Dr. Scott Sicherer on Managing Food Allergy in Kids

in Food Allergy
Published: July 2, 2010

Scott Sicherer, M.D., is an associate professor of pediatrics at the Mount Sinai School of Medicine in New York and a leading food allergy researcher at the Jaffe Food Allergy Institute. At the CSACI conference in Montreal in 2006, Allergic Living spoke with him about his then-newly released book, Understanding and Managing your Child’s Food Allergies.

What are some of the key things that you cover in this book?

People ask me millions of questions: ‘How do you know whether to do the skin test or the blood test?’ and ‘what does it mean?’ ‘How do you decide whether to do a food challenge?’ In the book, they can read about what goes through the doctor’s mind. Even more importantly, what are you telling the doctor? If you’re an educated consumer and know how to give your doctor the history, you’re going to be able to go in and be much more helpful.

What do you suggest for those with a food-allergic child with non-food-allergic siblings?

There isn’t one right answer. It may make complete sense with a younger child to exclude multiple foods from the house. But as the child gets older, it may make sense to bring those foods back into the house. That has its own educational value: how do I learn to read labels, how do I learn how to get the right food for me because – if they haven’t cured food allergy – I’m going to have a household where I have to manage that for myself and my kids.

How do parents balance the need to keep allergic children safe with the eventual need to let go a bit?

Balance is a beautiful word and, where I go through ages and stages in the book, the transitioning process is there. When you go into a restaurant and your child is old enough, you transition them into telling the restaurant personnel about their allergy. You get to hold their hand a little so that when they’re older they have the tools necessary to do this.

When we ask parents: what’s the worst part about your child having a food allergy? They say, ‘They could die.’ What do the teenagers say is the worst thing? The social issues. By hiding it or eating dangerously, they’re acting like their friends. By having their friends educated, it creates, really, a circle of safety.

The friend will say: ‘you didn’t ask enough questions’ or ‘she has a milk allergy, do it in a separate pan, not on the grill where you’re making cheeseburgers.’ It becomes not a big deal to have the food allergy when your friends have bought in.

What would you like parents to understand the most about living with food allergies?

That it’s manageable. There has to be a balance: you can’t be cavalier, and you also don’t want to live in a box. Anxiety is normal when you have an anaphylactic type of food allergy. But I’ve had families where their vacation was ruined because they saw some leftover food in the hotel room. I don’t think it has to be that way, and there are experts in talking you through it.

You need to understand what kinds of exposures are likely to cause reactions. That’s covered; that may make you feel more calm. The more education you have, the better you can control the environment. If you’ve done those things, but you still feel boxed in – and that’s normal – speaking with a counselor is really a good idea.

Allergic Living Recommends: Understanding and Managing Your Child’s Food Allergies by Dr. Sicherer, published by Johns Hopkins University Press.

First published in Allergic Living magazine.

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