When a child has a food allergy, it can be very stressful for the child and the parents. Multiple studies have shown that that there is an enormous amount of stress and anxiety involved. Food allergies affect lots of day to day decisions and can make parents feel afraid, guilty and even paranoid.
Allergies and Anxiety
Studies have been conducted to survey parents of children with allergies, these studies show that most parents feel that their child’s food allergy affects social activities, meal planning, grocery shopping and eating out at restaurants. Parents say that the allergy can cause tensions with their extended family due to their lack of understanding that a food could potentially be life threatening for their child. Many also reported marital tensions due to a difference in parenting styles. Mothers tended to try to protect their child from the smallest possibility of risk while the fathers often took a more relaxed approach in allowing the child to have as much life experience as possible. Studies show that some mothers have changed or given up their jobs in order to be closer and more available to their child in case of emergency.
Studies also show some ambivalence in parents, they experience anxiety about keeping their child safe but also don’t want to be too hypervigilant and cause their child to miss out on childhood experiences such as school trips, birthday parties and sleepovers.
For the child, studies show that a child with a peanut allergy has a lower quality of life than a child with Type 1 Diabetes. Though both have to be careful of what they eat, the peanut allergic children reported more “fear of an adverse event and more anxiety about eating, especially when eating away from home.” The peanut allergic children showed more fear toward potential hazards in their surroundings and felt more limited in physical activities.
So what can be done to help combat the stress and anxiety associated with food allergies?
The psychological impact of food allergies has been studied by experts. Fatalities from food allergies are relatively rare and in almost all cases the person who has died did not get adrenaline or did not get it in time. Psychologists are trying to find ways to support children and parents so that they can learn to live safely with the allergy and also so they don’t become caught up in their anxiety. Some of the larger allergy clinics are even bringing these psychologists on site to help families from the first diagnosis.
Talking it through and breaking down fears
Some of the techniques used by these psychologists involve breaking down the fears of the child. They find that comforting a child’s fears by telling them that everything is okay misses an opportunity to talk about the dangers that the child faces and let them know that it’s okay to talk about things that make them anxious. Dr Eyal Shemesh, who works at the Jaffe Food Allergy Institute at Mount Sinai Hospital, New York suggests breaking down the child’s fears by asking them to explain exactly what it is that they are afraid of. He then tries to create a reality based context, if the child is afraid of not being able to use their EpiPen, then you help make sure that they know how to use it. Dr Shemesh creates a process of showing the child what the realities of the fears are so that by the end of the process they can see how many things must go wrong for the worst outcome to happen. He explains that the most important thing to do is to find out the child’s fears and speak about them openly.
Paediatric psychologist Jennifer LeBovidge works with food allergy families at Boston’s Children’s Hospital food allergy program. She sees a range of families, from those looking for tips to feel more secure in dealing with allergies in daily life, to those with “patterns of avoidance that go above and beyond what is necessary for food allergy management”. These children are so anxious about their allergy they won’t eat lunch at school, hug their friends or even touch doorknobs.
Techniques to reduce anxiety
Some children become so nervous about their allergy that they will refuse to eat foods that they are not allergic to. This is referred to as avoidance coping. Dr Linda Herbert of the Children’s National Medical Centre’s allergy and immunology division in Washington D.C. describes a case where a boy with a tree nut and peanut allergy has been diagnosed with oral allergy syndrome to peaches and plums. He began refusing to eat fruits, vegetables, crackers and bread out of fear of allergic symptoms. Dr Herbert used relaxation techniques to help him overcome his fears. She then used problem solving to help distinguish good foods from bad foods. They created two lists of foods and places where he usually eats (like home, school and restaurants), he then ranked them based on how scary he found them. After creating an emergency action plan, he began working his way through the list, from least scary upwards. He eventually became more comfortable eating the foods he had avoided before and became more open to eating in different locations.
