August 8, 2025 • 30 mins
Since 1 in 3 children in the United States deal with food allergies, it's imperative that parents be prepared and help their children and their classmates learn about the possible consequences of allergic reactions. On this episode, we are discussing innovative treatments, that latest guidance for epi devices, legislation to increase research funding, and more. Let's get more information from FARE Senior Director of Education and Support Dr. Kelly Cleary.
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Episode Transcript
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Speaker 1 (00:06):
Welcome to Virginia Focus. I'm Rebecca Hughes of the Virginia
News Network. Since one in three children in the United
States deals with food allergies, it's imperative that parents be
prepared and help their children and their classmates learn about
the possible consequences of allergic reactions. On this episode, we're
discussing innovative treatments, the latest guidance for epidevices, legislation to
(00:29):
increase research funding, and more. Let's get more information from
Fair Senior Director of Education and Support, Doctor Kelly Cleary.
Welcome to the show, Doctor Cleary. I'm so glad you
made time to speak with us today about this very
important topic.
Speaker 2 (00:44):
Thanks so much for having me. I'm excited to be here.
Speaker 1 (00:48):
So today we're talking about food allergies and of course
with the kids going back to school, that is definitely
something that needs to be discussed in and people need
to be educated about. Why don't you tell us your
experience and what makes you an expertise in this area?
Speaker 2 (01:05):
Sure? So, I am a pediatrician. My background is in
emergency medicine and also mental health. So I have taken
care of kids and teens and young adults coming into
the emergency department with severe allergic reactions. But I've also
been on the other side of it in the past
(01:25):
few years to understand the psychosocial elements of food allergies
as well and how that affects this community. And then
I am also a mom of four kids, one of
whom has multiple anaphylactic food allergies. So I do this
for a living, but I also do it at home.
Speaker 1 (01:45):
Oh wow, since you do have some first hand experience,
why don't you share with our audience. How did you
find out that your child had these allergies? Like the
first you know, the first go around, what happened that
told you you had an issue?
Speaker 2 (02:00):
So my son was actually diagnosed very young. He was
one of those infants that had very severe ezema from
the get go, so his skin was just inflamed, I
want to say, since he's been a few weeks old,
so we knew to really explore that there was something
else going on with him and ended up going down
(02:23):
the food allergy route. Lots of times that's not the case,
and the first exposure to an allergen is often the
first sign that there may be a problem. So we
had a different entry into that because of his severe eczema.
But often it's that someone will ingest a food and
(02:44):
then from there have a reaction to it. Sometimes you know,
a mild reaction and then people are pursuing is this
really an allergy?
Speaker 1 (02:53):
Okay, So let's talk about those reactions for a second,
because I think some of those can often be overlooked.
Like you said, they're mild, what would we look for
if we're having a reaction to a food.
Speaker 2 (03:05):
So, as you said, you hit the nail on the
head that reactions, they can really vary in the way
that they present. So some could be really mild where
you're seeing a mild rash or some sneezing or some
itchy eyes, but they could really progress to being involving
(03:26):
multiple symptoms and multiple systems, so involving the gastro intestinal
system with nausea, vomiting, diarrhea, sometimes causing vital sign changes
like a change in how fast your heart is beating
or a change in your blood pressure. Sometimes they can
involve dizziness or feeling you know, just something isn't right
(03:49):
in the way that kids or young adults are feeling
or adults. So really the spectrum of what we see
is very different. You'll hear often for food allergies that
people talk about having something in their throat or not
being able to breathe, And those are two definite signs
that we see where we could have difficulty in breathing
(04:13):
or swelling in the mouth or mucus membranes. So you're
looking for things like rash, swelling, sometimes changes in vital
signs which would indicate a more severe reaction, but difficulty breathing.
All of those would constitute a reaction. But it's a
spectrum of symptoms that we see.
Speaker 1 (04:34):
Okay, So could it be something as minor as maybe
a tickle in your throat or is that something completely different?
Speaker 2 (04:40):
Absolutely, it can start off as something very minor. It
could start off as a mild symptom like one or
two hives around your lips, or one or two hives
somewhere on your body. Certainly a tickle in the throat.
So are those are mild symptoms that you would see
of people having food allergic reaction?
Speaker 1 (05:02):
Now, when we're talking about children in school generally speaking,
I think, and you're the expert. Of course, by the
time they get to school, they kind of know. Parents
know what they are and are not allergic to is
would you say that's correct?
Speaker 2 (05:17):
So that's what we always assumed, But what we're seeing
more of now is that twenty five percent of kids
who are requiring epinephrine for anaphylaxis have never had a
diagnosis of a food allergy. So we are seeing this
event where kids who had no prior knowledge that they
(05:38):
had food allergies are manifesting their first signs of food
allergies in school. Which is why it is just so
important that anyone taking care of kids and students really
understands food allergies well, because the first sign of a
reaction could be the first presentation for that student.
Speaker 1 (05:59):
Wow. Yeah, okay, So I'm glad I asked that question.
I know personally, I have three children, and my daughter,
she used to complain about stomach issues. But she was
also like one of those really dramatic kids, you know
what I'm saying, And she had a little streak in
her that was a little manipulative, and so she would,
you know, if I had some ice cream, I would
(06:20):
feel better. But it turns out she's lactose intolerant, and
it took us a while quite a while to figure
that out what's your advice to parents on how to
get those diagnoses sooner.
Speaker 2 (06:35):
So I think you bring up a couple of great
points there. The first is the difference between food allergies
and food intolerances.
Speaker 1 (06:43):
So, as you.
