Transcription:
How to Safely Address Your Child's Food Allergies at School This Year

Deborah Howell (Host): Everything was so much easier before your child became allergic to peanuts, or berries, or seafood, right? And it's even more complicated when they're at school. Well, if you're wondering how to safely address your child's food allergies at school this year, this podcast is for you. Welcome to our health podcast. I'm Deborah Howell, and we are here today with Dr. Sharon Yee. Dr. Yee is Board Certified in Internal Medicine and Allergy and Immunology. She practices with Allergy and Asthma Consultants of Rockland and Bergen Counties and is an affiliated physician with Montefiore Nyack Hospital. Thank you so much for joining us today, Dr. Yee.

Dr. Sharon Yee (Guest): Hi, Deborah. Thank you for having me. I'm very excited to have this interview with you.

Host: Me too. Let's jump right in. What exactly is a food allergy?

Dr. Yee: Food allergy is an immune reaction that the body experiences to certain protein allergens of food. The most common food allergies are eggs and milk in kids. The very most common food allergy in adults and children are tree nuts and peanuts. The other more common food allergies are the shellfish, fish, wheat, soy.

Host: I even have a friend that's allergic to all fruit.

Dr. Yee: Right. That is actually another interesting type of allergy. It's not a real food allergy, but it's — certain fruits, even nuts and vegetables look like pollen to the body because the chemical structure of the raw foods has a similar structure to the pollen allergen. It's almost like the body thinks you're eating pollen and some people experience itching, even tongue swelling, hives on their face when they eat these fruits and vegetables. But usually, if you eat it in the cooked form — let's say you have an allergic reaction to apple in the raw form and you eat an apple pie you're usually fine.

Host: My doctor said I have to eat the apple pie. Sorry. All right. If you suspect that your child might have food allergies, what's the very first thing you should do?

Dr. Yee: Of course, you want to see a doctor, preferably an Allergist, to have food allergy testing. If you do suspect a food allergy in a child or your child, you don't want to avoid because studies have shown avoidance actually increases risks of developing a food allergy. In fact, all of the pediatric guidelines recommend not introducing nuts into the children's diet until they are 3- or 4-years-old. They believe that because of that, there is more of a prevalence of peanut allergy in children because of long-term avoidance.  

Host: What are these tests like?

Dr. Yee: Testing is actually pretty simple. It doesn't require needles. Kids always are fearful of injections and needles, but it does not require any needles. We call it skin prick testing. It's almost like — I tell my patients pokey tickles. It's like a toothpick that scratches the surface of the skin, so it doesn't entail any bleeding at all.

Host: Excellent. So, really there's no recovery period after the test? They can go right back to school the next day?

Dr. Yee: Definitely. In terms of the testing, it's a very simple test. It only takes 15 minutes. A positive test will entail some itching and swelling at the site of the allergen, but within the hour the skin actually recovers, and their person is fine.

Host: My sister was allergic to a bunch of stuff, and what they did was they taped everything in her house to her body like a fork, and a knife, and aluminum, and part of her leather bag that she was carrying around. That's an extreme situation?

Dr. Yee: Yeah, so that's another type of allergy. We call that contact dermatitis or an allergic type of eczema or surface rash. That's a — I call it a chemical allergy, and that's how you do a chemical allergy test, which is through a test called patch testing. She had something that's called a patch test completed.

Host: Nothing to do with food allergies?

Dr. Yee: No.

Host: Okay, so I think some people are freaked out a little bit about getting tests because they think it might have to be an extreme thing like she went through for days and days. This sounds like this is much, much easier. Now a diagnosis has been made, what are some of the treatment options or behavioral patterns that can help your child?

Dr. Yee: Of course, most importantly, you have to discuss with the parent the anaphylaxis plan. In an anaphylaxis plan, you want to identify the food that the individual is going to be avoiding, and then what symptoms to look for. We go over the different symptoms to look for for an allergic reaction, and then the treatment plan. Usually, for mild symptoms that involve itching, even hives, a little bit of lip swelling, Benadryl is the treatment. Epinephrine or an EpiPen or another type of EpiPen called AUVI-Q is recommended for a more severe reaction, which entails difficulty breathing, throat swelling, wheezing, chest tightness, even dizziness, which is a sign that the blood pressure is dropping. These are all symptoms of a serious allergic reaction we call anaphylaxis.