Normalizing food allergies
Mental health experts say that it is important to normalize food allergies from the first diagnosis. You can reduce stress levels in the home by using these problem solving methods. Children feel safer and less stressed when they know the facts of their allergy, know what actions to take by themselves and what actions will be taken by others in case of an emergency, and gradual but safe exposure to feared situations. This gives children the opportunity to change their way of thinking from worst case scenario to a more realistic view while still making sure that they are being careful.
Psychologist Dr Mary Klinnert works with food allergy families at the National Jewish Hospital in Denver. She believes it’s important to teach children about their allergies in a normal tone at a young age in the same way you would teach them about crossing a road and bike safety. She believes that when allergy precautions and carrying medicines are a part of daily life then these actions are more likely to be kept up in teenage years.
Dr Ruchi Gupta has a daughter with severe allergies. She uses role playing to help her daughter with her allergies. She uses situations such as a teacher who tells the class that they are going to have cupcakes and helps her daughter to develop responses such as “Excuse me, Miss Jones, but I have food allergies and can’t be around those.” Practising these sentences makes it easier for the child to speak up in a real situation. It empowers the child to be able to speak up for themselves. Getting kids to check food labels and ingredients also helps to make them feel in control of their allergies. Gupta also speaks about the importance of making sure that your child’s friends know about the allergy and are able to use an auto injector. Talking to the kids openly and frankly helps create a wider safety net of the child. Just as parents look online and in person for allergy groups for support, it’s important for the child to have a support group too.
Dr Klinnert also expands on this idea, the idea of “building an umbrella of safety”. She believes that many people think that they have fully prepared themselves and their child for an emergency but in fact they may be missing several key matters. For example, not training every caregiver and making sure that they fully understand what has been taught to them, and not being comfortable administering the adrenaline. She also finds that they may not always communicate fully with the child, such as not telling them that their caregiver has been trained in how to deal with anaphylaxis. Since this would bring comfort to the child and help reduce stress and anxiety, it’s important to make sure that they know.
Let your child take the lead
As a child gets older, usually by 9 or 10, they’re capable of making some of their own decisions, taking increasing responsibility and working together with their parents to protect themselves from food allergies. This can be achieved by letting them experience new opportunities like sleepovers, school trips etc. Giving them a sense of competence at a young age helps them to grow confident and comfortable as they grow older, making them become more likely to speak up about their food allergies.
As your child gets older they become more aware of the dangers of their allergy including the possibility of death. This is most likely a normal part of development and not an indicator of dangerous anxiety. It makes it even more important to ensure your child feels in control of their allergy.
It’s important to remind yourself and your child that allergies are not a dreaded disease but a manageable issue. Children with food allergies can do anything that anyone else can do, they just have to protect themselves against a few foods. If anxiety has become a big issue for the child or in the family, don’t hesitate to contact a psychologist or psychiatrist with food allergy management experience. It can also help to see your allergist. They may do an oral food challenge to see if the allergy has been outgrown. Research shows that even if the food challenge shows that the allergy is still present, the experience helps improve the quality of life. Families often emerge from the tests feeling more confident.
Research also shows that food allergic children are often more empathetic and responsible than their peers. They “have an advantage later in life because they faced adversity at a young age.” Dr Shemesh finds that “children with food allergies may grow up knowing how to face challenges in life better than their peers. The point is to keep risk at a minimum and to learn to live with risk.”
There are many products that can help make kids and parents feel more confident in their allergy. Our Anaphylaxis Emergency Response Case has guides which show the symptoms of anaphylaxis and how to use an adrenaline auto injector. This makes it ideal for kids who are worried that they or their care giver won’t know what to do in case of emergency and also for caregivers who may not be confident in what they should do.
If you have a young child who doesn’t understand their allergy, an allergy book can help explain their allergy in a child friendly way.
Disclaimer: The information provided is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Allergy Lifestyle Limited (t/a) Allergy Lifestyle) uses reasonable endeavours to check the accuracy of information provided however no warranty is given that they are error-free.