Speaker 2 (06:44):
Noted, food intolerances often involve the GI system or gastro
intestinal system and can involve things like bloating or abdominal
pain or you know, sometimes change in stool, and that
is often a reaction to a food indicating an intolerance,
(07:06):
whereas a food allergy is an immune mediated response that
can be life threatening. So just to kind of put
those two out there, but I agree with you that
out of my four kids, I certainly have a couple
of them who have many more complaints than others. And
I think that in those kids, it's hard for us
(07:28):
to decipher, you know, what needs medical attention and what
does it. I know that my general rule of thumb
as a pediatrician and as a parent is if they're
complaining repetitively, if those complaints are not going away and
they're getting worse, I often go in. Again, as a
(07:49):
pediatrician who has had a lot of experience in the
past few years in mental health, one of the other
things that we don't want to ignore is that sometimes
what we call all these somatic complaints, things like headaches
or belly aches or body aches and pains, could also
indicate that our kids are going through tough times with
things like anxiety and oppression. So really bringing them into
(08:12):
their pediatrician, and even if you're bringing them into the
pediatrician to say they are complaining of belly aches, you know,
five times a week when they're going to school, I
think it's really important to just address those concerns and
make sure that we're not missing anything in our kids.
Speaker 1 (08:30):
Yeah, I definitely agree with that. For sure. You got
lucky and got your diagnosis early. I felt so guilty
when I found out she had that intolerance, you know,
like I had just been talking it up to her
being mischievous because she typically is, and that was that
was a horrible thing to go through as a parent.
But I can only imagine, you know, the struggles that
(08:50):
she endured. I know earlier you said something about these
sociosocial impacts of these allergies, right, is that what you
called it?
Speaker 2 (08:59):
Psychosocial?
Speaker 1 (09:00):
Yeah? So social, while't we talk about that a little bit?
Tell us what that means.
Speaker 2 (09:03):
Absolutely, and I'll also tell you no guilt. You know,
sometimes diagnoses take a long time to make and I
think as parents, we always you know, kind of put
that on ourselves, but you know, we also have to
definitely give ourselves a little bit of grace in understanding
that sometimes it's a process and it's not always going
(09:26):
to be on that first visit that they pick up
something like a lactose intolerance. But the psychosocial impact of
food allergies, I think is really important because we're seeing
in this population and community a lot higher incidents of
anxiety and depression. We're also seeing a higher incidence of
(09:46):
bullying in this population. So about one in three kids
with food allergies is reporting bullying. And what makes bullying
different in the food allergy community is that sometimes a
bullying is actually done with the allergen. So not only
is this bullying, you know, affecting a child's emotional well being,
(10:09):
but it's threatening their physical well being, you know, if
someone is putting their allergen in their face or throwing
their allergen. So the psychosocial impact of food allergies is
one that I know we at FAIR are really paying
attention to as are lots of medical professionals because the
day to day, you know, walking a life in the
(10:32):
shoes of a kid or a teen or young adult
or adult with a food allergy, there are a lot
of places where anxiety is high. And you know, if
you had to think about you know what if you
couldn't participate in having a birthday cake at the birthday
(10:52):
party that you went to, or you know, if you
were a fourth grader and needed to navigate how do
you tell your friends that you can't have pizza on
Pizza Fridays or after the big soccer game on Sunday
and everybody is eating a treat that's brought from another parent,
not being able to eat that, or advocating for yourself
(11:12):
and asking all the questions that need to be asked.
So there's lots of places where we see anxiety popping
up in this population.
Speaker 1 (11:23):
Wow, yeah, I hadn't really thought about that, but you're right. Then,
when you're a kid, there's this desire to fit in
and anything about you that is different is seen sometimes
as a negative thing, which is honestly ridiculous. I personally
have tried to teach my children that weird is the
way to go. But you know, what can we do
(11:46):
to support children, both the ones with the allergies who
are suffering these things, but also to educate and help
the bullying children to understand the severity of what they're doing.
Speaker 2 (12:00):
So it's all about inclusivity. And I think that this
extends even beyond food allergies. I think, as you pointed out,
it just extends wherever there's a difference. When my son
was little, we used to call his food allergy his
quote unquote special and then as he started meeting kids
that had other issues that they were facing. You know,
(12:21):
we had a good friend that had type one diabetes
and you know, he was maybe three and a half,
and he asked me, is that her special? And you know,
we really started to kind of talk about that everyone
has something special about them. Sometimes there are things that
we just see and know about a lot more quickly.
(12:42):
But I think that it's about inclusivity, and I think
that this time of year and back to school is
a great time as parents and caregivers that we start
to talk about that. One of the resources that Fair
has is called be a PAL, and PAL stands for
protect the life life, but it's not focused on you know, oh,
(13:03):
how do you administer an EpiPen? We have those resources
and those are geared towards adults, but this resource is
really geared toward how could you be a good friend
to someone who has food allergies and how could you
be more inclusive to that friend? What could you maybe
think about? And it's sometimes as easy as washing your
(13:24):
hands after you eat, or you know, thinking about what
you can do to kind of bring in so that
if you're celebrating your birthday, everyone is included, and you know,
non a non food and you know, a non food treat,
or ask the teacher if you could go out for
more recess. You know, my son has certainly found ways.
(13:48):
I'll tell you the one of the best stories that
I had was when the principal told me that the
allergy table was getting a little rowdy. And what we
found out was that a bunch of my my son's
you know, good friends who are all just wonderful kids,
were asking their parents to send in allergy free lunches.