Host: I've got it. Now, when they're in school, it's different because when you're at home, you know your whole routine and if there's a problem you can use the pen. It's also tougher to avoid those foods that your kid is allergic to when they're at school. What are some of the ways that we can safely address food allergies at school?

Dr. Yee: Communication is definitely key, especially with the school nurse, even the teachers. It's always good to have — a lot of the newer schools will provide the kids with anaphylaxis worksheet that needs to be completed by the doctor. I think nowadays, as food allergies are more prevalent and people are more aware — there's more awareness, schools are willing to work with parents. There are peanuts or tree nut free tables at school or food allergy tables at school. You have to educate your child on what foods may contain their allergen. Children are pretty smart these days. They know what to avoid. It's just about teamwork and communication.

Host: Do kids sometimes get bullied because of their food allergies?

Dr. Yee: It's definitely an issue, yes. Children do get bullied at school. Another thing to know is that some people have this misconception that touching a peanut will put the kid into anaphylaxis, but that's actually a misconception. Touching a food that you're allergic to really should not cause a severe allergic reaction. Ingesting the food is really the only way that one should have a severe allergic reaction. Let's say in school, a kid is throwing peanuts at a kid. Of course, that's not a good thing, but at the same time, parents shouldn't be — or even teachers or the kids themselves shouldn't be worried that they had peanuts thrown at them and are going to go into an allergic reaction. That's not true.

Host: Or if they touch a shrimp?

Dr. Yee: Or if they touch a shrimp, right. Or if they have peanut butter put on their face.

Host: My goodness, the things kids think of.

Dr. Yee: Right.

Host: Well, as you said, education is the key in the school, classroom, and in the lunchroom as well.

Dr. Yee: Right. Yeah, definitely.

Host: And so the kids know to stay away from the brownies with the nuts in them, and again, education is at home — are there resources at school for these kids in case a child has a situation at home where they're not going to get that training?

Dr. Yee: I know the New York State Government has advised almost all New York schools to have EpiPens. I'm not sure — I think a lot of the New York schools are training a lot of their school teachers how to use the EpiPen in case their child has an allergic reaction. There is a lot of awareness now in terms of resources at school to help kids with food allergies. I think the New York Government itself is also aware and passing regulations to help kids with food allergies.

Host: Okay, so the lunch menus are prepared with that in mind?

Dr. Yee: I'm not sure if the lunch menus are prepared with them in mind. I still hear that kids are offered — there's pizza at school. There are still kids who bring peanut butter in school. No, not completely 100%, but it makes it difficult for kids who don't have peanut allergies as well. Although there's awareness, I don't think it's fair for the kids who don't have food allergies not to be able to eat certain foods.

Host: Yeah, it's tricky, isn't it? I guess the best thing is to pack lunch, right?

Dr. Yee: Kids with food allergies, ideally, the best thing is to pack lunch, yes.

Host: All right. I would also say venture in and meet that school nurse on day one when September rolls around and introduce your child, make sure she or he is familiar with that nurse and is comfortable going to that nurse if they have a problem, and kick the school year off on a positive that way.

Dr. Yee: Yeah, definitely. Like I said before, communication is key. Most schools are equipped with EpiPens themselves. I know some schools request extra EpiPens to be kept in school just for the individual kids, but a lot of schools have stocked EpiPens at the school, which actually makes it nicer in terms of cost. EpiPens are not cheap, so sometimes it's not practical to have an extra pen for each child in school. In stock, EpiPens are ideal.

Host: We want to thank you so much, Dr. Yee, for taking time out of your busy day to be on the podcast today. We really do appreciate it.

Dr. Yee: Thank you, Deborah. I hope people are more aware now of how to manage food allergies. Thank you.

Host: We thank you. I'm Deborah Howell. Thanks so much for listening to this episode of our Health Talk podcast. Head on over to our website at MontefioreNyack.org to get connected with one of our providers or go to www.RBAllergy.com/Doctor-Sharon-Yee.html. If you've found this podcast helpful, please share on your social channels, and be sure to check back soon for the next podcast. Have yourself a terrific day.