May 27, 2025 • 54 mins
In this insightful episode of Don't Feed the Fear, researcher/physician Dr. Scott Sicherer and author/food allergy coach Sloane Miller join Dr. Amanda Whitehouse for a panel discussion focusing on the complexities of dating and physical intimacy for individuals with food allergies.
The group discusses evidence-based guidelines for kissing and physical intimacy when managing food allergies. Dr. Sicherer shares findings from his research and provides practical advice for patients. The discussion includes common concerns and questions voiced within the allergy community, emphasizing the importance of open communication with partners and proactive planning to prevent allergic reactions during intimate moments.
Please note: This episode contains discussions on mature topics, including dating, intimacy, and emotional well-being in the context of food allergies. These subjects may not be suitable for young children. Listener discretion is advised.
Listeners will gain valuable insights into:
- The science behind allergen persistence in saliva and its implications for physical intimacy.
- Practical steps to minimize the risk of allergic reactions during close contact.
- Strategies for discussing food allergies with partners to foster understanding and safety.
- Examples of ways to talk about this with children beginning at a young age.
To support this discussion, Dr. Whitehouse has created a free handout summarizing the key takeaways from this two-part series. Listeners can request this resource by contacting her through Instagram at @thefoodallergypsychologist or through her website: Connect — Amanda Whitehouse Phd.
This episode aims to empower individuals with food allergies to navigate their personal relationships confidently and safely.
Dr. Sicherer and colleagues' 2006 study: Peanut allergen exposure through saliva: Assessment and interventions to reduce exposure - ScienceDirect
Sloane Miller: www.allergicgirl.com
Special thanks to Kyle Dine for permission to use his song The Doghouse for the podcast theme!
www.kyledine.com
Find Dr. Whitehouse:
-thefoodallergypsychologist.com
-Instagram: @thefoodallergypsychologist
-Facebook: Dr. Amanda Whitehouse, Food Allergy Anxiety Psychologist
-welcome@dramandawhitehouse.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker (00:01):
Welcome to the Don't Feed the Fear podcast, where we
dive into the complex world offood allergy anxiety.
I'm your host, Dr.
Amanda Whitehouse, food allergyanxiety psychologist and food
allergy mom.
Whether you're dealing withallergies yourself or supporting
someone who is, join us for anempathetic and informative
journey toward food allergy calmand confidence..
(00:28):
Welcome back to the Don't Feedthe Fear Podcast.
We are here on the springseason..
We are talking about things thatwe don't want to talk about.
I am trying to create a spacehere for the conversations that
we tend to avoid, that we don'twant to talk about because
they're uncomfortable.
We might not have as muchinformation about.
We might be uncomfortableasking, and today's exception
(00:48):
might be the peak of that.
We are addressing theintersection of food allergies
and physical intimacy.
This is a subject that issensitive, but it's very
important for people who arenavigating relationships with
food allergies.
Parents don't want to talk totheir kids about it.
Our kids don't want to hearabout it, especially from us,
but it's very important for allof us to know.
(01:10):
I have two amazing guests hereto help me with this
conversation.
The first is the expert on thistopic, Dr.
Scott Sicherer.
He is the director of the Elliotand Roslyn Jaffe Food Allergy
Institute.
He is the chief of the Divisionof Allergy and Immunology in the
Department of Pediatrics andMedical director of the Clinical
Research Unit.
He is a clinician and a clinicalresearcher, he's written several
(01:33):
books on the topic, the mostrecent of which is the Complete
Guide to Food Allergies inAdults and Children that came
out in 2022.
And relevant to today'sconversation, he is a co-author
of a very important paper thatwas published in 2006 In the
Journal of Allergy and ClinicalImmunology about peanut allergen
exposure through saliva.
(01:53):
So this was the first paper toexplore and document what is
happening with allergens left inour mouth after we eat, so that
we could get an understanding ofwhether there is risk in
kissing.
So I'm so grateful to have Dr.
Sicherer here to talk about allof his knowledge with us, our
other esteemed guest today isSloane Miller.
Sloane holds a master of finearts degree, a master of social
(02:14):
work degree, and a certificatein professional coaching, and
she's a specialist in foodallergy management.
She is the author of the MemoirAllergic Girl, and she's the
founder and president ofAllergic Girl Resources, a
consultancy devoted to foodallergy awareness.
She combines a lifetime of herpersonal experience living with
food allergies with herprofessional expertise to
connect with people about how tolive safely, effectively, and
(02:37):
joyously with food allergies.
You can findher@allergicgirl.com.
And it was Sloane's idea to havea discussion on this topic with
Dr.
Sicherer to explore the medicalrealities of food allergies in
the context of relationships andphysical intimacy and strategies
for communicating thatunderstanding to our children
and helping them to communicatethem to the people that they
(02:58):
enter into relationships withyou.
So I'm so appreciative to Sloanefor the great idea and excited
to share this conversation withyou.
But first, please be aware thatthis episode does contain
discussions on sensitive andmature topics related to
physical intimacy Listenerdiscretion is advised and we
recommend not playing thisepisode with young children
present.
Dr. Amanda Whitehouse (03:16):
So thank you everybody for joining us to
listen.
We wanted to record this panelconversation today for, parents,
for any providers who werecurious about how do I talk to.
Kids and young adults aboutsafety and their food allergies.
When it comes to sensitivetopics like relationships,
dating, physical intimacy, it'sa difficult topic.
Sloane.
You suggested that we do thisand I think you had a lot of
(03:36):
good thoughts on why this is areally needed conversation.
Sloane Miller (Allergic G (03:40):
Thank you so much, Amanda, and it's
such a pleasure to be here withboth of you today.
And what I'm seeing in my foodallergy coaching practice, and
again, that's also aself-selecting group, I.
So I think there's much, muchmore going on out there that is
just not choosing to come in totalk about this or is not
(04:01):
feeling that challenged, um, orhaving challenges privately.
But what I'm seeing are theseflection points of the
beginnings of.
Intimacy and curiosity about,um, romance and physical
intimacy around, um, teenagehood, young teenage hood, right?
So late middle school, earlyjunior high.
(04:25):
And then this other flectionpoint around high school and
early college and thenpost-college.
And what I've seen in mypractice in terms of people
coming to see me, is delaying.
Intimacy because they, there'sso much fear and.
Lack of clarity around realrisks.
(04:48):
What are the real risks fromkissing?
If someone's eaten yourallergen, what do I do?
How do I have that conversation?
Who has the information?
And then as, um, I.
Young people are turning intoyoung adults.
Uh, how are you dating onTinder, you know, in your
twenties and having thisconversation?
(05:10):
Will you be rejected by futurepeople because, oh, it's just
too difficult.
Um, and certainly younger peopleare having those thoughts as
well, but that's what I'm seeingoverall delaying intimacy
because of lack of clarityaround communication what the
real risks are.
Dr. Amanda Whitehouse (05:29):
Yeah, I agree.
And I think what I see happen isthe delaying intimacy.
Based on this fear and notvalues, and then somehow an
individual's personal value isgetting clouded with or shaped
by their food allergies ratherthan what, what are my goals for
my relationships and what are myvalues around age and timing of
intimacy so, Dr.