(14:10):
And so this table was growing in size and started
to be the loudest table in the cafeteria and they
were having a fun, rowdy time with each lunch. And
you know, as much as most calls from the principal
would would make me having a sit down with my son,
this one did not. I was proud of him for
(14:34):
advocating for himself, and I was proud of his friends
for really being inclusive of him. One of the things
at FAIR that we say for parents and caregivers is
teaching your child you know what if you couldn't you know,
what if you couldn't trick or treat the same way
that everyone else on the block could. What if you couldn't,
(14:54):
you know, enjoy a cupcake at the end of a
classroom birthday celebration. I think get Really, kids want to empathize,
and I think that that teaches them a bit more
how to if they really think about, oh wow, if
that was me, you know, how would I feel? Yeah?
Speaker 1 (15:11):
I agree. I think a lot of our problems with
our children can be solved with simple conversations. You know,
and I don't know that we in the community of
parents these days have enough of those, often enough and
early enough.
Speaker 2 (15:24):
Absolutely, I agree with you that I think communication and
that I say as not only a pediatrician, but as
a mom who's learning every day. I have. One of
my four kids is starting high school this week, and I,
you know, just trying in my head to do checklists
(15:44):
of all of the conversations that I want to be
able to have with him and to keep the lines
of communication open. I want him to feel that he
can talk to me. But I think on so many levels,
communicating with our kids is key because you know, finding
out how was your day, like, what what really happened
in your day, what was good about your day, what
(16:06):
what what wasn't Those are things that whether your child
has a food allergy or not, those open doors to
you know, understanding more about how they are feeling throughout
the day when you're not there, right.
Speaker 1 (16:20):
And I love that you said it like that because
in our house, you know, we tried to make sitting
at the table of important regular activity. My youngest is
now a senior this year in high school, so I wow,
feel you. But that was one of the things that
we would do is discuss and you know, we called
it the high low game. And I actually saw it
(16:41):
on a movie and I can't remember which one, but
you know, what's your high point of the day and
what's your low point? And they were grown Oh, this
is stupid, Mom. I don't want I don't want to
do this. I don't want to talk. And I'd be like, Nope,
this is what we do here at this table of
those phones and all the digital stuff is not here,
you know, and this is time for us to really
connect and me to learn exactly what's going on in
(17:02):
your life, you know. And it ended up every single
time with some of the greatest conversations between not only
me and the kids, but the kids themselves, and it
kind of bonded them together. Let's shift gears for a second.
Let's talk about some of the treatments and things that
are available for people with food allergies these days.
Speaker 2 (17:21):
So, first and foremost, if you see someone who is
experiencing a severe allergic reaction, really we have one treatment
and one treatment only, and that is an epinephrine autoinjector.
So if we see that someone is having a severe
allergic reaction, which is called anaphylaxis, we say EPI first
(17:44):
and EPI fast, and that's what that student, child, adult,
anyone with a severe allergic reaction needs. And we qualify
a severe allergic reaction as you know, two or more
mild symptoms or involving two body systems or involving either
(18:05):
respiratory system or change in vital signs, so we really
look at what is happening in that individual, but especially
in kids. I always say, if you suspect anaphylaxis, you
give that EPI first and EPI fast. But the way
that people with food allergies are really dealing with their
day to day is through prevention and avoidance, which is
(18:29):
what makes having a food allergy so difficult because you know,
we have to eat for, you know, our own sustenance,
but we also eat for enjoyment and celebration. So just
monitoring that in every way. And then there are therapies
that are out there. There's one FDA approved therapy for peanuts,
(18:51):
which is an oral ambunotherapy, and it involves, under the
care of the physician, giving small amounts of the allergen
to try to build up, you know, an ability to
if you were exposed to that allergen not have a
severe allergic reaction.
Speaker 1 (19:11):
Okay, now, I know I've heard in the past complaints
that the EPI devices can be expensive. Are there options
out there to get help with those, because I know
you need more than just one. Are there options to
help you get the one. How many of her you need?
Speaker 2 (19:27):
Absolutely, so you can look on a lot of the
manufacturer site for the Epineffron autoinjectors. There are coupons that
you could use. Fair has been involved in advocacy for
different legislation to look at capping the price of EpiPens.
So we're seeing improvement in this. But I would always
say as a food allergy parent to you know, make
(19:51):
sure that you are even talking to the pharmacist and
making sure that you're getting the best price that you
possibly can for the EpiPen, because you are right. I
can tell you we have EpiPens at home. I have
EpiPens at school. I have EpiPens that travel in soccer bags.
I have EpiPens that travel in basketball bags. So really
(20:15):
making sure that wherever my son is an EpiPen is
an epinephrine auto injector, because there are many types, is
accompanying him as well.
Speaker 1 (20:26):
Okay, now is there a place that you don't want
to keep one? Like is it going to negatively affect
the medication if you leave it in a hot car?
Speaker 2 (20:35):
Absolutely? Great question. So you do have to be mindful
of the temperature. So an epinephrine autoinjector does not do
well in extreme temperatures. Now there are ways to handle this,
and we've gotten special carrying cases. If I know we're
going to be skiing, because you know, that's when you
think about how food allergies affect people. You could be
(20:59):
at the top of a mountain in and still need
to have your epinefern auto injector with you. You could
be at summer camp in the you know, on the
hottest day of camp, and you still need to have
your epiniffrin auto injector with you. So there are ways
that we look at temperature controlling. There are some types
of carrying cases that will allow for easier control of that,
(21:24):
but you do have to be mindful of temperature, you know,
the very low and the very high. It is definitely
recommended to not keep an epineffern autoinjector in your car,
especially on very hot or very cold days.
Speaker 1 (21:40):
Okay, that is good to know. So how many should
a person keep?
Speaker 2 (21:45):
So really, you know, you don't we happen to keep
the epineffern autoinjectors in you know, his bags, just as backup.
But what we really do is I have one case
that you go with him all of the time, and
then we keep an epineprin auto injector at school as well,
(22:06):
so the nurse's office keeps one for him, and then
there is one that travels with him all the time.
