Food Allergies: An Open Letter

Dear Parent,

If I understand you correctly, my child’s food allergy is causing you great inconvenience. I wanted to let you know that I can completely relate. The first time my daughter had an allergic reaction I was quite busy on hospital rounds and had to leave before finishing. This ruined my Saturday night, which was spent with patients rather than my frightened family.

I’m not sure about you, but besides inconvenience, I also felt stupid and helpless. I didn’t recognize the reaction for what it was. I just assumed she had some bug causing hives, stomach ache, wheezing, and shortness of breath. Thankfully my wife figured it out and sent me to get an ingredient list for the cookie I gave my kid to get her through rounds. Boy, did I feel like an idiot!
It turns out to have been the walnuts, and now we’re quite careful. She hasn’t had a reaction since, but carries an epinephrine injector with her, just in case.

When you asked me why all the kids seem to have allergies these days, I didn’t have an answer, but your observation was right on target (although you sounded a bit sarcastic when you asked). Food allergies are more common, perhaps for a variety of reasons. This can give parents like me quite a bit of anxiety, and it doesn’t make my daughter feel all warm and fuzzy either.

So I understand you complaint. It’s tough to have a kid in a nut-free classroom. I appreciate how hard it must have been to remember to send in nut-free treats with your kids. The weekly classroom emails and newsletters are easy to ignore, as are the frequent reminders from the teacher. And it must be terribly hard, when making muffins, to leave out the walnuts. I mean, muffins without walnuts? Who does that?

I hold out great hope that you and your child will not have to suffer through another year in a nut-free classroom. Though my daughter will miss your kid, she does feel a bit less anxious knowing she’s a bit less likely to have to jab herself with an EpiPen while waiting for EMS.

Have a happy and healthy school year.

Sincerely,

PalMD

12 Comments

  1. Bob K.

     /  August 24, 2013

    The reason allergies have become more common is probably at least in part due to increasing vitamin D deficiency. It starts with mothers who are vitamin D deficient during pregnancy and ends with children who never play outdoors any more and if they do, they are slathered in sunscreen.

  2. This probably is very little comfort, but this seems to be a common issue lately for parents of children who have food allergies severe enough to require an epipen. My n=1 anecdotal evidence seems to suggest that folks are unfazed by the epipen – as of one can just pick one of those up otc. The worst was a parent who sent her son to boy scout camp this summer. They not only ignored her requests to help make her child safe, but also ridiculed her as a “helicopter mother” behind her back as if the phrase “life threatening allergic reaction” was no big deal.

    I guess I would have though they’d take a parent who is a doctor more seriously than your average parent. Foolish me…

    • gingerest

       /  August 28, 2013

      The first three references are cross-sectional studies, which means that the temporal relationship between vitamin D status and allergy can’t be determined. The fourth is drawn from a longitudinal study (LSAC, which rocks) but doesn’t actually use the data longitudinally for this report – the predictor and outcome are drawn from the same wave of the study. Same problem.

      • Bob K.

         /  August 28, 2013

        Well, they may not be as strong as a longitudinal study (how do you do a longitudinal study on childhood allergies – do I need to test the eggs for vitamin 10 years before a child is born?), but it begs the question – if there isn’t a relationship between vitamin D deficiency (which we are continually understanding as having a stronger and stronger influence of immunity dysfunction) then why would people with peanut allergies be dramatically more likely to have vitamin D deficiencies? At some point, you have to apply common sense and say, “yeah, the proof isn’t there, but the evidence is strong enough that being a ‘denier’ isn’t going to serve us well”.

  3. No worries! I won’t send nuts! Not even in my own kids’ lunches. No problem.

    I did get frustrated by the soccer mom who lectured at me last week when I offered to bring snacks. Her child is, well…”not actually allergic”…but has “bad reactions” to: high fructose corn syrup, food coloring, preservatives, gluten, sugar, even just the sugar in an apple is too much, high fructose corn syrup, sugar in any form, processed anything….

    It was completely exhausting to listen to. Oranges are okay, though. Which is good because that was my original plan. (But don’t oranges have some fructose or something? Confusing.)

    “You know water? That’s what he drinks. Everything else has sugar, and high fructose corn syrup…..”

    I wonder if some parents can’t tell the difference between batshit nonsense and legitimate food allergies.

    • Bob K.

       /  August 25, 2013

      This is probably why PalMD got attitude as well. While his child has legitimate allergies, so many people have “make believe” allergies that are really just part of their orthorexic tendencies that it makes people doubt anyone claiming to have legitimate allergies. Consider how many people claim to have allergies to gluten. We’re not talking about people with celiac disease, but people who “quit gluten” and now they “feel better”, ie they are riding a sweet placebo effect. I call them orthorexics because they just keep restricting their diets more and more. Sounds like you got someone who is a pretty advanced orthorexic and dragging her kids into it as well. I just feel sorry for her children. When someone won’t even let her kids eat fruit, you know you’ve got a quack on your hands. And yes, oranges have fructose in them.

  4. Well said, Bob K, well said! I have a few patients in my practice who are severely restricting their children’s diet in the hopes to curtail problematic behaviours. I feel sorry for those children.

  5. So what do the severely-restricted kids eat? How do they get adequate nutrition if the parent is self-diagnosing “allergies” without any sort of professional oversight?

  6. Jack D

     /  August 29, 2013

    Do the numbers support the statement that there are “more allergies” now, or do we just have a heightened awareness? Are allergic kids just surviving more often into adulthood raising awareness, or do we have a higher propensity for allergy as a society now than when we were kids? My feeling leans on the former, but I don’t really have numbers or research at my fingertips, so I was wondering what information is available.

  7. The link in the post takes you to the data. The data do support an increase in food allergies, not simply increased awareness.

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