Sicher, talk about yourresearch, please, what you know
(05:52):
and where we stand today withthe science on this topic.
Dr. Scott Sicherer (05:57):
Well, first of all, let me thank you for the
invitation to join and to speakabout this topic, which is
actually a topic that I, I, I,I'm a researcher, but I'm also a
pediatric allergist.
I see children, I see teenagers,I see young adults.
I see some non young adults.
Uh, and this is a topic thatdoes come up and I bring this
topic up, at every visitactually with that age group
(06:21):
and, um.
I will have a parent leave theroom if they want to, or if they
don't want to, they can stay.
Or if it's an 18-year-old orolder, I will definitely have
the parent, um, step out of theroom for, for this conversation.
And I've seen actually that whenI bring the conversation up, um,
the parent is act is typicallyvery comfortable with it and the
(06:42):
teenager may or may not be.
Um, but, but it is a very commonthing and I, and I, I don't
ever, not.
Talk about some aspect of this,usually about the kissing part
of it.
There's not a lot of researchabout, um, exactly what the
risks are, but like everythingelse with food allergy, I.
Part of it depends on, on theperson's own allergy.
(07:04):
Uh, if you're incrediblysensitive to trace amounts of a
food, which is not the mostcommon thing, the average
person, for example, with apeanut allergy, reacts to
essentially a peanut kernel ormore of peanuts so that, you
know, contextualizes things.
I mean, not everybody isreactive to you know, virtually
like dust amounts of it.
(07:25):
And you know, that's somethingto discuss with your allergist,
but.
In a kiss, for example.
If someone had been eating thefood that you're allergic to, of
the food is still in the mouthof the person who ate it after
they've eaten it.
Um, it will decline with time,but for some amount of time it's
there.
If the kiss is on the cheek, uh,and I actually give a scenario,
(07:49):
I kind of change it to agrandparent scenario.
So here's what I usuallyactually say to people.
It's like, well, let's say yourgrandma had milk or your grandma
ate peanut then gave you a kisson the cheek.
Um, maybe your cheek will getred, maybe it won't, but I would
not expect a severe allergicreaction from that.
I that's the typical, you know,scenario I would answer.
(08:10):
Um, is there someone who's superduper sensitive where a kiss on
the cheek after grandma ate somepeanut butter would be a
problem?
Maybe.
But for the vast majority ofpeople, it's either gonna be a
red spot or nothing.
Um, many of my patients have hadskin testing done.
They get a bump where the skintest was.
That's way more exposure than akiss should be, right?
So it's not something thatshould be a high risk scenario.
(08:33):
Then I go on and I don't take abreak like that, but uh, then I
go on and I say, now, if grandmalicked your eye, don't know why
grandma was licking your eye,but your eye would probably
swell shut because that's sortof like an open area and having
your grandma had eat, eaten somepeanut or some milk or something
and, and then your eye, your eyemight swell shut.
(08:53):
I wouldn't expect that to becomean anaphylactic reaction.
There is exception to thatmaybe, but that's not typical.
Kissing mouth to mouth andexchanging saliva.
So some people call that frenchkissing or passionate kissing.
Then it's a different storybecause now what They ate is in
the saliva and now the saliva'sin your mouth.
So basically the food is in yourmouth, and then anything's
(09:14):
possible depends on how much wasleft in there.
And, you know, there could be aneven an anaphylactic reaction
from that situation.
So that's, that's sort of myoverview.
You can ask me more questionsabout it, but, but, but that's
how I, I get the conversationgoing.
Dr. Amanda Whitehouse (09:28):
When you age up to older kids and you're
having that conversation aboutkissing or French kissing, my
kids call it movie kissing,You've laid the groundwork that
there is a possibility of areaction that will range quite
widely based on a lot offactors.
How do you advise them to enterinto that safely with.
The person they might be kissingas far as time and how much is
(09:49):
consumed and all of thosedetails,
Dr. Scott Sicherer (09:51):
Sure.
Well there's two aspects tothis.
One is, um, the idea that youhave to be thoughtful about it,
You know, there aren't a lot ofstudies on this and the types of
studies that are out there arenot, you know, super perfect at
figuring out prevalence, butroughly five to 10% of people,
older people with food allergiesreport having had some reaction
(10:13):
from kissing, and it wasprobably a surprise to them when
it happened.
They may not have thought aboutit until it happened.
They may not have discussed itwith someone before it.
It's usually not severe, but itcould be as we talked about.
So as soon as I start thatconversation with my sort of
joking way of doing it to getthe ball rolling, um.
I think that, you know,someone's already protected
(10:35):
because they may not havethought about it before, but
once they think of it now, itcould be part of the process.
And what that means, and I dobring this up as we talk about
it, it means that you wouldn'tspontaneously start, and I'll
use the term making out withsomebody at a party who you
don't have any kind ofinteraction with other than,
Hey, I'm gonna start making outwith you.
(10:56):
They don't know you, they don'tknow your allergies, you don't
know them, you don't know whatthey've eaten.
It's not a relationshipsituation.
Now, I had, uh, long ago a sayto me, um, you know, boys wanna
kiss me and they're gonna dowhatever I tell them to do for
me to be safe, for them to kissme.
Right?
There was no concern that it'sgoing to be a, a, a relationship
(11:20):
breaker or something like thatto have to say, Hey, I have
allergies.
We're, this is gonna be a littleodd, but I want to talk to you
before we would start, you know,kissing, uh, and, and so again,
not having a, you know, in myday it was spin the bottle kind
of thing, but not having just,you know, spontaneous kissing,
(11:40):
but in a relationship then yourfood allergy is known.
And so, uh, then I could givethe instruction, right, of what
would you tell a partner whoyou're going to be definitely
passionately kissing with whatshould they do, uh, to make that
safe.
And so, so part of theconversation is not having
(12:02):
spontaneous make out sessions.
The other part of theconversation as well, if you are
going to be passionatelykissing, what are the safety
rules?
And so this goes to a study thatwe did many years ago.
Where we said, Hey, you know,let's pick a food.
And we picked peanut.
We had people who are notallergic to peanut eat a full
serving of peanut, like a peanutbutter sandwich, ver amount of
(12:24):
peanut, um, like two tablespoonsof plenty of peanut.
And then we measured the peanutprotein in the saliva over time.
We had them do things like chewgum.
We had them do things like, um,brush their teeth.
Almost anything.
Uh, so first of all, you couldmeasure plenty of peanut in the
mouth after you've eaten apeanut butter sandwich.
So, you know, the saliva doeshave peanut in it.
(12:46):
It might vary person to person,but it's, it's plenty detectable
and plenty likely to cause aproblem.
If I gave this, uh, extremeexample of I just finished the
sandwich and now I'm gonna spitin your mouth, um, that, that
would have plenty of peanut andprobably cause most people to
react who are allergic topeanut.
However, with time itdissipates.
And we found that, you know,chewing gum, rinsing, brushing,
(13:09):
these are all things thatbrought the amount down
significantly and probably tothe point where it wouldn't be a
problem for most people.
But sometimes for some of thepeople that were in our study,
you could still pick up a littlebit of peanut left.