So for us, we've got a red case that he knows,
you know, when he comes in, it's left by the door,
and when he leaves, he takes that as well. His
happens to be able to clip to his bike, it
can clip to his backpack, so he can just kind
(22:28):
of bring that with him wherever and whenever he leaves you.
As you said before, these are expensive, so it's not
you know, you are sometimes limited to, you know, having
one or two of these quote unquote duo packs that
are out there, so you know, certainly having one that
(22:49):
goes with you all the time, and for students one
that remains at school.
Speaker 1 (22:54):
Right, So let's shift gears now and talk about a
little bit of the research and things about that that
are going into allergies and stuff, because, like you said,
there's there's this I guess you said it's a new
pill that allows peanut allergy people to possibly not always,
but possibly gain more of a tolerance. So it's not
(23:16):
as severe of a reaction. I personally have a high
school friend who I caught up with I don't know,
maybe five ten years ago, and she had never had
allergies in her life and was starting to have allergies
to things that she's eaten forever. And it was like,
you know, all of a sudden, she would try something,
(23:37):
and all of a sudden, she's having a severe hospital
you know, life threatening reaction. And they would give her,
you know, the epinephrine and all that, and then she'd
be fine. She'd know not to eat that anymore. And
it was really starting to negatively affect her ability to
eat in general, Like it was getting out of hand.
And she found a doctor, I want to say, out
in California, somewhere on the West coast who you had
(24:01):
zeroed in on a particular condition, and I don't remember
the name, but she had to fly out there and
she had like a almost laparoscopic brain surgery of sorts
where he fiddled in her brain and all those allergies
went away. But that's not to say that that's true
for all allergies.
Speaker 2 (24:19):
Correct, Yeah, No, that certainly is not a regimen that
I'm as familiar with but what we are seeing and
the point that you make, we are seeing a lot
more adult onset food allergies. Right now. We're seeing that
about thirty three million people in our country are affected
(24:40):
by food allergies. So again with back to school, when
you think about that, that's like one in every thirteen
kids or two in every classroom across our country. So
really a lot of people who are involved. And you know,
research is at the core of that. And one of
FAIR again food allergy Research and Education missions is to
(25:01):
improve the quality of life of the food allergy community.
And one of the main pillars of that is to
do that through transformative research. We also do it through
education and through advocacy. And I can say that as
a pediatrician and as a mom to a food allergic son,
I am really hopeful right now. I think that there
(25:24):
are a lot of places in the research worlds that
give me hope that at some point my son's life
will not be the same as it is today. And
I think that, you know, certainly one of the missions
at FAIR is to support that research, and I think
that those options are going to come to fruition in
(25:46):
the next few years.
Speaker 1 (25:47):
Yeah, that's that's great news. And I don't know if
this is true, and I'm not sure if you know
this either as a pediatrician, but I have even heard
that some gynecologists are telling vermenopausal and menopausal women that
allergies can be a part of that process as well.
Have you heard that?
Speaker 2 (26:06):
So anytime your body is shifting in many ways, you
know there obviously I could see that the link there
would be something about your body is shifting from a
hormonal basis. But really, adult onset food allergies can happen
at any time, which is why if you feel particular
symptoms to something that you've eaten, it's important to note
(26:30):
that and and talk to your physician about it. Because
we are seeing a higher incidence of adult onset food allergies,
and that's different than it was decades ago.
Speaker 1 (26:43):
Right, definitely. So I'm just the curious person and you're
the expert. Is there anything that my audience needs to
know about this subject that I just didn't know to
ask you about.
Speaker 2 (26:54):
What I would say is as a food allergy parent,
So if you are listening and you have a food
allergic student who's going back to school, it's really important
to communicate to everyone at that school. So bringing in
your medical forms that have your child's allergens clearly identified,
(27:15):
having unexpired medications there, knowing what the policy and procedures
for the school are, what happens on a field trip,
what happens when there's a substitute teacher, things like where
are the EpiPens kept? Who is trained in that school?
So really asking the question to keep your child safe,
(27:35):
and if you are listening and your a parent and
your child doesn't have food allergies, really asking your child
to empathize and to think, well, what if I couldn't
do that, how would it feel? And how can I
possibly make the day to day life of one of
my friends in my class with food allergies a little
bit easier?
Speaker 1 (27:56):
Yeah, definitely I love that answer. So I think we've
covered it pretty well. But I definitely want you to
plug your website.
Speaker 2 (28:04):
Great because our website has so many resources Food allergy
dot org. And I say that as a caregiver, So
if you have a child with food allergies, we have
tons of resources on tips and tricks for travel and
for dining out. If you're a school administrator or a teacher,
(28:25):
we've got webinars that have been recorded, and resources that
are really geared towards school professionals in recognizing and responding
to anaphylaxis, knowing the signs and symptoms. If you're a
parent or a teacher, we have be a pal as
I mentioned before, the protect a Life course. If you're
(28:47):
working in food service, we have a course called fair
Check where your food service staff could be educated on
how to keep your kitchen safer for all of your
food allergic patrons. So really a lot of resources on
our website, but foodalergy dot org and you can always
(29:08):
find me at education at food allergy dot org. That's
my email.
Speaker 1 (29:12):
Awesome, I love it. Do you think we've covered it
pretty well?
Speaker 2 (29:16):
I think we did well.
Speaker 1 (29:17):
Thank you so much for coming on the show today.
I really really appreciate your time.
Speaker 2 (29:22):
Thank you so much for having me. I can talk
about food allergies forever, such an important topic.
Speaker 1 (29:29):
I hope you have enjoyed today's show. Thanks for tuning
in to the show on your favorite local radio station.
