Airplane Travel With Food Allergies

We flew cross-country over the Thanksgiving holiday. We were booked on 3 Southwest flights for our trip. Southwest does offer peanuts for their in-flight snack, but will make a substitution upon request. As we were flying with dairy, egg, peanut and tree nut allergies, we at least take advantage of their "no-peanut snack", providing some sense of security.

For those of you who've never flown Southwest with a peanut allergy, here's what to do:

• Call Southwest a day or two before the flight to alert them of the peanut allergy. If booking your tickets online, on the "Southwest Airlines Payment and Passenger Information" screen, click on the link to "Add/Edit Disability Assistance Options."you can make note of the allergy. I'd still call prior to the flight.
• Speak with a Customer Service Agent (CSA) upon arrival at the airport. You will then be given a "Peanut Dust Allergy Document" and the CSA will alert the Boarding Agent to stock the plane with an alternative snack.
• This "Peanut Dust Allergy Document" entitles the family to pre-board, allowing a family member to wipe down a seating area if necessary.
• Upon boarding, the Peanut Dust Allergy Document is handed over to the on-flight crew.

That's it. Easy!

We were on 3 flights and the procedure worked perfectly. There were snack options for everyone ranging from pretzels to crackers to Lorna Doone® cookies, Ritz® cheese crackers and pita chips. Several of these snacks contained my child's allergens,  but we read labels and chose accordingly. I know many food allergic flyers choose not to eat anything in-flight, and that's fine too. Of course one can always bring safe snacks from home.

I like the way Southwest handles peanut allergies. It saves me the worry of 150 people opening packets of peanuts and releasing peanut dust all over the cabin and I think most people don't even notice the substitution. When the man in the row in front of us requested peanuts for his snack, the flight attendant said, "We're a peanut-free flight, but ask me when you're getting off the plane and I'll give you a complimentary pack of peanuts. Would you like crackers or cookies now?".

Yeah Southwest!

Food Allergy Jingle Raises Awareness About Safety During the Holidays

Two young girls, calling themselves the "Peanut Free Players" sing a holiday themed song about food allergies. Take a few moments away from your holiday planning, pull the kids up to the computer and enjoy this clever jingle.

A Food Allergy Friendly Thanksgiving

I've got a section on my site devoted to allergy-friendly traditional Thanksgiving dishes. Please check out the "Holiday Dinner Menu" as you finalize your last minute recipes. If you're considering brining your turkey, first read this article.

Food Allergy Assistant wishes all of you a safe and delicious Thanksgiving dinner!

Food Allergy Program for Schools

The Food Allergy and Anaphylaxis (FAAN) has published a newly revised "School Food Allergy Program". It is now available for purchase. This updated version includes Safe@School®, a CD-Rom, which provides educators with a slide presentation and talking points to train others about food allergies. This comprehensive guide is for schools at every level with information geared toward principals, teachers, school nurses, food service staff, and parents.

Is this something your school could use? Talk to your principal, school nurse or parent teacher organization if you think this would be a valuable resource for your school. At $80 ($75 for FAAN members), you may believe it to be a worthwhile holiday gift for your child's school.

Peanut Allergy: What Do You Think of Banning Peanuts?

http://foodallergyassistant.blogspot.com/2010/11/food-allergy-news-from-annual.htmlOh, Dr. Bahna, president of the American College of Allergy, Asthma and Immunology (ACAAI), has sure stirred up a pot of trouble. As mentioned in a previous post, the ACAAI has been conducting their annual meeting over the past few days. Perhaps the most publicized information coming out of the meeting, has been comments about peanut bans made by Dr. Bahna. Check out this report from NPR's Health Blog. Of particular interest to me are the dozens of comments which rest on both sides of the issue.
 
I don't know if it's because we were originally dealing with nearly ten different food allergens, but I've never been an advocate of food bans. However, I am an advocate of making reasonable accommodations for medical needs. Therefore, when I contact an airline and request that peanuts not be served on our flight due to a peanut allergy, I expect that reasonable request to be honored. If suddenly those orange cheese curls became the popular in-air snack, I'd be just as adamant that those snacks not be served on our flight either. Imagine a huge cloud of cheese dust circling over my milk allergic's child head- a nightmare!

I am in favor of school cafeterias providing safe places for all children to eat lunch. If that means a separate safe table for my child, I want to be able to make that reasonable request.

Yes, the topic of food allergies can cause great debate, but for those of us who live with a food allergy, there is no debate. Anaphylaxis can be fatal and we should expect reasonable accommodations to be made to prevent a reaction.

Food Webinar on Food Labels May Inform Those With Food Allergy

The Imtermational Food Information Council Foundation (IFIC) is holding a webcast about something I read multiple times each day (no, I'm not talking about e-mails)- food labels.