And so the thing that had thebest outcome in terms of us not
being able to detect the peanutin their mouth anymore was when
they had not ingested anythingelse for a few hours and then
(13:33):
ate a meal that.
Or a partial meal that had nopeanut in it, and then we tested
their saliva and we couldn'tfind anything.
So, so it is the case that, youknow, chewing gum or rinsing out
brushing and all that stuffhelps a lot, but the time period
and also eating another food,why would that be?
So, you know, when you've eatensomething and this was, you
(13:54):
know, peanut butter, so I'mgonna give you other examples,
but I.
With peanut butter, you knowthere's gonna be some between
your teeth and it's gonna leachout and you know, that type of
thing.
sure, the chewing gum gets moresaliva going.
You end up swallowing more,there's more saliva being
generated and, and gettingswallowed.
So it's a dilution processthere.
Rinsing your mouth, brushingyour teeth.
These are all dilution processeswhether you have brushed your
(14:18):
teeth well or not might be avariable.
Whether there was some peanutbutter leftover from the last
time you used your toothbrush,you know, all of those different
nuances may be there.
I think the reason that.
Waiting that longer time is, itjust gives more time for things
to dissipate and then eating a aallergen safe meal.
It gives you more time to havethings pass around your teeth,
pass over your mouth, um, havemore saliva come.
(14:39):
So it's really a, a combinationof physical movement and, and di
dilution effects.
So that's what I tell mypatients.
It's like if you, you know, soyou're in a relationship, you're
going to be, you know, kissingpassionately, uh, you are.
Partner is best off notingesting the food for a few
hours and then having somethingthat you also could eat that's
safe.
Now, questions that could comeup if someone's thinking about
(15:00):
this a lot would be, well, whatif there's like a little kernel
of a cashew stuck between theirteeth that's gonna come loose
while we're kissing?
You know, these are all.
Nuances, uh, that, you know,there hasn't been a study of
every single food or every, youknow, type of food or every
consistency of food, but Ithink, you know, the, the
(15:20):
general, uh, approach I gave youbefore about, uh, not eating it
for a few hours, eatingsomething else would probably
solve most of those concernsbecause you would've already
gotten, um, other food to knockout the food that had been there
before.
Dr. Amanda Whitehouse (15:37):
Thank you for sharing that.
A lot of kids then start tohave.
Like you said, the specificquestions about what if, what
if, and these outlying unlikelyscenarios, like you said, the,
the kernel stuck between theteeth.
I know there have been some casestudies where it is showing that
it does happen, but can youspeak to how rare that is in
your professional experience andwhat you've heard from your
(15:57):
colleagues?
Dr. Scott Sicherer (15:58):
Yeah, so anything that's unusual gets a
lot of press.
I.
And so there, there are lots ofconcerns and you know, Sloan
manages this as well.
Like there are families who areindividuals who have become so
with, so with food allergy, andagain, you have to talk to your
(16:18):
allergist and everyone isdifferent, but, for the, for
most people, casual exposureisn't going to be an issue.
And what do I mean by casualexposure?
I mean, I do have patients whoare worried, like, what if my
child touches a peanut?
Um, what if somebody breathes onthem after they had a peanut
cereal?
You know, these are kinds ofthings that people worry about
(16:39):
and it is important when youhave food allergy to be
cautious, right?
Label, reading screen, extremelyimportant.
Having a very, uh, detailedconversation in a restaurant.
And I spend a lot of time inour, you know, in, in my clinic
talking about these topics youcould ask me to talk about the
more I'm gonna stop myself fromdoing too much talking on those
topics.
But for the most part, um.
(17:00):
That's where the energy goes in.
Getting a safe meal, doing a lotof talking, reading the labels
every single time verycarefully.
But if you're worried that theremight be something on a doorknob
or someone's gonna breathe onyou or things like that, that's
getting too far, um, you'regoing to a baseball game,
someone you know in the next rowis eating something that you
can't eat and you're worriedyou're gonna have an allergic
reaction.
For the vast, vast, vastmajority of people, that is
(17:22):
nothing that they need to worryabout.
And you just need to, you know,talk to your doctor.
There might be age-relatedissues.
There might be, you know, otheraspects.
But for the vast majority of ofpeople, those are not things
that they'd have to worry about.
So within that context, um, Iwouldn't want someone to be, you
know, that concerned that theywould be delaying having a
(17:43):
relationship over this.
Or that they would not behaving, um, physical, uh,
contacts.
Um.
Of kissing of sex or, oranything else based on, on a
worry like this, it should bemanageable and it shouldn't be
high risk once you know thesecret, so to speak.
Right?
Like, if you don't know aboutthese things and you hadn't
thought of it before, that'swhere a surprise might come.
(18:05):
But, but knowing about it, Ithink is, is the biggest part of
that.
And I have.
You know, additionalconversations about many topics
of casual exposure.
Like I'm going, you know, with afriend to the baseball game, or
I'm going to, um, be at a barwhere there's, you know, nuts
on, you know, in a bowl on thecounter.
(18:28):
All of these things, you know,typically we're focused on
making sure that what you'reeating doesn't have the, the
food in it, the protein in it.
It's not seeing it from adistance.
We did a study with peanutbutter where, because we, you
know, there are people who werepoor reactions and, and anything
is possible and there couldalways be exceptions, but we
took 30 children who were.
(18:49):
Very strongly positive to peanuton testing and whose families
felt that they reacted fromcasual exposure and we had them
sniff peanut butter for 10minutes.
We rubbed the peanut butter onthem.
in this study we did it in adouble-blind, placebo controlled
fashion where they didn't knowand the doctor didn't know when
we were rubbing real peanut orfake peanut, or when they were
(19:10):
sniffing real peanut or fakepeanut.
of the 30, uh, children who wentthrough this procedure, um,
there was only one reaction.
To sniffing that was likebreathing.
Trouble, and it happened to haveoccurred during placebo.
So they weren't actuallysniffing anything.
It was just nervousness.
And in the touching part of thestory, a third of, so we're
(19:33):
rubbing peanut
Sloane Miller (Allergic G (19:34):
Yeah.
Dr. Scott Sicherer (19:35):
their back or we're, we're rubbing not
peanut butter that had somehistamine in it to make it itchy
Anyway.
And a third of the people whowere rubbed with peanut got a
little redness there, but thatwas it.
And two thirds didn't even getredness because your skin
barrier usually blocks that.
Now your eye doesn't do that sowell, which is why I gave that
example earlier.
you know, I use that informationto just try to add some context.
(19:58):
are other situations where likeif you're milk allergic and
you're near like a.
One of those machines that boilsthe milk cappuccino or whatever.
I mean, aerosolizing milk byboiling, it can cause an
allergic reaction.
'cause you're actually blowingit into the air.
It's like someone with pollenallergy, it's in the air.
It makes them sneeze and itchand can have problems.
So it's not like food can'tcause a problem through non
(20:21):
ingestion exposure.
It's just that it's usually.
Like more unusual scenarios likeboiling something like if you're
allergic to beans and you'reover a pot of boiling or
shellfish, like if, if there'sjust cold shell shellfish on the
table, I wouldn't expectparticles to be.
around.
Just like they don't pop off ofpeanut butter.