You can now listen to this show or past shows
through the iheartapp or on iHeart dot com. Just search
for Virginia Focus under podcasts. I'm Rebecca Hughes with a
Virginia News Network, and I will be here next week
on Virginia Focus.
Welcome to Virginia Focus. I'm Rebecca Hughes of the Virginia
News Network. Since one in three children in the United
States deals with food allergies, it's imperative that parents be
prepared and help their children and their classmates learn about
the possible consequences of allergic reactions. On this episode, we're
discussing innovative treatments, the latest guidance for epidevices, legislation to
(00:29):
increase research funding, and more. Let's get more information from
Fair Senior Director of Education and Support, Doctor Kelly Cleary.
Welcome to the show, Doctor Cleary. I'm so glad you
made time to speak with us today about this very
important topic.
Speaker 2 (00:44):
Thanks so much for having me. I'm excited to be here.
Speaker 1 (00:48):
So today we're talking about food allergies and of course
with the kids going back to school, that is definitely
something that needs to be discussed in and people need
to be educated about. Why don't you tell us your
experience and what makes you an expertise in this area?
Speaker 2 (01:05):
Sure? So, I am a pediatrician. My background is in
emergency medicine and also mental health. So I have taken
care of kids and teens and young adults coming into
the emergency department with severe allergic reactions. But I've also
been on the other side of it in the past
(01:25):
few years to understand the psychosocial elements of food allergies
as well and how that affects this community. And then
I am also a mom of four kids, one of
whom has multiple anaphylactic food allergies. So I do this
for a living, but I also do it at home.
Speaker 1 (01:45):
Oh wow, since you do have some first hand experience,
why don't you share with our audience. How did you
find out that your child had these allergies? Like the
first you know, the first go around, what happened that
told you you had an issue?
Speaker 2 (02:00):
So my son was actually diagnosed very young. He was
one of those infants that had very severe ezema from
the get go, so his skin was just inflamed, I
want to say, since he's been a few weeks old,
so we knew to really explore that there was something
else going on with him and ended up going down
(02:23):
the food allergy route. Lots of times that's not the case,
and the first exposure to an allergen is often the
first sign that there may be a problem. So we
had a different entry into that because of his severe eczema.
But often it's that someone will ingest a food and
(02:44):
then from there have a reaction to it. Sometimes you know,
a mild reaction and then people are pursuing is this
really an allergy?
Speaker 1 (02:53):
Okay, So let's talk about those reactions for a second,
because I think some of those can often be overlooked.
Like you said, they're mild, what would we look for
if we're having a reaction to a food.
Speaker 2 (03:05):
So, as you said, you hit the nail on the
head that reactions, they can really vary in the way
that they present. So some could be really mild where
you're seeing a mild rash or some sneezing or some
itchy eyes, but they could really progress to being involving
(03:26):
multiple symptoms and multiple systems, so involving the gastro intestinal
system with nausea, vomiting, diarrhea, sometimes causing vital sign changes
like a change in how fast your heart is beating
or a change in your blood pressure. Sometimes they can
involve dizziness or feeling you know, just something isn't right
(03:49):
in the way that kids or young adults are feeling
or adults. So really the spectrum of what we see
is very different. You'll hear often for food allergies that
people talk about having something in their throat or not
being able to breathe, And those are two definite signs
that we see where we could have difficulty in breathing
(04:13):
or swelling in the mouth or mucus membranes. So you're
looking for things like rash, swelling, sometimes changes in vital
signs which would indicate a more severe reaction, but difficulty breathing.
All of those would constitute a reaction. But it's a
spectrum of symptoms that we see.
Speaker 1 (04:34):
Okay, So could it be something as minor as maybe
a tickle in your throat or is that something completely different?
Speaker 2 (04:40):
Absolutely, it can start off as something very minor. It
could start off as a mild symptom like one or
two hives around your lips, or one or two hives
somewhere on your body. Certainly a tickle in the throat.
So are those are mild symptoms that you would see
of people having food allergic reaction?
Speaker 1 (05:02):
Now, when we're talking about children in school generally speaking,
I think, and you're the expert. Of course, by the
time they get to school, they kind of know. Parents
know what they are and are not allergic to is
would you say that's correct?
Speaker 2 (05:17):
So that's what we always assumed, But what we're seeing
more of now is that twenty five percent of kids
who are requiring epinephrine for anaphylaxis have never had a
diagnosis of a food allergy. So we are seeing this
event where kids who had no prior knowledge that they
(05:38):
had food allergies are manifesting their first signs of food
allergies in school. Which is why it is just so
important that anyone taking care of kids and students really
understands food allergies well, because the first sign of a
reaction could be the first presentation for that student.
Speaker 1 (05:59):
Wow. Yeah, okay, So I'm glad I asked that question.
I know personally, I have three children, and my daughter,
she used to complain about stomach issues. But she was
also like one of those really dramatic kids, you know
what I'm saying, And she had a little streak in
her that was a little manipulative, and so she would,
you know, if I had some ice cream, I would
(06:20):
feel better. But it turns out she's lactose intolerant, and
it took us a while quite a while to figure
that out what's your advice to parents on how to
get those diagnoses sooner.
Speaker 2 (06:35):
So I think you bring up a couple of great
points there. The first is the difference between food allergies
and food intolerances.
Speaker 1 (06:43):
So, as you.
