Thursday, October 25, 2012

Thirteen tips to Navigate the Holidays Joyfully and Safely

We hope that the FAC’s children and families experience the true magic and joy of the holiday season from Halloween through New Year’s. At the same time, we are aware that the holidays can create certain challenges and stressors for those with food allergies. Our FAC experts Nancy S. Rotter, PhD, and Elisabeth Stieb, RN, are well versed in these issues.  Dr. Rotter is a pediatric psychologist who treats children with medical conditions, and specializes in understanding the challenges of preparing allergic children for transitions at different developmental stages. Ms. Stieb manages education and school issues, among other leadership roles in the practice. She also cares for our patients during oral food challenges. Ms. Stieb has a connection with patients because her own children have allergies. Together with some of our parents, they offer these tips to help you navigate the season happily and safely. 

1.    Your children will follow your example.  Focus on the fun that is possible rather than anything the allergies cause you to forego.

2.    Focus on the family and friends with whom you are most comfortable (if you can). One mother says: “Our children, now 3 and 4, are allergic to multiple foods (milk, egg, wheat, etc.). That makes breakfast challenging. Yet for several years we have hosted a holiday ‘sausage fest’ breakfast for several families. In an effort to keep things safe, we ended up with 14 kinds of sausage the first year.  The breakfast is full of protein, tastes good, and most importantly, is a vivid reminder of the support of these special friends as we grow more comfortable around forbidden foods.”

3.    If you can host, you will have the most control over the environment and the food. But don’t feel you have to stay home. If you are a guest, notify the host/hostess well in advance to discuss the menu. Be honest, but not alarmist. We know it can be challenging, but how you communicate is very important. Use your intuition and listening skills too. If you do not believe that the host/hostess is able to cook an allergy-friendly meal or it feels like an imposition, bring your own food. This is also certainly true if you expect a potluck or a buffet.

4.    If your allergic children are young, and it is possible, share the responsibility of watching your child with another adult. This way you are free to socialize. Then trade off so your counterpart can have fun too.

5.    Have realistic expectations and a backup plan.  Anticipate that surprises will occur (Uncle Henry's fiancée brings the most delicious-looking candy-laden chocolate cake ever). Talk with your family ahead of time and anticipate that. Despite their best laid plans, there may be disappointments and frustrations, particularly about holiday treats. Generate a backup plan.  It might include sneaking off to play video games that are typically restricted, an early departure or other subtle exit.

6.    Do allow your children to ‘trick or treat’ if supervised in an age appropriate manner.  Buy safe candy or prepare safe treats and allow your child to swap the unsafe treats he or she receives.  Or allow your child at Halloween or any other time to accrue points toward a special activity, fun toy or something else the child values. It may serve as a helpful distraction to have your child keep a tally as they go (e.g. during Halloween, rather than focusing on the number of treats he/she can't eat, focus on the number of points or bonus treats they do get). Some of our parents auction off various toys to the highest candy bidder. 

7.  Be prepared to trade in unsafe treats throughout the holiday season. Make fun and unusual safe treats, like rock candy.  It is allergen free and a mini science experiment.

8.    Plan for the unexpected, such as unscheduled school celebrations.  Make sure your child’s teacher has a stockpile of safe treats. For example, Oreos are a less perishable cookie that is safe for dairy- and egg -allergic children. Since the holidays involve a variation from the daily routine, be attentive to all the new and unexpected foods and celebrations.

9.    Create new holiday traditions. These could be anything from sports (holiday bowling with a holiday-themed dress code), to a silly scavenger hunt (funny hats required), filming an annual video, a backwards board game party (everyone goes from finish to start) or a craft activity (build a birdhouse instead of a gingerbread house). The emphasis should be on the activity, which can be done at a non-meal time. Host a paper garland, clay menorah or other decoration- making party instead of a cookie- baking party if your family’s allergies make the latter hard.

10. Read labels on all products. Be aware that holiday foods often have allergenic ingredients added. Some ingredients can be hidden, like almond flour in a cake. Ingredient statements during holidays are different from non-holiday periods. A previously safe product may have different ingredients.

11. Holidays often bring opportunities to travel over the river and through the airports. Carry your Epi pen, medicines, Food Allergy Action Plan, airline letter and safe foods to eat in transit.   

12. In fact, as you should be doing at all times during the year, keep your EpiPen, antihistamines or other medicines with you and/or your allergic child at all times.

13. And, now, knowing you are prepared, relax and enjoy!

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