But if you're cooking shellfish,boiling it, frying it, or fish
(20:41):
for that matter, then the steamcoming off of that does carry
protein and you could havesymptoms.
So I go through all of thesedifferent scenarios with people
if they're asking and if they'reconcerned about it.
And it's usually for people whoare more reactive.
'cause not everybody, like Isaid before, not everybody's
super sensitive.
Getting that question that youasked about case studies, so I
think, you know, most peopledon't recognize that what
(21:05):
happens in the medical litliterature is if you see
something unusual, um, you, youwrite it up and you send it to a
journal and maybe they'llpublish it and those might
collect.
So if it's something that islike.
Creating multiple of those, thenyou end up with case series, um,
and then you might end up withlike more and more information
(21:27):
about it.
But when things are pretty rareand unusual.
And grab media attention, youend up with a scenario where I
think that what we usually thinkof as a case report, so an
example of that would be, um,many years ago there was a bunch
of reports about someone who,where it was labeled as the kiss
(21:49):
of death.
You know, there was thisteenager who kissed their
boyfriend and died it made somuch headline and everything,
and then I.
It caused a lot of, you know,worry among people, which, you
know, it is what it is.
But then like a long time afterit came up like, oh, this person
had very severe asthma.
There was a not under control,it was an asthma attack and it
(22:11):
had nothing to do with beingkissed.
There's a report of a deathfrom, um, oral sex where.
The giver had eaten peanutbutter, and so the idea would be
that mu uh, exposure to thepenis from the oral mucosa of
(22:34):
the person who ate the, the oralsurface of the person who ate
peanut butter caused asignificant reaction for the
person that they were givingoral sex to.
However, you could read thatreport and say, are we sure?
You know, there's one reportlike that, it seems like.
That person's like, I would'vethought like that person's penis
(22:55):
should have become incrediblylike swollen and rashy.
And that's never mentioned inthe report.
So I'm not saying it's not atrue case.
I'm just saying that it's suchan unusual thing.
It made it to the news.
Have I ever had a patient eversay that that happened?
Maybe they wouldn't want to sayit happened, but I haven't had
anyone say it happened.
(23:15):
When, when have reactions tofoods, moms who are
breastfeeding will often say,well, I've been eating that
food.
Do I need to stop eating it?
a small amount of the proteinthat the mother is ingesting in
immunologically intact formmakes it into breast milk.
But it's a very small quantity,and so that same baby who
(23:38):
reacted pretty violently topeanut didn't react to the
mother's breast milk.
And or who reacted to egg didn'treact to the mother ingesting
egg and breastfeeding, eventhough there's some small amount
in there.
Are there case reports orreports of babies getting sick
from the allergen that's in themother's breast milk?
Yes, there are.
And there, there I would say isprobably more reason to expect
(24:02):
that there's some protein fromthe foods that the mother eats
in the mother's breast belt tobe there.
Now, if we're gonna starttalking about sperm o r
ejaculate having the food thatthe person was eating in it, or
if we're gonna be talking aboutvaginal, lubrication, having the
protein that the person ate init.
(24:24):
Theoretically, yes, but theamount would presumably be close
to not measurable drugs.
Are not proteins.
'cause proteins are largemolecules.
Drugs are often not largemolecules, and they get into,
um, juices of your body more,more easily than proteins do.
(24:48):
So, for example, um, right?
Like if you have an eyeinfection, usually get eye
drops.
It's harder for like a pill youtake to help your eye.
Actually, that goes for, forallergy too.
I mean, when you take anantihistamine.
It might help your eye but notso much.
'cause it's harder for the drugto get into the secretions of
your eye.
(25:09):
But some does get there and so,but those are small molecules.
Proteins are harder to do that.
I see
Sloane Miller (Allergic Girl) (25:16):
I do have, I do have a quick
question.
I just had an asparagus thought,just like a random asparagus
thought, right?
So if we're talking about, um,both vaginal secretions and
seminal secretions, I.
For, there are many of us whoeat asparagus, and then like the
next time you pee,
Dr. Scott Sicherer (25:34):
Yeah, that's an organic molecule.
It's not a
Sloane Miller (Allergic G (25:36):
okay.
Dr. Scott Sicherer (25:37):
so similarly, it's exactly this.
So thank you for that example.
'cause it's exact, exact sametheme when you smell peanut
butter.
You smell a very strong smell.
And a lot of people who areallergic to peanut get ill from
that.
I put it similar to a protectiveeffect.
Like if ibr, if I into a roomwith a gun and pointed at your
head, you're gonna have avisceral response.
(25:59):
You're probably gonna shake, youmight, you know, you might wet
yourself.
You know, like anything'spossible with that kind of fear.
'cause you know that this is adangerous situation.
Right.
And then if I showed you, wellwait a minute.
You know, this is a plastic toy.
What are you worried about?
You know.
So, so yeah, there's aprotective response when you
smell peanut, but that's anorganic odor that has no protein
(26:19):
to trigger an allergic reaction.
Now getting back to this examplewith, um, drugs, there are some
reports of people having areaction from secretions the
person's body secretion goes tothe person who's got the drug
allergy, and they have somewhatkind of response to that.
So that I would say isincredibly rare.
(26:41):
Unusual, but it's more likelikely than where it's the
protein has to get into theseplaces, so it's harder for the
protein to get into thoseplaces.
But the, but, but the example ofbreast milk is, is, is one of
these things.
So, so I would say that.
You know, we have not generallytold people, oh, you know, you
(27:02):
can't, you know, sperm in youfor like X number of hours since
that person ate the food.
You know, like that's not aninstruction that we have.
You know, typically givenpeople, now you could say, well,
gee, you know, like.
How do you know for sure thatthat's not something to worry
about?
I guess I would say, I don'tknow.
(27:24):
It's, uh, we did try to measurefood protein in ejaculate before
and just can't do it becausethere's too much gunked up
protein there to be able to usean assay on.
But, um, but in real life wehaven't gotten this kind of
scenario and it seems like itwas, would be very, very
unusual.
(27:45):
the, the kissing is much more.
Understandable.
The food is in the mouth and soit's, you know, it's not really
ha, it's not like it has to gothrough digestion and get
processed, get to thebloodstream, find its way from
the bloodstream to a secretionand you know, like there's so
many extra steps there.
I.
So I think that that's justdifferent.
there are people who haveallergies to sperm.
(28:06):
Uh, actually usually theejaculate fluid, not so much the
sperm itself.
And those allergies are alsorare in and of themselves.
Um, and they are treatable.
either by using a condom so thatthere's not direct contact or by
doing a desensitization therapy,which is kind of an unusual one,
but gradual, uh, introduction tothe sper of the sperm.
(28:30):
but, but that's a different kindof thing.
It's not attributed to what theperson has ingested.
Sloane Miller (Allergic Girl (28:35):
So I, I wanna, can we go back, um,
a few steps?
Well, firstly, thank you so muchfor doing that original peanut
study that basically all of usout here in the field are still
using and.
To help people understand.
I use it personally.
I use it with I, my partnerknows the study because he knows
(28:56):
once he eats my allergen, youknow, that's probably it for the
night.
In terms of kissing, he also hasa beard and food is, and
particles are transmittedthrough the beard to my skin.