Speaker 2 (06:44):
Noted, food intolerances often involve the GI system or gastro
intestinal system and can involve things like bloating or abdominal
pain or you know, sometimes change in stool, and that
is often a reaction to a food indicating an intolerance,
(07:06):
whereas a food allergy is an immune mediated response that
can be life threatening. So just to kind of put
those two out there, but I agree with you that
out of my four kids, I certainly have a couple
of them who have many more complaints than others. And
I think that in those kids, it's hard for us
(07:28):
to decipher, you know, what needs medical attention and what
does it. I know that my general rule of thumb
as a pediatrician and as a parent is if they're
complaining repetitively, if those complaints are not going away and
they're getting worse, I often go in. Again, as a
(07:49):
pediatrician who has had a lot of experience in the
past few years in mental health, one of the other
things that we don't want to ignore is that sometimes
what we call all these somatic complaints, things like headaches
or belly aches or body aches and pains, could also
indicate that our kids are going through tough times with
things like anxiety and oppression. So really bringing them into
(08:12):
their pediatrician, and even if you're bringing them into the
pediatrician to say they are complaining of belly aches, you know,
five times a week when they're going to school, I
think it's really important to just address those concerns and
make sure that we're not missing anything in our kids.
Speaker 1 (08:30):
Yeah, I definitely agree with that. For sure. You got
lucky and got your diagnosis early. I felt so guilty
when I found out she had that intolerance, you know,
like I had just been talking it up to her
being mischievous because she typically is, and that was that
was a horrible thing to go through as a parent.
But I can only imagine, you know, the struggles that
(08:50):
she endured. I know earlier you said something about these
sociosocial impacts of these allergies, right, is that what you
called it?
Speaker 2 (08:59):
Psychosocial?
Speaker 1 (09:00):
Yeah? So social, while't we talk about that a little bit?
Tell us what that means.
Speaker 2 (09:03):
Absolutely, and I'll also tell you no guilt. You know,
sometimes diagnoses take a long time to make and I
think as parents, we always you know, kind of put
that on ourselves, but you know, we also have to
definitely give ourselves a little bit of grace in understanding
that sometimes it's a process and it's not always going
(09:26):
to be on that first visit that they pick up
something like a lactose intolerance. But the psychosocial impact of
food allergies, I think is really important because we're seeing
in this population and community a lot higher incidents of
anxiety and depression. We're also seeing a higher incidence of
(09:46):
bullying in this population. So about one in three kids
with food allergies is reporting bullying. And what makes bullying
different in the food allergy community is that sometimes a
bullying is actually done with the allergen. So not only
is this bullying, you know, affecting a child's emotional well being,
(10:09):
but it's threatening their physical well being, you know, if
someone is putting their allergen in their face or throwing
their allergen. So the psychosocial impact of food allergies is
one that I know we at FAIR are really paying
attention to as are lots of medical professionals because the
day to day, you know, walking a life in the
(10:32):
shoes of a kid or a teen or young adult
or adult with a food allergy, there are a lot
of places where anxiety is high. And you know, if
you had to think about you know what if you
couldn't participate in having a birthday cake at the birthday
(10:52):
party that you went to, or you know, if you
were a fourth grader and needed to navigate how do
you tell your friends that you can't have pizza on
Pizza Fridays or after the big soccer game on Sunday
and everybody is eating a treat that's brought from another parent,
not being able to eat that, or advocating for yourself
(11:12):
and asking all the questions that need to be asked.
So there's lots of places where we see anxiety popping
up in this population.
Speaker 1 (11:23):
Wow, yeah, I hadn't really thought about that, but you're right. Then,
when you're a kid, there's this desire to fit in
and anything about you that is different is seen sometimes
as a negative thing, which is honestly ridiculous. I personally
have tried to teach my children that weird is the
way to go. But you know, what can we do
(11:46):
to support children, both the ones with the allergies who
are suffering these things, but also to educate and help
the bullying children to understand the severity of what they're doing.
Speaker 2 (12:00):
So it's all about inclusivity. And I think that this
extends even beyond food allergies. I think, as you pointed out,
it just extends wherever there's a difference. When my son
was little, we used to call his food allergy his
quote unquote special and then as he started meeting kids
that had other issues that they were facing. You know,
(12:21):
we had a good friend that had type one diabetes
and you know, he was maybe three and a half,
and he asked me, is that her special? And you know,
we really started to kind of talk about that everyone
has something special about them. Sometimes there are things that
we just see and know about a lot more quickly.
(12:42):
But I think that it's about inclusivity, and I think
that this time of year and back to school is
a great time as parents and caregivers that we start
to talk about that. One of the resources that Fair
has is called be a PAL, and PAL stands for
protect the life life, but it's not focused on you know, oh,
(13:03):
how do you administer an EpiPen? We have those resources
and those are geared towards adults, but this resource is
really geared toward how could you be a good friend
to someone who has food allergies and how could you
be more inclusive to that friend? What could you maybe
think about? And it's sometimes as easy as washing your
(13:24):
hands after you eat, or you know, thinking about what
you can do to kind of bring in so that
if you're celebrating your birthday, everyone is included, and you know,
non a non food and you know, a non food treat,
or ask the teacher if you could go out for
more recess. You know, my son has certainly found ways.
(13:48):
I'll tell you the one of the best stories that
I had was when the principal told me that the
allergy table was getting a little rowdy. And what we
found out was that a bunch of my my son's
you know, good friends who are all just wonderful kids,
were asking their parents to send in allergy free lunches.
(14:10):
And so this table was growing in size and started
to be the loudest table in the cafeteria and they
were having a fun, rowdy time with each lunch. And
you know, as much as most calls from the principal
would would make me having a sit down with my son,
this one did not. I was proud of him for
(14:34):
advocating for himself, and I was proud of his friends
for really being inclusive of him. One of the things
at FAIR that we say for parents and caregivers is
teaching your child you know what if you couldn't you know,
what if you couldn't trick or treat the same way
that everyone else on the block could. What if you couldn't,
(14:54):
you know, enjoy a cupcake at the end of a
classroom birthday celebration. I think get Really, kids want to empathize,
and I think that that teaches them a bit more
how to if they really think about, oh wow, if
that was me, you know, how would I feel? Yeah?
