While most guests at a family wedding last weekend were shmoozing with each other, Anne Seymour made her way to the kitchen. The Maryland mother of three has a child with severe food allergies, so she and her husband went to find out what was in what.
"What's the big deal?" an aunt asked about their food patrol efforts. "The big deal," she replied, "is that we end up at the hospital" – should eggs or tree nuts wind up on or near their daughter's plate.
When it comes to educating and convincing others about the imperatives that accompany food allergies, "it is constantly an uphill battle," Seymour says. People may get vigilance around certain nut allergies, she says, but beyond that, "it's a hard concept for them to understand." The most common food allergies among kids include milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish, with the most severe reactions typically associated with peanuts or tree nuts, according to Food Allergy Research & Education, a Washington, D.C.-area nonprofit.
[Read: 7 Protein-Packed School Lunch Ideas.]
If it seems like suddenly food allergies are everywhere, that's because they are. About 1 in 13 children has food allergies, according to FARE, which notes recent data showing that food allergies among kids have jumped by 50 percent since the late 1990s.
Peanut allergy alone has skyrocketed, according to research by Scott Sicherer, professor of pediatrics at Mount Sinai's Icahn School of Medicine and researcher at its Jaffe Food Allergy Institute in New York and author of "Food Allergies: A Complete Guide to Eating When Your Life Depends on It." In 1997, he found 1 in 250 kids allergic to peanuts; the rates rose to 1 in 125 in 2002 and nearly 1 in 70 in 2008.
What's going on? No one really knows the specifics beyond a presumed interaction between genetics and the environment. Sicherer rattles off a few theories such as the lack of sun exposure and, hence, vitamin D in indoor living environments; the way foods are processed; and the one he favors – the "hygiene hypothesis," the idea that modern hygiene, with antibiotics, vaccinations and cleanly lifestyles, has redirected our immune systems to attack otherwise innocuous agents.
In any case, children – and those who care for them – face an unprecedented array of allergies, some of which are life-threatening. (Adults, too, are affected by food allergies, but the data is insufficient, Sicherer says). While quality-of-life concerns and, in some cases, bullying can challenge children with food allergies, they can enjoy as full a life as their allergy-free peers. But that requires entire communities to learn the ins and outs of food allergies. And there's a steep learning curve.
As Sicherer explains, most social activities surround food. Whether it's a birthday or holiday party, he says, "there's always food around. There's always a constant concern around that."
Michael Pistiner was working as a pediatric allergist when his son developed food allergies. And yet, despite his expertise in allergy management, it took about two months for him and his wife to become comfortable with their new routine.
Pistiner, who works at Harvard Vanguard Medical Associates and calls himself a food allergy educator, suggests working with your child’s school to spread awareness. "The school is really a hub, and it's so central to many of our lives," he says, explaining that outreach at school can penetrate the entire network of students and parents. .
Last year, the National School Boards Association issued allergy guidelines: Safe at School and Ready to Learn: A Comprehensive Policy Guide for Protecting Students With Life-Threatening Food Allergies. The Centers for Disease Control and Prevention is also expected to release national school guidelines for food allergies.
But here are some basics. Allergic reactions can range from throat itch to throat closing, hives and vomiting. So you should talk with a doctor if you think your child may have a food allergy. Remember, too, that "reactions are unpredictable," writes John Lehr, CEO of Food Allergy Research & Education, in an email. "You can have a history of mild reactions, and then suddenly experience anaphylaxis without warning." For that reason, anyone with a food allergy should carry two auto-injectors of epinephrine, which treats anaphylaxis, a severe allergic reaction.
Below are some more tips for navigating a highly allergenic world:
• In the case of a severe reaction: Pistiner says to follow these three steps: Inject the child with epinephrine, call 911 and alert the child's parents.
Call 911 first in case the reaction requires more epinephrine, and call parents last to save time, he explains. Consider practicing with an auto-injector, and don't be afraid to use it, he says.
• If you are the parent of a child with food allergies: Have an action plan and share it. That means briefing anyone caring for your child with his or her needs. Lehr suggests providing schools with "a written food allergy management plan" specifying how to enable your child's safe and full participation in school activities and respond to any allergic attacks.
• If you are caring for a child with food allergies: You'll need to know how to read labels and understand issues regarding cross-contamination, with the basic rule being, "If you can't read it, don't eat it," Pistiner says. "It's not a job that people need to necessarily take on or jump right into. It's something that getting all the information and learning how to do it and feeling comfortable is going to be really important." Children with food allergies can also bring their own snacks or treats to play dates or other occasions. Seymour, for example, typically packs a treat for her daughter to enjoy at birthday parties, where the cake is off-limits.
[Read: When Nutrition Labels Lie.]
• If you are ever around someone with a food allergy, which is to say, everyone: Have a little compassion. "Food allergies are for real," Pistiner says. "They need to be taken seriously in all circumstances and at all times." And the help of others will make all the difference to children with food allergies, he says. "It can allow them to have great play dates and parties and experience all the fun things that kids without food allergies can, and the more understanding and support the other families have, the easier it's going to be to pull this off."
Clarified on 10/04/2013: A previous version of this story failed to note Michael Pistiner’s current affiliation. He is a pediatric allergist with Harvard Vanguard Medical Associates.