I'm, I've sensitive skin and Iwill definitely get hives.
From that.
So it's usually a shower in afew hours from that study, which
(29:17):
was very, very helpful.
So thank you.
Um, if we could go back totalking about spontaneity
because for young people, youngadults, um, people in their
twenties who are able tocommunicate, like that young
person who was like, boys wannakiss me and I will tell them,
(29:38):
what they need to do.
Fantastic.
Like that is an idealconversation.
It's like ideal, right?
A lot of people are not likethat.
Um, of all genders are just notcommunicating that clearly and
or they wanna be spontaneous.
And I get that question a lottoo about like how to be
spontaneous and, and my phrasefor that is like, I can
(30:00):
absolutely be spontaneous withpreparation.
So that's my version ofspontaneity.
How, but how can we.
How can we help young peoplefeel spontaneous, um, and
understand risk and understandwhat to do if, if in the tiniest
(30:21):
chance there is a problem?
Dr. Scott Sicherer (30:24):
I think there's a few things there.
So, kissing is not the onlyinstruction.
I'm talking to teenagers about.
Um, we talk about alcohol.
I always bring alcohol up, evenwhen, so my joke on that one is
like, whatever their age is, Isay like, well, you've got.
Six more years before you'relegal to drink, but sometimes
people accidentally get alcohol.
Um, and so, you know, I open theconversation that way typically
(30:45):
and point out that alcohol is aproblem with someone who has a
food allergy for reasons thatthe person doesn't.
Think about actually.
And so you know, if you are, sothe first thing that people
probably think about is, well,there's some allergen in the
alcohol that I have to worryabout.
But the bigger problem is thatif you're ine, well one of the
bigger problems is if you'reinebriated, you might eat
something that you wasn't reallysafe.
(31:07):
'cause you just like.
Are not inhibited and, um, youmay not realize you're having a
reaction.
And on top of all of that,alcohol acts as what we call an
augmentation factor or aco-factor.
It makes reactions worse.
It makes the protein, uh, getinto the body quicker.
I.
Without as much digestion, andso it makes a worse reaction.
I explain to people like, ifthis much cashew is, you know,
(31:30):
ingested without alcohol, it'salmost like you ate that much
cashew with the alcohol, and soit's a worse reaction.
And so, you know, giving thatkind of thing is also a
spontaneity theme because youknow, you have to think about
where you are, what you'redoing, You know, as you said,
Sloan spontaneity, I'm, I couldbe spontaneous with some
(31:50):
preparation.
I mean, I think it's the samething this way.
So, you know, like if, ifyou're, if someone is coming up
to you, you know, to give you aspontaneous kiss, you could say
over here, you know, you mighthave eaten something I'm
allergic to, or let's just, youknow, elbow it since, uh, I have
some allergies and, and justlike you're laughing about it
now the person who you know is.
(32:12):
In charge, which is the personwith the allergies could make it
like a, a laugh, a laugh moment,you know, just to lighten it.
But, you know, I, I don't think,you know, I, one of the things I
say is that your friend, likewhen I say to teenagers.
So, side, side point, right?
Teenagers are at higher risk forfatal reactions, mostly because
they may be less likely to tella friend they're getting sick,
(32:35):
uh, tell a friend that theycan't eat this, um, try to hide
their issue and then not useepinephrine, right?
So with that in mind, I, I focuson, you know, people that
you're.
Interacting with your peers.
Don't want you to be sick.
They're, they, the last thing inthe world they want is for you
to start having allergicreaction in front of them.
That is what they do not want tohappen and it's way, they would
(32:58):
be way more disappointed, nothearing you speak up for
yourself and let them know thatyou have the allergies and what
you need done then to end upwith a problem.
And so, you know, for you tosay, Hey, I'm sorry I just can't
find anything to eat here.
Uh, I'm just gonna have a coke.
Um, or to say, Hey, I'm sorry.
I know you wanted to give me akiss and a hug, but how about an
(33:19):
elbow today?
Because I'm worried aboutwhatever.
You know, they're gonna behappier to know that, um, and to
not have something happen.
They don't wanna be responsiblefor causing you to be sick.
So, I I, I also throw that intomy counseling.
Sloane Miller (Allergic G (33:33):
also, partners do not want to be the
cause of sickness or witnesssomething terrible happening,
and so arming potential romanticpartners.
With information, with realrisks and real information.
Also, here's my EpiPen.
This is what to do in case ofemergency is, is a gift to say
(33:55):
this is how to help me.
And you know, it doesn't have tobe a big deal, but there are
real risks here and here's whatto do.
And it's like a three really,it's, it can be a three sentence
conversation, which is one ofthe things that I talk about in
coaching is that this doesn'thave to be paragraphs and
paragraphs.
It's really.
You are in charge of you andyour body.
(34:16):
You know the risks, you knowwhat you're allergic to.
As long as you know you areletting someone in to that part
of you just in case.
But also'cause no one wants tosee you, hurt your friends, nor
does, nor a romantic partner.
They really don't wanna hurt youand any way they wanna be close
to you and intimate with you.
Dr. Amanda Whitehouse (34:36):
I think that the way that Dr.
Sicherer, described having thoseconversations.
The way that people receive itis the way that they will then
carry it forward into being theones to initiate the
conversation.
So what you modeled anddescribed about starting young
and adding piece by piece askids get older is I think how it
more naturally happens inrelationships too, right?
(34:56):
When people have had thoseconversations, then they would
communicate.
Differently and a less amount ofinformation to a buddy on the
basketball team with them thanthey would to someone that they
were dating.
So I think we model that in ourconversations, and I think you
set a good example of that, Dr.
Sicherer
Sloane Miller (Allergic Gi (35:10):
Well also even bringing it up about
grandparent, because if we'retalking to parents on this
podcast about their youngchildren and the parents are
having, let's say, challengeswith in-laws or their own
parents accepting a child'sallergy and saying, well, it's
just I ate, I just had a peanutbutter sandwich.
A little kiss on the cheek won'thurt.
(35:33):
I think.
For parents to model thatconversation.
Well, actually there's somerisk.
It might cause some itching orsome discomfort.
And for even a child as young astwo to say, no, what did you
eat?
Grandma, uh, or grandpa or auntor uncle and, and teaching a
child and, and we talked aboutthis, um.
(35:54):
About body autonomy, right?
That and agency and the like.
The soonest you can get thoseconversations going about, this
is my body and this is my.
Um, medical condition that Iwant to understand and know how
to communicate the better.
And I think parents can modelthat conversations they're
having with grandparents for thechild and help the child learn
(36:17):
to advocate to adults aroundthem, whether it's a teacher
that wants to kiss them or afriend of the whomever it is,
and they're like, no, no.
What'd you eat?
You know?
Dr. Scott Sicherer (36:27):
Well, actually your, you know, your
example moved the age group downand so it is, um, it is a
conversation with.
like when there's food around,um, a, a, a well-meaning, uh,
parent who ate something andthen blows raspberries on the
baby's belly, you know, is gonnafind that they're blowing some
hives onto the baby's belly.
(36:49):
Um, again, may not be asserious, you know, exposure, but
it's still, you know, is ununsightly.