Speaker 1 (15:11):
I agree. I think a lot of our problems with
our children can be solved with simple conversations. You know,
and I don't know that we in the community of
parents these days have enough of those, often enough and
early enough.
Speaker 2 (15:24):
Absolutely, I agree with you that I think communication and
that I say as not only a pediatrician, but as
a mom who's learning every day. I have. One of
my four kids is starting high school this week, and I,
you know, just trying in my head to do checklists
(15:44):
of all of the conversations that I want to be
able to have with him and to keep the lines
of communication open. I want him to feel that he
can talk to me. But I think on so many levels,
communicating with our kids is key because you know, finding
out how was your day, like, what what really happened
in your day, what was good about your day, what
(16:06):
what what wasn't Those are things that whether your child
has a food allergy or not, those open doors to
you know, understanding more about how they are feeling throughout
the day when you're not there, right.
Speaker 1 (16:20):
And I love that you said it like that because
in our house, you know, we tried to make sitting
at the table of important regular activity. My youngest is
now a senior this year in high school, so I wow,
feel you. But that was one of the things that
we would do is discuss and you know, we called
it the high low game. And I actually saw it
(16:41):
on a movie and I can't remember which one, but
you know, what's your high point of the day and
what's your low point? And they were grown Oh, this
is stupid, Mom. I don't want I don't want to
do this. I don't want to talk. And I'd be like, Nope,
this is what we do here at this table of
those phones and all the digital stuff is not here,
you know, and this is time for us to really
connect and me to learn exactly what's going on in
(17:02):
your life, you know. And it ended up every single
time with some of the greatest conversations between not only
me and the kids, but the kids themselves, and it
kind of bonded them together. Let's shift gears for a second.
Let's talk about some of the treatments and things that
are available for people with food allergies these days.
Speaker 2 (17:21):
So, first and foremost, if you see someone who is
experiencing a severe allergic reaction, really we have one treatment
and one treatment only, and that is an epinephrine autoinjector.
So if we see that someone is having a severe
allergic reaction, which is called anaphylaxis, we say EPI first
(17:44):
and EPI fast, and that's what that student, child, adult,
anyone with a severe allergic reaction needs. And we qualify
a severe allergic reaction as you know, two or more
mild symptoms or involving two body systems or involving either
(18:05):
respiratory system or change in vital signs, so we really
look at what is happening in that individual, but especially
in kids. I always say, if you suspect anaphylaxis, you
give that EPI first and EPI fast. But the way
that people with food allergies are really dealing with their
day to day is through prevention and avoidance, which is
(18:29):
what makes having a food allergy so difficult because you know,
we have to eat for, you know, our own sustenance,
but we also eat for enjoyment and celebration. So just
monitoring that in every way. And then there are therapies
that are out there. There's one FDA approved therapy for peanuts,
(18:51):
which is an oral ambunotherapy, and it involves, under the
care of the physician, giving small amounts of the allergen
to try to build up, you know, an ability to
if you were exposed to that allergen not have a
severe allergic reaction.
Speaker 1 (19:11):
Okay, now, I know I've heard in the past complaints
that the EPI devices can be expensive. Are there options
out there to get help with those, because I know
you need more than just one. Are there options to
help you get the one. How many of her you need?
Speaker 2 (19:27):
Absolutely, so you can look on a lot of the
manufacturer site for the Epineffron autoinjectors. There are coupons that
you could use. Fair has been involved in advocacy for
different legislation to look at capping the price of EpiPens.
So we're seeing improvement in this. But I would always
say as a food allergy parent to you know, make
(19:51):
sure that you are even talking to the pharmacist and
making sure that you're getting the best price that you
possibly can for the EpiPen, because you are right. I
can tell you we have EpiPens at home. I have
EpiPens at school. I have EpiPens that travel in soccer bags.
I have EpiPens that travel in basketball bags. So really
(20:15):
making sure that wherever my son is an EpiPen is
an epinephrine auto injector, because there are many types, is
accompanying him as well.
Speaker 1 (20:26):
Okay, now is there a place that you don't want
to keep one? Like is it going to negatively affect
the medication if you leave it in a hot car?
Speaker 2 (20:35):
Absolutely? Great question. So you do have to be mindful
of the temperature. So an epinephrine autoinjector does not do
well in extreme temperatures. Now there are ways to handle this,
and we've gotten special carrying cases. If I know we're
going to be skiing, because you know, that's when you
think about how food allergies affect people. You could be
(20:59):
at the top of a mountain in and still need
to have your epinefern auto injector with you. You could
be at summer camp in the you know, on the
hottest day of camp, and you still need to have
your epiniffrin auto injector with you. So there are ways
that we look at temperature controlling. There are some types
of carrying cases that will allow for easier control of that,
(21:24):
but you do have to be mindful of temperature, you know,
the very low and the very high. It is definitely
recommended to not keep an epineffern autoinjector in your car,
especially on very hot or very cold days.
Speaker 1 (21:40):
Okay, that is good to know. So how many should
a person keep?
Speaker 2 (21:45):
So really, you know, you don't we happen to keep
the epineffern autoinjectors in you know, his bags, just as backup.
But what we really do is I have one case
that you go with him all of the time, and
then we keep an epineprin auto injector at school as well,
(22:06):
so the nurse's office keeps one for him, and then
there is one that travels with him all the time.
So for us, we've got a red case that he knows,
you know, when he comes in, it's left by the door,
and when he leaves, he takes that as well. His
happens to be able to clip to his bike, it
can clip to his backpack, so he can just kind
(22:28):
of bring that with him wherever and whenever he leaves you.
