Allergy advice

[fireheart]

OK, so at my service, we have a number of kids with various allergies. A few have multiple allergies: one is wheat, dairy, nuts, egg and sesame (from memory), while another is gluten and dairy free. We also have one kid who can't have gluten for behavioural reasons and two vegetarian kids (My guess is ovo-lacto as dairy and egg products are fine by their parents).

Two of the kids at my service are of particular note, one is a casual child, the other is a regular. The regular gave me a scare this morning. Turns out that last night, he'd gone home and had a mild allergic reaction (ie treatable with antihistamine) and the parents figured it was caused by residue.

Now, here's my dilemma: the kid gets his own food (mum and dad bring it in: it's not that they don't trust us, but they've had a bad experience in the past where their child accidentally ingested a dairy product and nearly died, so I can understand their paranoia. Said kid is Grade 1) but the parents don't want to "single him out" too much. We're planning on getting him a separate set of cutlery and utensils and at the moment, when we prepare food, I prepare anything for the kids who are allergic or intolerant FIRST before preparing the food for the rest. (So for instance, the other day we did toasted sandwiches. We had 3 kids with allergies/intolerances/diet and I set things up accordingly, so that the kid who was gluten/dairy free had hers done first, then the just plain gluten free was next and then the vegetarian kid was last. After that it was mass sandwich transit >.<)

Is there anything else I can do or should be doing for this child? Our theory is that the "Residue" in this case was caused by another child touching him shortly after mealtime. Unfortunately it was a delayed reaction and while we do keep an eye on him, we don't want to single him out too much. (Despite this, he's fast growing on me)

[paperfiend]

As the parent of a milk/egg/nuts/sesame allergic 4-year-old, here's what I'd say:

What are the procedures in your classroom/facility around food, as far as the children are concerned? Good practices that might help, if they aren't already in place, are:

1. Limit food to a particular area or set of tables (no wandering around the room carrying food).

2. Clean the tables with something more than just water after food time is done (and ideally, beforehand also). Commercial wet wipes have been found to be effective at removing allergens, as is soap and water. Hand sanitizer / Lysol doesn't remove allergens. We use baby wipes for this sometimes since they contain a detergent.

3. Have all children wash their hands with soap and water when they arrive at the facility (to prevent contamination from food they ate at home), and then again immediately after eating before they move into "non food" areas.

4. Make sure the allergic child washes his hands with soap and water before eating. I guess all kids should do this anyway, but it's particularly important for the child with allergies!

My son's preschool did #3 as a general measure against germs so it may be helpful that way too!

BTW I'm really impressed with your thoughtfulness about the order in which you prepare the food. It's basic food allergy procedure but a lot of people (even those in child caring positions) don't really think about it.

[scruff]

We also have one kid who can't have gluten for behavioural reasons

You seem to have a good handle on the allergies prep, I just felt obliged to comment on this line. :-)
Not everyone with food allergies/sensitivities has symptoms on the embarrassing spots /having difficulty breathing line.
Some of us get hyper. Me, if you give me tartrazine (used to be used here as a colouring in budget orange drinks) , I'll talk 6x faster than normal and you'll need to scrape me off the ceiling by the end of the evening. :-)
I _miss_ tartrazine. Probably no-one who's had to deal with me on it also misses it.

[fireheart]

As the parent of a milk/egg/nuts/sesame allergic 4-year-old, here's what I'd say:

What are the procedures in your classroom/facility around food, as far as the children are concerned? Good practices that might help, if they aren't already in place, are:

1. Limit food to a particular area or set of tables (no wandering around the room carrying food).

2. Clean the tables with something more than just water after food time is done (and ideally, beforehand also). Commercial wet wipes have been found to be effective at removing allergens, as is soap and water. Hand sanitizer / Lysol doesn't remove allergens. We use baby wipes for this sometimes since they contain a detergent.

3. Have all children wash their hands with soap and water when they arrive at the facility (to prevent contamination from food they ate at home), and then again immediately after eating before they move into "non food" areas.