And then it's like, oops.
And you know, as you mentionedbefore about the beard, you
know, that's another examplewhere sometimes dads will, you
know, have something stuck or.
For some reason, it's always thedads who are eating cashews and
wiping their mouth on some towelin the kitchen.
(37:10):
And then the towels used to likewipe something off the young
child and then they have hivesfrom that.
So like those kinds of transferof, uh, allergen, you know,
again, they're not typicallysevere reactions, but they could
be, you know, uncomfortable.
And it does take.
Conversations, we actually talkabout ages and stages, and so
you know, what we're giving,like what I'm talking to
(37:32):
families about for an a, a babyversus a toddler who can grab
food versus, you know, themiddle where they start to have
more autonomy and they're, youknow, they, they have to be
around more peers who are eatingthings and have, you know,
decisions about what they cancontrol or not.
And then the high school yearswhere it's a whole other story,
you know, like each, each ofthese ages and stages has its
(37:53):
own.
Um, things to talk about for,for managing allergy.
So kissing comes up in a varietyof age groups.
Sloane Miller (Allergic Girl (38:02):
It does and and it should.
It's enjoyable and people withfood allergies.
should have and hopefully have afull range of wonderful
experiences, including intimacythat is at the level and the
safety that they want.
And one of the takeaways thatI'm hearing from you, um, which
(38:24):
is great, is that the, the realrisk of anaphylaxis, of, of
going into really severefatality danger zone is really,
really tiny.
Is really, really tiny, and it'sreally an outlier.
Did I get that correctly?
Dr. Scott Sicherer (38:40):
I think you do.
So you always talk to yourallergist.
There's always an exception.
There's, you know, people whoare listening podcasts like this
probably have a, you know, more,uh, significant past history.
So, but I think talking in thecontext of your own allergies
with your allergist, but I, Istill would say that on a
epidemiologic basis, um, it'swhat's what you're getting in
your mouth and eating is themost.
(39:01):
Significant risk and kissingpresents the potential for that.
Um, although again, most of thetime even, you know, any kind of
simple, you know, non saliva tosaliva kind of kiss is not going
to that significance of a, of adanger.
Sloane Miller (Allergic Gi (39:19):
And, uh, by, by the bye on a personal
note.
I have had a range of thoseexperiences, um, where I will
have from getting a cheek kissfrom someone who has dogs and
touches their dogs and thentouches their face.
I'm allergic and asthmatic todogs instant hives.
(39:41):
I've had experiences where aguy, we had the conversation,
very clear conversation, heunderstood my food allergies.
He had eaten cashews earlier inthe day, and I talk about this
in my book and I.
was, we figured afterwards itwas probably in his beard, but
he didn't, he had, it had beenhours, he had brushed his teeth,
(40:02):
he'd eaten something else.
We'd had dinner together of asafe meal and still I had hives
everywhere and asthma.
And again, it luckily it didn'tprogress.
Um, and it was a mistake eventhough we had had the
conversation and even though he,you know, it had been a long
time, that beard, that beard is.
Dr. Scott Sicherer (40:23):
beard, beard.
Beard is an extra
Sloane Miller (Allergic Girl (40:25):
be beard is an extra, or, and body
hair is an extra scenario.
However, again, it was a honestmistake.
I had all my medicationsnecessary.
We, I took, I did what I neededto do to stay safe, and we had a
very positive, it was a positiveexperience.
It wasn't like he ran screamingfrom the apartment.
He is like, what can I do?
we need to do?
(40:45):
And we, we figured it out.
So.
had a range of those experiencesfrom saliva to beard.
Um, and, I've had all theconversations too.
And so I, I think the reason I'msaying this is because mistakes
can happen.
Even when you are the mostcareful and you've explained the
(41:07):
risks and you've had all theconversations, and that's why
you have your anaphylaxis actionplan.
That's why you have all yourmedications.
That's why you've spoken to yourallergist about the real risk
for you.
Um, and, and you just.
That's part of intimacy is thatsometimes things happen and
that's okay, and that is notsomething to be afraid of.
(41:28):
Uh, but that's, I think, part ofthe normal part of anyone's
intimate experience, um, thatthings happen that are
unexpected.
And as long as you arespontaneous and prepared that
you can have a safe and positiveexperience.
Dr. Amanda Whitehouse (41:43):
You used the word earlier, Sloan, that
it's enjoyable, and I also thinkit's beyond that.
To have close relationships isan essential part of the human
experience and of having ahealthy, well-rounded life.
I certainly don't mean to say.
Everyone must have arelationship.
Some people choose not to, andthat's okay.
But for the most part, I thinkit really is central to our
wellbeing.
Not just romantic relationships,but to feel safe and connected
(42:06):
to people without this layer offear and protection.
And that's not really a healthyway to navigate relationships.
So to find a way through that Ithink is really important
socially and emotionally.
Sloane Miller (Allergic G (42:15):
Yeah.
Yeah, the avoidance, certainlywhen I was a kid.
Um, and.
You know, EpiPen didn't exist.
Epinephrine existed andepinephrine was given in the
hospitals, but EpiPens didn'texist yet.
So, um, what I was told by theallergist was, avoid, avoid your
allergen and if you haveexposure, go to the hospital.
(42:37):
That's what, that was, what washappening in the seventies and
early eighties.
And what I did was, um, Iglobalized that.
Avoidance and ended up avoidinga lot because of my allergens.
And that's what really promptedme to start my practice and
write this book because didn'twanna live like that anymore.
(42:58):
I didn't wanna live.
An avoidant lifestyle.
And I didn't want avoidance tobe my only coping mechanism.
And, um, and to your point thatyes, this is part of a whole
human the whole breadth of humanexperience and that we need more
tools in our toolbox other thanavoid, of course, avoid your
(43:21):
allergen.
Of course, however, as a globalcoping mechanism, there are
other, there are other thingsthat you can do.
Dr. Scott Sicherer (43:31):
Well, I mean, just to very briefly, uh,
pick up off of that point, um.
The past couple of decades,there wasn't much more out there
other than avoiding and having abackup plan of, of epinephrine.
And now there really are moreconversations going on in
doctor's offices because thereare possible therapeutics,
(43:51):
whether it's uh, you know, aninjected biologic like
Omalizumab or doing oralimmunotherapy.
Uh, and there's a lot more inthe pipeline that's coming
there.
You know, there are, um, other,other options other than just
avoidance for people.
For, for many of the people withfood allergies, happily.
Dr. Amanda Whitehouse (44:08):
Yeah, which is very exciting My son,
has done a combination of OITand Slit, and so these
conversations.
Us.
He's only 13, but obviously westart young and we talk early.
These conversations are quitedifferent because there's still
risk.
We're managing it.
But as you said, it's soindividual to each patient,
depending on their history andwhat they've done.
So back to the importance oftheir doctors talking to them
(44:29):
about it.
I love the way that youdescribed that you do this.
In my experience, this is nothappening very frequently.
Uh, no one's had thatconversation with my son.
A lot of my clients, I'm thefirst one to mention to them,
you know.
What do you know?
What's your plan?
Please go talk to your doctorabout it.
What are your thoughts on that?
