Living With A Food Allergy

Living with a food allergy  

The advice here is primarily written for parents of a child with a food allergy. However, most of it is also relevant if you are an adult with a food allergy.

Your child’s diet

There is no cure for food allergies, although many children will grow out of certain ones, such as allergies to milk and eggs. The most effective way you can prevent symptoms is to remove the offending food (known as an allergen) from their diet.

However, it's important to check with your GP or the doctor in charge of your child’s care first before eliminating certain foods.

Removing eggs or peanuts from a child's diet is not going to have much of an impact on their nutrition. Both types of these are a good source of protein, but can be replaced by other alternative sources.

A milk allergy can have more of an impact as milk is a good source of calcium, but there are many other ways you can include calcium in your child’s diet, including green leafy vegetables. 

Many foods and drinks are fortified with extra calcium.

If you are concerned that your child’s allergy is affecting their growth and development, see your GP.

labels

It's very important to check the label of any pre-packed food or drinks your child has, in case it contains ingredients they are allergic to.

Under EU law, any pre-packed food or drink sold in the UK must clearly state on the label if it contains the following ingredients:

• celery 
• cereals that contain gluten (including wheat, rye, barley and oats) 
• crustaceans (including prawns, crabs and lobsters) 
• eggs 
• fish 
• lupin (lupins are common garden plants, and the seeds from some varieties are sometimes used to make flour) 
• milk 
• molluscs (including mussels and oysters) 
• mustard 
• tree nuts – such as almonds, hazelnuts, walnuts, brazil nuts, cashews, pecans, pistachios and macadamia nuts 
• peanuts 
• sesame seeds 
• soybeans 
• sulphur dioxide and sulphites (preservatives that are used in some foods and drinks) at levels above 10mg per kg or per litre 

Some food manufacturers also choose to put allergy advice warning labels (for example, "contains nuts") on their pre-packed foods if they contain an ingredient that is known to commonly cause an allergic reaction, such as peanuts, eggs or milk. 

However, these are not compulsory. If there is no allergy advice box or "contains" statement on a product, it could still have any of the 14 specified allergens in it.

Look out for "may contain" labels, such as "may contain traces of peanut". Manufacturers sometimes put this label on their products to warn consumers that they may have become contaminated with another food product when being made.

food products contain allergy-causing food:

• Some soaps and shampoos contain soy, egg and tree nut oil. 
• Some pet foods contain milk and peanuts. 
• Some glues and adhesive labels used on envelopes and stamps contain traces of wheat. 

Again, read the labels of any non-food products that your child may come into close physical contact with.

Unpackaged food

Currently, unpackaged food doesn't need to be labelled in the same way as packaged food. This can make it more difficult to know what ingredients are in a particular dish.

Examples of unpackaged food include food sold from:

• bakeries (including in-store bakeries in supermarkets) 
• delis 
• salad bars 
• "ready-to-eat" sandwich shops 
• takeaways 
• restaurants 

If you or your child have a severe food allergy, you need to be careful when you eat out.

The following advice should help:

• Let the staff know. When booking a table at a restaurant, make sure the staff know about your child’s allergy. Ask for a firm guarantee that the food you or your child is allergic to won't be in any of the dishes served. The Food Standards Agency (FSA) offers chef cards that provide information about your child’s food allergy, which you can give to restaurant staff. As well as informing the chef and kitchen staff involved in cooking your food, let waiters and waitresses know so they understand the importance of avoiding cross-contamination when serving you. 
• Read the menu carefully and check for "hidden ingredients". Some food types contain other foods that can trigger allergies, which restaurant staff may have overlooked. Some desserts contain nuts (such as a cheesecake base) and some sauces contain wheat and peanuts. 
• Prepare for the worst. It's a good idea to prepare for any eventuality. Always take your child’s anti-allergy medication with you when eating out, particularly if they have been given an auto-injector of adrenalin (read more about treating food allergies with a auto-injector). 
• In older children, you can use what is known as a "taste-test". Before your child begins to eat, ask them to take a tiny portion of the food and rub it against their lips to see if they experience a tingling or burning sensation. If they do, it suggests that the food will cause them to have an allergic reaction. However, the "taste-test" doesn't work for all foods, so it shouldn't be used as a substitute for the above advice.

Can allergies be prevented

There is currently no evidence-based advice for prevention of food allergies.

It used to be believed that avoiding eating peanuts during pregnancy and when breastfeeding could help reduce the risk but this theory has now been questioned. 

It's important to follow the standard recommendations for pregnancy and breastfeeding, whether or not you have a family history of food allergies.

Tips for food allergen avoidance at home

Utensils, cookware, glassware, storage containers, and other food preparation equipment

• Thoroughly clean before preparing or serving safe meals.
• Prepare safe meal first to avoid inadvertent cross-contact
• Be aware of the potential for cross-contact with utensils. For example, a knife used to prepare peanut butter and jam by a non-allergic child could introduce peanut into an otherwise safe jar of jam and subsequently cause a reaction in a peanut-allergic sibling eating the jam.
• Designate specific containers for use by the allergic person only. For example, avoid sippy-cup mix-ups by using a specific cup for the allergic child or using an obvious label

Refrigerator/freezer and kitchen larder

• Keep food containers covered/sealed to prevent spill contamination
• Assign a specific shelf or cabinet for safe foods. Consider using colour codes or tags for easy identification

Good practices for the family

• Wash hands before and after meals but particularly before serving allergen-free meals and after ingestion of allergens
• Confine food consumption to specified dining areas or create allergen-free zones within the home
• Wipe down surfaces after preparation and ingestion of meals. Cleaning surfaces with standard cleaners has been shown to be sufficient for removal of allergens such as peanut.
• For young children, unsafe foods should be kept out of reach both at the dinner table and when storing foods

Tips for eating out

Before (prepare)

• Check the menu (is it online?) to determine if there are suitable meal options
• Call ahead to assess the restaurant’s ability and willingness to accommodate your needs
• Consider carrying a print out of our help sheets with information about allergens and warnings about cross-contact
• Take your emergency medications, especially any adrenaline auto-injector pens you have been prescribed

During (communicate)

• Communicate clearly and directly about food allergy. It is best to speak directly to the person making the food, but don’t forget to speak to other staff including the waiter and/or manager.
• Ask about ingredients and method of preparation. Do not trust ingredient lists on menus at face value

AVOID high-risk places for cross-contamination, such as:

• Buffets
• Ice cream parlors
• Bakeries
• Chinese and Asian restaurants (for peanut and tree nut allergies)
• Seafood restaurants (for fish and shellfish allergies)
• Deep fried foods, where the oil is reused for different foods and may therefore be contaminated by previously cooked foods
• Potlucks and parties where homemade dishes come from a variety of sources