Speakers ranging from dieticians, college professorsa and lawyers will discuss the rules and regulations that support the use of label claims and look at research into how people use food labels when making choices.

Specifically, discussion will be around:

• FDA guidelines for food labeling and health claims
• The Federal Trade Commission's views of health benefit claims
• A look at food culture and consumer behavior

The webcast is today- 9:30 am ET. If interested, you must pre-register. There are continuing education credits available for those who qualify.

It would be great for the food allergy community to have a presence in this webinar

 

Food Allergies and News From Annual Conference of ACAAI

Last week, the American College of Allergy, Asthma and Immunology (ACAAI) held its annual meeting in Phoenix. The organization, established in 1942, is made up of over 5500 health professionals and is dedicated to improving patient care in the areas of allergy and immunology.

Presenters at the meeting shared studies and research, much of it pertaining to food allergy. I've tracked down a few pieces of relevant presentations. As more is released, I'll share it. In the meantime, this will be of interest to those of us in the food allergy arena:

In a session titled "The Ability of Adults and Children to Visually Identify Peanuts and Tree Nuts", Co-authors: Todd L. Hostetler, MD, and ACAAI Member Bryan Martin, MD, (The Ohio State University/Nationwide Children's Hospital) report on a study in which only 50% of nut allergic people (ages 6 and up) could identify a picture of the nut they are are allergic to.

In "Adverse Reactions to H1N1 Vaccine after Tolerating Seasonal Flu Immunization", Amber M. Patterson, MD, (The Ohio State University/Nationwide Children's Hospital) says that tolerance to flu vaccine one year does not suggest future tolerance as the amount of egg in the vaccine varies widely.

In "If Kissing or Sex Leaves You Tingly, Is It Love or Allergies?" Dr. Sami Bahna talked about how allergic reactions to kissing and other intimate acts are more common for those with food and medication allergies.

Something else I've been watching for awhile is the use of Chinese herbs as a cure for peanut allergy. There was a session at the meeting, "Chinese herbs can complement proven allergy treatments", in which it was reported that Food Allergy Herbal Formula, previously shown to reduce anaphylactic reactions in peanut allergic mice, has now been shown to be safe for humans. Sounds promising!

Dr. Bahna, president of ACAAI, raised the ire of some in the food allergy community with several statements about bans 9or not) of peanuts in schools and airplanes.  Check it out and see what you think.

For more information on the ACAAI annual meeting, scroll through the Twitter conversation. More information about the organization can be found at their website.

Did any of these reports have a specific interest for you? I'm thrilled with the continued research on all fronts of food allergy. Let's continue to talk about egg allergy and flu vaccine and peanut allergy bans and promising food allergy cures. Let's keep making forward progress!

Fund A Cure for Food Allergies

This month, FAAN is again participating in the Pepsi Refresh contest. The group is asking for $250,000 to find a cure for food allergy. If this idea makes it to the top two ideas, we all win! It is currently ranked 59th. Your vote is needed. The vote of your parents, friends, neighbors, entire e-mail distribution list is needed. Imagine what a quarter of a million dollars for food allergy research could do!

You can vote every day all month. Please go to the Pepsi Refresh contest and vote today. Or you can text 104004 to Pepsi (73774). Then tweet it, FB it and get the word out to others. Anyone can vote. The contest ends November 30.

Last month, FAAN asked everyone to vote for Camp TAG, food allergy summer camps, in the Pepsi Refresh contest. Camp TAG didn't win, but since it made it to the top 100, there is still a chance for it to get it into the top two this month.

Food Allergy and Why Two Doses of Epinephrine May Be Necessary

A recent study reported in the Journal of Pediatrics determined the need for people with food allergies to carry multiple doses of epinephrine.The study followed 605 children (median age 5.8) to find out how many of them needed a second dose of life-saving medication after suffering a food related allergic reaction. Twelve percent of patients needed the second dose, causing the researchers to support the recommendation of carrying two doses of self-injectable epinephrine.

Now, 12% doesn't seem like a high number to me, but how are you to know if you or your child require that second dose? At this point my child carries one epi to school. A second one is in the nurse's office. When traveling, we carry multiple epis and there are several in our house.

For those interested in two dose medications, Twinject® offers a back-up dose. Their site suggests that 20% of reactions require a second dose. Since both doses are in one pen, the Twinject can be used in a single with carrying pouch. Our allergist has always prescribed the Epi Pen®, but I plan to discuss other options.

It's on the list...

What brand of epi do you use? How many pens do you have?