As you said before, these are expensive, so it's not
you know, you are sometimes limited to, you know, having
one or two of these quote unquote duo packs that
are out there, so you know, certainly having one that
(22:49):
goes with you all the time, and for students one
that remains at school.
Speaker 1 (22:54):
Right, So let's shift gears now and talk about a
little bit of the research and things about that that
are going into allergies and stuff, because, like you said,
there's there's this I guess you said it's a new
pill that allows peanut allergy people to possibly not always,
but possibly gain more of a tolerance. So it's not
(23:16):
as severe of a reaction. I personally have a high
school friend who I caught up with I don't know,
maybe five ten years ago, and she had never had
allergies in her life and was starting to have allergies
to things that she's eaten forever. And it was like,
you know, all of a sudden, she would try something,
(23:37):
and all of a sudden, she's having a severe hospital
you know, life threatening reaction. And they would give her,
you know, the epinephrine and all that, and then she'd
be fine. She'd know not to eat that anymore. And
it was really starting to negatively affect her ability to
eat in general, Like it was getting out of hand.
And she found a doctor, I want to say, out
in California, somewhere on the West coast who you had
(24:01):
zeroed in on a particular condition, and I don't remember
the name, but she had to fly out there and
she had like a almost laparoscopic brain surgery of sorts
where he fiddled in her brain and all those allergies
went away. But that's not to say that that's true
for all allergies.
Speaker 2 (24:19):
Correct, Yeah, No, that certainly is not a regimen that
I'm as familiar with but what we are seeing and
the point that you make, we are seeing a lot
more adult onset food allergies. Right now. We're seeing that
about thirty three million people in our country are affected
(24:40):
by food allergies. So again with back to school, when
you think about that, that's like one in every thirteen
kids or two in every classroom across our country. So
really a lot of people who are involved. And you know,
research is at the core of that. And one of
FAIR again food allergy Research and Education missions is to
(25:01):
improve the quality of life of the food allergy community.
And one of the main pillars of that is to
do that through transformative research. We also do it through
education and through advocacy. And I can say that as
a pediatrician and as a mom to a food allergic son,
I am really hopeful right now. I think that there
(25:24):
are a lot of places in the research worlds that
give me hope that at some point my son's life
will not be the same as it is today. And
I think that, you know, certainly one of the missions
at FAIR is to support that research, and I think
that those options are going to come to fruition in
(25:46):
the next few years.
Speaker 1 (25:47):
Yeah, that's that's great news. And I don't know if
this is true, and I'm not sure if you know
this either as a pediatrician, but I have even heard
that some gynecologists are telling vermenopausal and menopausal women that
allergies can be a part of that process as well.
Have you heard that?
Speaker 2 (26:06):
So anytime your body is shifting in many ways, you
know there obviously I could see that the link there
would be something about your body is shifting from a
hormonal basis. But really, adult onset food allergies can happen
at any time, which is why if you feel particular
symptoms to something that you've eaten, it's important to note
(26:30):
that and and talk to your physician about it. Because
we are seeing a higher incidence of adult onset food allergies,
and that's different than it was decades ago.
Speaker 1 (26:43):
Right, definitely. So I'm just the curious person and you're
the expert. Is there anything that my audience needs to
know about this subject that I just didn't know to
ask you about.
Speaker 2 (26:54):
What I would say is as a food allergy parent,
So if you are listening and you have a food
allergic student who's going back to school, it's really important
to communicate to everyone at that school. So bringing in
your medical forms that have your child's allergens clearly identified,
(27:15):
having unexpired medications there, knowing what the policy and procedures
for the school are, what happens on a field trip,
what happens when there's a substitute teacher, things like where
are the EpiPens kept? Who is trained in that school?
So really asking the question to keep your child safe,
(27:35):
and if you are listening and your a parent and
your child doesn't have food allergies, really asking your child
to empathize and to think, well, what if I couldn't
do that, how would it feel? And how can I
possibly make the day to day life of one of
my friends in my class with food allergies a little
bit easier?
Speaker 1 (27:56):
Yeah, definitely I love that answer. So I think we've
covered it pretty well. But I definitely want you to
plug your website.
Speaker 2 (28:04):
Great because our website has so many resources Food allergy
dot org. And I say that as a caregiver, So
if you have a child with food allergies, we have
tons of resources on tips and tricks for travel and
for dining out. If you're a school administrator or a teacher,
(28:25):
we've got webinars that have been recorded, and resources that
are really geared towards school professionals in recognizing and responding
to anaphylaxis, knowing the signs and symptoms. If you're a
parent or a teacher, we have be a pal as
I mentioned before, the protect a Life course. If you're
(28:47):
working in food service, we have a course called fair
Check where your food service staff could be educated on
how to keep your kitchen safer for all of your
food allergic patrons. So really a lot of resources on
our website, but foodalergy dot org and you can always
(29:08):
find me at education at food allergy dot org. That's
my email.
Speaker 1 (29:12):
Awesome, I love it. Do you think we've covered it
pretty well?
Speaker 2 (29:16):
I think we did well.
Speaker 1 (29:17):
Thank you so much for coming on the show today.
I really really appreciate your time.
Speaker 2 (29:22):
Thank you so much for having me. I can talk
about food allergies forever, such an important topic.
Speaker 1 (29:29):
I hope you have enjoyed today's show. Thanks for tuning
in to the show on your favorite local radio station.
You can now listen to this show or past shows
through the iheartapp or on iHeart dot com. Just search
for Virginia Focus under podcasts. I'm Rebecca Hughes with a
Virginia News Network, and I will be here next week
on Virginia Focus.
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