4. Make sure the allergic child washes his hands with soap and water before eating. I guess all kids should do this anyway, but it's particularly important for the child with allergies!

My son's preschool did #3 as a general measure against germs so it may be helpful that way too!

BTW I'm really impressed with your thoughtfulness about the order in which you prepare the food. It's basic food allergy procedure but a lot of people (even those in child caring positions) don't really think about it.

1) the kids have a choice on where they sit to a point. Were starting to crack down on the seating plans though. We have four tables, one of which is a home corner table. Kid in question normally sits at a regular table or on the floor.

2) would a standard surface spray be ok to use? We don't use hand sanitizer at the service period. (Any service that has a school holiday program DOES) said spray is bleach free (we don't use bleach at the service due to the fact that it's a shared space)

3) the food and non-food area are the same, but we will talk about this with the kids. Ww have a discussion time with them about different things that are either service relevant or community relevant. The hand washing after eating was suggested by the parents of this child so that may be something we plan on incorporating.

4) we do this anyway. The kids are fairly good with handwashing.

Thank you for that! When I was coordinating temporarily, we had a couple of kids with allergies and usually when they were at the service I'd try and make sure that the alternate snack was something they could eat in addition to the fruit and veg we served (we currently give them fruit in the afternoons). Here that's not always the case, so we make the same thing for those kids, but with alternate ingredients. (Ie gluten free bread instead of regular bread)

One thing we are going to do very soon is draw up a chart of who can/can't have what and keep it both on the fridge and in the cupboard so that at a glance, we can tell who can and can't have what. It also saves me having to ask the coordinators who can't have what. (Said chart would have the allergen at the top and then the kids names colour coded ie red would be severe, green would be mild/moderate, blue would be lifestyle/dietary underneath so that if the kid does accidentally ingest dairy or wheat or whatever we know what to give them)

[Seshat]

Just tossing this out there as an example of 'behavioural allergies'.

I'm a cheap drunk: citric acid (citrus fruits) will make me act exactly as if I'm drunk.
Red wine with sulfides in it will make me feel and behave VERY drunk on one standard drink, or less.

Oh: and both of those were before I went onto my current medication regime. I have no clue what would happen now!

It's (probably) not life-threatening to the kid, but based on how it happens to me, he won't feel like himself, and he'll know he's doing 'wrong' things but his impulse control will be seriously hampered. Attempts to discipline the kid will have limited effect, because - well, it's like being sufficiently drunk that you're not really in control anymore.

[Cooper]

As someone with a gluten allergy, here's an experience on how it affects behavior:

When I worked at Way of the Sub I didn't know I was allergic to gluten, so I'd have Subs for lunch. In the morning I'd be alert, cheerful, and energetic. In the afternoon I'd be lethargic, grumpy, neurotic, and prone to meltdowns.

Gluten can make a huge difference.

As for what you're doing, it seems you're doing everything right. Be sure to wash the area you're preparing on as well, just in case.

[Kal]

Some of us get hyper. Me, if you give me tartrazine (used to be used here as a colouring in budget orange drinks) , I'll talk 6x faster than normal and you'll need to scrape me off the ceiling by the end of the evening. :-)
I _miss_ tartrazine. Probably no-one who's had to deal with me on it also misses it.

A friend of my daughter's used to have that issue with smarties. One of the colouring agents (no idea which one) used to send her hyperactive. She was already active and loud without it and I couldn't help but be thankful I'd never seen her affected by the stuff.

[XCashier]

When I worked at Way of the Sub I didn't know I was allergic to gluten, so I'd have Subs for lunch. In the morning I'd be alert, cheerful, and energetic. In the afternoon I'd be lethargic, grumpy, neurotic, and prone to meltdowns.

Gluten can make a huge difference.