Food Allergies and Baking With Milk and Egg

As I've reported, we're adding tiny amounts of egg and milk in baked form to my egg and milk allergic child's diet. As all these food allergy transitions have been over the years, it's been challenging finding recipes that work. It sounds easy- just add an egg or some milk to any recipe.

It's not that easy. We're trying to stick to the guidelines of baking foods for at least 30 minutes at a minimum of 350 degrees. That eliminates most cookies and muffins and primarily leaves us with breads and cakes.

We've been eating an awful lot of chocolate cake in our house recently.

I'm in the routine now of having one baked good that contains one egg and one that contains a tiny amount of milk. My child eats egg one day and milk the next. The egg recipes are easier. Most cakes call for two eggs. For now, I use one regular egg and I substitute the other- usually 1 tablespoon flax seed mixed with 3 tablespoons water. The milk recipes take an advanced degree in chemistry with a minor in math. My childis off the scale allergic to milk so we're proceeding with extreme caution. I found a cake recipe that calls for 1/2 cup milk. I use 3 grams (our food scale comes in handy here) of dried milk powder mixed with an 1/8th of a cup of water. Then I add 3/8 cup of soy milk.  The plan is to gradually increase the amount of milk powder.

So, I'm certainly not complaining. Any time we can add more options to this food allergy diet is cause for great celebration, but I do see a need for a new kind of cookbook as more people are able to tolerate baked milk and egg.

In the meantime, we'll have to share.

Food Allergy Awareness in the Restaurant Industry

Okay, it has a funny name...MenuTrinfo...but I like the concept. MenuTrinfo stands for Menu, Nutrition, Information. Their mission is to help the restaurant industry provide better and clearer nutrition information to restaurant patrons.

MenuTrinfo just announced a series of webinars, free and open to any interested party. The first one is Nov. 16  from 11-11:30 am EST. The topic is "Practical Approaches to Special Diets and Nutritional Labeling". Betsy Craig, MenuTrinfo’s founder, will focus on current dietary trends, food allergy management, status of menu nutritional labeling legislation and resources where restaurant owners can turn to for help.


Sign up on their website if you'd like to participate. Feel free to pass this information along to your favorite restaurant. Educating restaurants in the area of food allergy, safe food handling and nutrition labelling is a win-win for all of us.

Food Allergy Challenges for Baked Egg and Milk

I just baked a cake. It has an egg in it. A real egg for my egg allergic child! Last night I baked bread in the bread machine. I put 15 grams of dried milk powder in it. Real milk for my milk allergic child!

I haven't shared anything about this nearly 3 month journey because like all journeys, it's had plenty of bumps in the road and wrong turns. Frankly, I feel like we've stepped off the road and we're ploughing our way through uncharted territory. It's scary. It's exciting. We continue to move forward.

This food allergy journey began in July 2010 when we made an appointment to do a baked egg challenge in our allergist's office. As instructed, I baked an angel food cake with 12 eggs. My egg allergic child needed to eat one piece to get roughly one egg. There was much anxiety leading up to the appointment. It's hard to convince a child to eat something after telling them for 10 years to never eat it. The anxiety made the appointment difficult. Physical symptoms were hard to separate from symptoms of anxiety. The challenge was not completed. We left the office not knowing if there had been an allergic reaction.

Over the next few days, we, the parents, decided to use egg in baked products- just one egg in a whole cake for example. Our allergist was aware and not totally comfortable with the plan, but acknowledged that we had the tools to handle a reaction if there was one.

There wasn't a reaction.

For several months now my egg allergic child has been eating baked goods containing one egg that have been baked for approximately 30 minutes.

So, we decided to tackle baked milk. We wanted to use a small amount of dried milk powder in a batch of muffins. For the first serving, we decided to go into the allergist's office. This wasn't a traditional food challenge as technically we weren't using enough of the allergen, but the reassurance of having a doctor close by was helpful. My milk allergic child was able to eat a whole muffin that contained 0.33 grams of dried milk powder. As per the allergist's instructions, we've continued to keep milk powder in the diet over the past week.

This experience has been fraught with anxiety for all of us, but we hope we're doing the right thing in the long run. Our efforts are two-fold: get missing nutrients into the diet and begin to introduce the allergen slowly to allow the body to recognize it as okay.

There continues to be moments of, "I think my mouth is tingling" and "What if I can't breathe after I eat this?". We work through each situation as it comes up with as much confidence as we can muster. We're just parents trying to do the right thing by our child.

I certainly can't recommend this method, but I can recommend an open dialogue with your allergist. The research is coming in quickly and it's hard to keep up with the latest recommendations. Talk to your doctor and make a plan that is best for your child and your family.

I'll keep you posted on ours and hope you'll keep us posted on yours. We can all learn from one another.