Dr. Scott Sicherer (44:49):
I, I think I'm like always having this
conversation and I, I know thatthe parents, I.
Love that, you know, this isbeing discussed during their
visit.
Um, so again, some kids might beembarrassed.
Um, you know, especiallystarting around, I probably, I
probably start doing around age13, 14 ish.
(45:10):
Um, it drives me crazy whensomeone disappears for several
years and then comes back andhasn't seen that.
'cause I say like, you, youshould have a yearly visit.
And what goes into the mind ofmany families is well.
Like, I'll skip a year for testsand then they end up skipping
two or three years becausethey're like, well, it's just
the tests.
And they don't remember that wetalked for an hour.
(45:32):
So it's like, well, tests aretests, but you know, the
discussion about the allergy isthe more important part of the
visit in my point of view.
So, so it gives me theopportunity to talk about all of
these other things.
And this is, I mean, I also talkabout.
Drugs.
Um, and I joke about that, that,you know, well, not heavily
joke, but it's sort of likethere's drugs out there and, you
know, that could also, uh, cloudyour, you know, ability to pick
(45:56):
up the right food or make youmore hungry to eat the wrong
food and then not realize you'rehaving a reaction.
So I.
That only took three seconds forme to say, but like putting all
of that into a package jail, Idon't know what to tell you
about.
Every allergist doesn't coverit.
There's, you know, there's a, alot that has to be done in, in a
visit and there's a lot to talkabout, um, I guess for a family
(46:16):
listening to this, or a parentor anyone listening to this to
feel comfortable bringing it upwith your doctor.
Um, not to put the burden ofstarting the conversation on the
family instead of on the doctor,but, uh.
You know, there's the, theliterature is out there and it
is part of most of ourinstruction forms, and it's in a
sentence somewhere, almosteverywhere that the doctors can
(46:38):
see.
But whether they find the timeto do it, I guess, is, is, is
the question here?
we're we, the three of us couldspread the word and, and
Sloane Miller (Allergic Girl) (46:46):
I think for a lot of families,
like I never raised this with myallergist, my pediatric
allergist or my adult allergist,they never raised it with me.
And I think there's probably anassumption like it's being taken
care of elsewhere, like your GPor a pediatrician is doing it,
or so.
So a question, so a, you'resaying it's appropriate for
families to bring it up?
Um, now if your allergist, yourpediatric allergist, or your
(47:09):
regular allergist, if you're anadult, doesn't know the answer,
it, would it be your gp, wouldit be like, like who has the
information?
I.
Dr. Scott Sicherer (47:21):
You know, we're speaking about a niche
area within allergy that as you,as you asked me, is this a
common thing to ha be a problem?
And among adults, you know, fiveor 10%.
So, so the majority of peoplewho have food allergy maybe
never thought of this, neverexperienced a problem with it
and never will.
For me, who specializes in foodallergy, it's a part of every
(47:42):
visit that I have with ateenager, among other things
that we talk about as teen forteenagers.
So, you know, all I can say is Iwish it were a more open thing
if, if a, if a listener saidlike, where could I read about
stuff like this?
I mean, probably, I don't know.
Uh, if your book has it, my bookhas it.
Um, you know, it does, but youknow, then you'd have to know
(48:03):
to, to read more.
A t the Jaffe Food AllergyInstitute, we do a weekly, I'm
sorry, a monthly, uh, communityengagement thing like on Zoom or
in person.
Actually tonight when we'rerecording this thing, we have a
bunch of our, um, researchersare doing, uh, in a live
presentation of our researchwork and what's out there for
(48:24):
treatments.
Uh, now and in the near future.
We similarly have.
Um, these talks on exactly thistopic.
Um, I I do an ask me anythingother thing.
So, so I think there are places,if you're interested in looking,
you're gonna find theinformation.
If you're just paying attentionto an occasional newspaper
article that might be blowingthings outta proportion, then
(48:46):
the answer is talk to, talk toyour trusted allergist about it.
I do think the board certifiedallergists are the right doctor
to know this information, and Ithink probably most of them do.
They may just not have time tohave this conversation or think
of it when, when the family,when they're trying to teach,
when to use the epinephrine, howto use the epinephrine.
Do you call nine one one?
Do you not call 9 1 1?
What about the label reading?
(49:07):
I mean, I do spend.
Way more time talking aboutlabel reading and restaurant.
I spend more time than any ofthose other topics.
'cause that's the trickiest partfor most of, most of my patients
is, is, is through therestaurants.
I could talk about that for anhour.
So, so I think, you know, thismight take back seat to some of
those other things and I don'tthink it should take back seat,
but, but you know, we are insort of like a.
(49:29):
A topic that maybe doesn't comefront of mind to most of the
families when they're in theoffice wondering like, is the
test gonna be better this year?
Or, you know, what do I do ifthere's an allergic reaction and
they're not thinking about this?
Which as we're admitting is notthe highest risk aspect of
living with a food allergy, butis something that could be
impactful on quality of life.
I will say that.
(49:50):
Um, in these conversations, the,the deeper questions, so to
speak, the ones that are notjust about kissing.
So the ones that are askingabout, you know, oral sex, um,
and stuff like that, thosetypically don't happen unless
the.
Parent is out of the room.
So
Sloane Miller (Allergic G (50:06):
Yeah.
Dr. Scott Sicherer (50:07):
so I usually get the ball rolling with
kissing and stuff while theparent's still there.
And then after the parent's out,I'll say, do you have any other
questions?
And if there are otherquestions, it's usually what
we've already covered today.
Um, it's, it's like, well, do Ihave to worry about sperm,
vaginal secretions?
And, you know, that's, that'susually the, the next thought
(50:27):
that people start to have.
Sloane Miller (Allergic Girl (50:29):
I, wanna make a plug, just a quick
plug for Centers of Food AllergyExcellence because also, um, and
this is my personal experience.
I've had wonderful allergists,but they're allergist
immunologists.
And food allergy is not theirspecialty necessarily.
And so, um, I think it's, if youcan get to a food allergy center
(50:52):
of excellence near you in thecountry, that that will really,
um, support your family andunderstanding these issues and,
uh, on a deeper level as well ashave an allergist at home near
you that you can see.
But.
Dr. Scott Sicherer (51:10):
Yeah, it's a good point.
I mean, I, I would say that allallergists are trained to take
care of food allergy, but you'reright that it's not necessarily
the focus for all allergists.
And so, you know, food allergyresearch and education or FARE,
does have like this FAREclinical network that, uh, lists
about 50 places that are extrathoughtful about food allergy.
And a lot of my patientsactually have two allergists.
(51:32):
They have me or my colleagueshere at Jaffe Food Aller
Institute.
Also their local allergist whomaybe is spending more time with
them for their hay fever orasthma.
And then, you know, they'll havetheir once a year visit for the
food allergy.
And, and there are a lot ofthings involved with a good food
allergy evaluation.
There's, uh, super medicallysupervised feeding tests and a
(51:54):
lot more talking and things likethat.
So, so yeah, I think your pointwell taken.
Dr. Amanda Whitehouse (51:59):
Do you wanna leave us with any last
thoughts
Dr. Scott Sicherer (52:00):
I mean, for me, I think I'm, I think I've
covered everything that you guyswere interested in talking
about, and I, I'm, I'm glad, uh,we focused on this area, which
is incredibly important andprobably under discussed.
