Bear on My Chair, she decided she wanted both. Midway through the caterpillar’s exploratory journey through fruit, she got so excited that she nibbled enthusiastically on my arm. Big, red welts began to appear, and my throat began to tingle. I yelled for my husband as I ran for my medicine.
My situation is the inverse of what you might usually see. While allergies in children are by now an unfortunate but normal occurrence, my daughter has none. I, on the other hand, have a lot, including dairy, eggs, all nuts, shellfish, sesame, anchovies, and soy. The list of foods I must avoid continues to grow.
When I was growing up, the accepted guidance around allergies was total avoidance until 2 years old. Then, the LEAP Study came out in 2015 and said, in essence, that children consistently exposed to peanut-containing foods at a young age had fewer allergies at age 5. The results caused the American Academy of Pediatrics to change its formal recommendation to say early introduction of peanuts helps prevent allergies, particularly for high-risk children.
I grew up in the “avoidance” period, but Isabelle, now almost a year old, has the benefit of these updates. When she was 4.5 months, our pediatric allergist strongly recommended we start feeding her allergens she’s at high risk for—all of them—three times a week for the next several years.
So, my husband and I crowded around her nervously with a spoonful of peanut butter in one hand and an epinephrine auto-injector in the other, ready to dial 911. She looked at us suspiciously, sniffing at the spoon. Then she put it in her mouth and immediately changed her mind, going after it with gusto. My husband and I looked at each other while she sucked vigorously on the now-clean spoon, not a single reaction to be seen. “Now what?” I asked.
Since then, it’s been a daily challenge: Feed her allergens, keep me safe. It’s not just the food on her face, hands, and clothes. Her spit is like a scene out of Alien: toxic to me if she’s eaten something I can’t. We have a rigorous, ironclad schedule that includes allergens only on certain days during dinner, with a cleaning, bath, and toothbrushing immediately afterward. Even so, I slip up regularly. One night, I decided to put her to bed and got too close to her face. So what should I do?
“Allergies were not as common 40 years ago, so now we’re aging into a place where these first waves of people with true food allergies are now young adults with babies,” says Tanya Laidlaw, M.D., director of translational research, division of allergy and clinical immunology, Brigham and Women’s Hospital, and associate professor, Harvard Medical School. She’s also Isabelle’s allergist and created our brilliant allergen plan.
There’s not a ton of research yet on allergy patients my age, and Dr. Laidlaw admitted my situation is the first time she’s ever heard of it from a parent. But I’m not the only one dealing with this. Lauren Bain, co-founder of healthy kids’ snack food company Littlemore, has celiac disease. While not technically a gluten allergy, it merits the same level of extreme avoidance.
But her kids do eat gluten at home. “I don’t want to create a gluten intolerance in my kids if there isn’t one,” she explains. She has a rigorous system: wiping off the toaster rack, not using the same knives, plates, and cutting boards, having her kids clean their hands and mouths after eating, keeping her gluten-free food in a designated area, and making sure never to cook with gluten flour that she might accidentally ingest through the air.
They talk about the situation a lot i n her family. Her son “is very aware of the fact that mommy can’t eat wheat. He’ll say, ‘Mommy, make sure you don’t take a bite of my sandwich because it’ll make you sick!’” she explains. All this was a contributing factor in Bain founding Littlemore. “We knew we wanted [our snacks] to be safe for school, daycare, and families dealing with food allergies,” she says, noting that some customers are actually the parents.
“Our allergies shouldn’t dictate anyone else’s food choices, especially our daughter’s.”
Carmel Young, lead editor at WheelieGreat, and her husband are allergic to shellfish (he also has a peanut allergy). Their 9-year-old, though, has no allergies, and they implement similar precautions and a biweekly dinner schedule. Every time their daughter brings food home from school, Young or her husband inspects it. Young’s daughter is under strict instructions not to kiss her father post-peanut, because last year they had an anaphylaxis scare due to that very situation.
And yet, Young feels strongly that “our allergies are my husband’s (and my) responsibility to deal with. Our allergies shouldn’t dictate anyone else’s food choices, especially our daughter’s,” she says. As with Bain, communication is key. “We taught her that an epinephrine injection can be the only way to protect us from an allergic reaction, and her dad even made her jab him with it one time as a means to protect him from a reaction,” she says, noting that it was actually a great tool for communicating the seriousness of the situation.
Dr. Laidlaw notes that, in my case, “this is a problem largely because of her age. In terms of keeping you safe, as soon as she comprehends the fact that these are the foods mom can’t have and I can, and she can wash her own hands after a meal, this won’t be an issue.” As children age, they can feed themselves in a self-contained way at a certain time of day, eliminating me from the process entirely. “When she’s 4, you can say, “Can you please eat your muffin over there and not kiss me afterward?’” explains Dr. Laidlaw.
Infants, on the other hand, are messy by nature. She suggests baked goods that are dry, not wet, and thus less likely to give me a contact allergy. I should wash my hands if I touch the food and give Isabelle a washcloth in the bath to get the trace allergens out of her mouth. Basically, I’m doing the things for her that she can’t do for herself yet. Dr. Laidlaw’s husband also has allergies, so she warned me months ago that a baby’s vomit or spit up can cause a reaction, too, and that food I can’t have should be clearly labeled in the fridge (I may have accidentally forgotten this advice and relearned it the hard way).
Once Isabelle can eat an entire serving of the allergens in question, I can assume it’s not an allergy. She’ll eat a diverse diet for the rest of her life, but I won’t necessarily be doomed to eating separate meals until the end of time, either. Having modifiable meals like stir-fry, which can have peanuts and eggs on top for her, will be the way to go.
But Dr. Laidlaw empathizes with my seemingly unending journey to feed my child without accidentally murdering myself. “It’s hard. People should be aware of that,” she says.
Photo: nortonrsx/Ekaterina Demidova