I'm finding that out for myself, too. I don't seem to have an actual allergy, but if I eat too many wheat products, I end up feeling bloated, unhappy, uncomfortable and have difficulty sleeping. And since wheat is in far too many things (just try finding a high-fiber gluten-free breakfast cereal! ) it's a real challenge.

[Cooper]

I'm finding that out for myself, too. I don't seem to have an actual allergy, but if I eat too many wheat products, I end up feeling bloated, unhappy, uncomfortable and have difficulty sleeping. And since wheat is in far too many things (just try finding a high-fiber gluten-free breakfast cereal! ) it's a real challenge.

Chex makes gluten-free breakfast cereal. I don't know if it's high fiber or not, but give it a shot.

[wolfie]

A friend of my daughter's used to have that issue with smarties. One of the colouring agents (no idea which one) used to send her hyperactive.

In a case like that, have you tried "edited" smarties? One day, give her only one colour of smarties, and see if she reacts. The next day, give her only another colour, and repeat until you've gone through all of them. This way, you find which colours are safe for her. Don't do the "all but one colour" instead - some colours may use combinations of dyes, with a single dye being in multiple combinations. If the "bad actor" is used in more than one colour, you'll never find what's safe by eliminating one colour at a time, since there will always be at least one colour with the "bad actor".

[XCashier]

Chex makes gluten-free breakfast cereal. I don't know if it's high fiber or not, but give it a shot.

I do like Corn Chex, but it's not high fiber, only 1 gram. Same with Rice Chex. The only Chex that is high fiber is...you guessed it...Wheat Chex!

[fireheart]

A friend of my daughter's used to have that issue with smarties. One of the colouring agents (no idea which one) used to send her hyperactive. She was already active and loud without it and I couldn't help but be thankful I'd never seen her affected by the stuff.

I don't know if it's everywhere or just the UK only, but they now use natural dyes for the smarties. The red ones are dyed with a variant of red cabbage (it used to be cochineal)

Also, a small update.

The kid is doing fine and we've now established a routine where kidlet comes and sees us as soon as he's washed his hands to get the food from us directly. Means that cross-contamination is reduced to some extent.

ETA: Kal, it does look like you're in the UK. If you see that family again, tell them that the smarties should be OK

[Kal]

In a case like that, have you tried "edited" smarties?

I'm not sure if their parents tried it, I just remember that smarties were a banned food for them. Any other sugar was absolutely fine, but smarties were a no.
It's been a few years anyway, their family moved and shifted schools and they lost touch.
Most people complain if you run scientific tests on their children anyway, so it probably wouldn't have been a good idea to try it myself.

[Seshat]

Actually, the 'scientific testing' or the prick test I described in another thread are the only known ways to be absolutely certain of a given allergen.

I mean the 'feed the kid half a dozen red smarties, note result, wait several days for his system to clear. Now try the same with green smarties....' test. It's not a full-on scientific test, but it's the easiest way to get the result.
I DON'T recommend it if the initial allergen response involved airway issues!
And talk to your doctor. I mean, REALLY talk to your doctor, and perhaps to an allergist. Find out what the worst possible result could be (most likely a sudden swelling of the airway, to the extent that the patient literally cannot breathe). Find out what other ways there are to identify the allergen, and what the best guess is about the risks. Then make an informed decision.

Below is an example drawn from my own life:

To find out what it was that gave me hives, we fed me controlled amounts of anything/everything unusual I'd eaten in the week preceding the first outbreak. Okay, store brand cheezels. So far so good. Also itchy. Used up a whole bottle of pinetarsol.

Then I got hives again. Wha? Hmm. Get another pack of the cheezels (someone else can eat them) and ingredient-compare to everything I'd eaten the preceding couple of days.

Got it. Natural colouring. Either annatto or turmeric, and given that I eat a great deal of Indian-subcontinent food, probably not turmeric. Indian food uses a lot of turmeric as a spice.


(Side note: the above is evidence that plant-based natural colouring is not inherently allergen-safe. Both annato and turmeric are plant-based.)


So now I don't eat anything containing annatto. Bugger.