FOOD ALLERGIES: ASK THE DOCTOR: HOW CAN I PROTECT MY SON FROM PEANUT ALLERGIES AT SUMMER CAMP?

Q: My son, who has a pretty severe peanut allergy, is going away to summer camp this year. I've notified the camp and they have assured me food options without peanuts will be available, but I am worried about hidden ingredients or even other kids eating peanut butter around him. I've heard that it is possible for someone with an allergy to have a reaction just from walking on a plane where people have eaten peanuts. Is this true? How can I protect my child when I'm not with him?

A: Often times, people mistake food sensitivities — a headache after chocolate or a stomachache from dairy products — with food allergies. Even with true food allergies, in the majority of cases, reactions are mild. But for caregivers of children with severe food allergies (as well as the children themselves, when old enough), it is important to be prepared to treat emergencies. A severe food allergy can cause a life-threatening reaction called anaphylaxis, where the body reacts drastically, affecting blood pressure and breathing.

Assuming your child has the life-threatening type of food allergy and has been diagnosed by a physician, there are several steps you can take to help keep him safe at camp. Notifying your son's summer camp before his arrival is a good place to start. Next, ask the camp to remove ALL peanut products from the kitchen for the week your son will be present. This safety measure helps to lessen the chance of your son having a reaction from a mistake, such as the use of utensils that have been used to prepare a dish with peanuts also being used to prepare your son's food, or a staff member providing peanut-containing foods to your son or to other children who may share food with your son. Although rare, it is possible for a person to react to a food they are allergic to just by smelling or being in its presence, which also is reason for removal of all peanut products from the camp kitchen.

Meet with the supervisor of the kitchen, as well as staff members who will act as caregivers to your son. Explain your son's allergy, since the camp staff may not be familiar with the real dangers of a severe food allergy, and the steps needed for treatment if a reaction occurs. Provide this information in written form as well, and ask that it be posted where staff can quickly refer to it.

It is important they understand a severe food allergy can be life-threatening and immediate. Many reactions occur while the food is still in the mouth, and if digested, usually within 30 minutes (almost never after three hours). Although food allergies usually occur each time the offending food is eaten, the severity of the reaction depends on the amount eaten. Sometimes, even very small amounts can cause a life-threatening reaction.

Even with the VERY BEST efforts to avoid peanuts, on average, accidents occur about once a year. It is important that anyone with a severe food allergy always have immediate access to injectable epinephrine, preferably two doses in case the reaction is severe (the EpiPen now comes in a two pack, and the newer Twinject has two doses in each injector). Teach the camp staff both the symptoms of a reaction (a complete list can be found in the related article link "Anaphylaxis" below) and how to inject epinephrine, so they can act fast if needed. Quickly administering epinephrine when the allergic reaction begins can be life-saving.

In addition to epinephrine, your child's doctor may suggest a chewable or liquid antihistamine (such as Benadryl) and the use of a liquid steroid medication. If you have not already done so, work with your son's allergist or pediatrician on an emergency treatment plan prior to your son leaving for camp. Make sure that the camp staff has all medications and directions necessary in case of an emergency.