Dr. Amanda Whitehouse (52:13):
I agree.
Sloan, any last thoughts thatyou wanna add?
Sloane Miller (Allergic G (52:16):
Thank you.
Thank you both.
Uh, I'm so glad to see and hearand have shed more light on this
topic.
And I'm, I'm really thrilledthat you bring this up, um, with
your clients and with yourpatients rather.
And I.
I would hope that thisencourages more families to know
that this is something that theyshould be bringing up, uh, to
(52:38):
their, um, allergist to exploreit.
That there is stuff to beexplored here that's really good
information and that your kidsdo wanna know and will need to
know as they age.
Dr. Amanda Whitehouse (52:51):
Thank you so much to both of you for
taking the time to share yourthoughts and your experience and
your insights.
I appreciate it so much.
Sloane Miller (Allergic G (52:58):
Thank you.
Dr. Scott Sicherer (52:59):
for the invitation.
Dr. Amanda Whitehouse (53:00):
Yeah.
Thank you for joining us forpart one of this two part series
on food allergies and physicalintimacy.
Stay tuned for part two nextweek where Sloane Miller and I
will be back to dive deeper intothese topics Together we'll
explore how to apply the advicethat Dr.
Sicherer gave us in real lifesituations.
How to communicate iteffectively with our children
and how to address the social,emotional, and mental health
(53:22):
aspects of navigatingrelationships and intimacy with
allergies.
In the meantime, if you want tokeep learning, you can read Dr.
Sicherer's book, the CompleteGuide to Food Allergies and
Adults and Children.
You can read Sloane Miller'smemoir Allergic Girl, and you
can reach out to me for the freeguide that I've created for you
based on this series of talks tohelp you navigate these
(53:42):
conversations and situations.
You can access that by followingme on Instagram at the Food
Allergy Psychologist andmessaging me asking for the free
guide.
Or you can visit my website atthe food allergy
psychologist.com and reach outto me through the contact option
I appreciate you listening, andwe will talk again soon.
the content of this podcast isfor informational and
(54:04):
educational purposes only, andis not a substitute for
professional medical or mentalhealth advice, diagnosis, or
treatment.
If you have any questions aboutyour own medical experience or
mental health needs, pleaseconsult a professional.
I'm Dr.
Amanda White house.
Thanks for joining me.
And until we chat again,remember don't feed the fear.
Welcome to the Don't Feed the Fear podcast, where we
dive into the complex world offood allergy anxiety.
I'm your host, Dr.
Amanda Whitehouse, food allergyanxiety psychologist and food
allergy mom.
Whether you're dealing withallergies yourself or supporting
someone who is, join us for anempathetic and informative
journey toward food allergy calmand confidence..
(00:28):
Welcome back to the Don't Feedthe Fear Podcast.
We are here on the springseason..
We are talking about things thatwe don't want to talk about.
I am trying to create a spacehere for the conversations that
we tend to avoid, that we don'twant to talk about because
they're uncomfortable.
We might not have as muchinformation about.
We might be uncomfortableasking, and today's exception
(00:48):
might be the peak of that.
We are addressing theintersection of food allergies
and physical intimacy.
This is a subject that issensitive, but it's very
important for people who arenavigating relationships with
food allergies.
Parents don't want to talk totheir kids about it.
Our kids don't want to hearabout it, especially from us,
but it's very important for allof us to know.
(01:10):
I have two amazing guests hereto help me with this
conversation.
The first is the expert on thistopic, Dr.
Scott Sicherer.
He is the director of the Elliotand Roslyn Jaffe Food Allergy
Institute.
He is the chief of the Divisionof Allergy and Immunology in the
Department of Pediatrics andMedical director of the Clinical
Research Unit.
He is a clinician and a clinicalresearcher, he's written several
(01:33):
books on the topic, the mostrecent of which is the Complete
Guide to Food Allergies inAdults and Children that came
out in 2022.
And relevant to today'sconversation, he is a co-author
of a very important paper thatwas published in 2006 In the
Journal of Allergy and ClinicalImmunology about peanut allergen
exposure through saliva.
(01:53):
So this was the first paper toexplore and document what is
happening with allergens left inour mouth after we eat, so that
we could get an understanding ofwhether there is risk in
kissing.
So I'm so grateful to have Dr.
Sicherer here to talk about allof his knowledge with us, our
other esteemed guest today isSloane Miller.
Sloane holds a master of finearts degree, a master of social
(02:14):
work degree, and a certificatein professional coaching, and
she's a specialist in foodallergy management.
She is the author of the MemoirAllergic Girl, and she's the
founder and president ofAllergic Girl Resources, a
consultancy devoted to foodallergy awareness.
She combines a lifetime of herpersonal experience living with
food allergies with herprofessional expertise to
connect with people about how tolive safely, effectively, and
(02:37):
joyously with food allergies.
You can findher@allergicgirl.com.
And it was Sloane's idea to havea discussion on this topic with
Dr.
Sicherer to explore the medicalrealities of food allergies in
the context of relationships andphysical intimacy and strategies
for communicating thatunderstanding to our children
and helping them to communicatethem to the people that they
(02:58):
enter into relationships withyou.
So I'm so appreciative to Sloanefor the great idea and excited
to share this conversation withyou.
But first, please be aware thatthis episode does contain
discussions on sensitive andmature topics related to
physical intimacy Listenerdiscretion is advised and we
recommend not playing thisepisode with young children
present.
Dr. Amanda Whitehouse (03:16):
So thank you everybody for joining us to
listen.
We wanted to record this panelconversation today for, parents,
for any providers who werecurious about how do I talk to.
Kids and young adults aboutsafety and their food allergies.
When it comes to sensitivetopics like relationships,
dating, physical intimacy, it'sa difficult topic.
Sloane.
You suggested that we do thisand I think you had a lot of
(03:36):
good thoughts on why this is areally needed conversation.
Sloane Miller (Allergic G (03:40):
Thank you so much, Amanda, and it's
such a pleasure to be here withboth of you today.
And what I'm seeing in my foodallergy coaching practice, and
again, that's also aself-selecting group, I.
So I think there's much, muchmore going on out there that is
just not choosing to come in totalk about this or is not
(04:01):
feeling that challenged, um, orhaving challenges privately.
But what I'm seeing are theseflection points of the
beginnings of.
Intimacy and curiosity about,um, romance and physical
intimacy around, um, teenagehood, young teenage hood, right?
So late middle school, earlyjunior high.
(04:25):
And then this other flectionpoint around high school and
early college and thenpost-college.
And what I've seen in mypractice in terms of people
coming to see me, is delaying.
Intimacy because they, there'sso much fear and.
Lack of clarity around realrisks.
(04:48):
What are the real risks fromkissing?
If someone's eaten yourallergen, what do I do?
How do I have that conversation?
Who has the information?
And then as, um, I.
Young people are turning intoyoung adults.
Uh, how are you dating onTinder, you know, in your
twenties and having thisconversation?
(05:10):
Will you be rejected by futurepeople because, oh, it's just
too difficult.
Um, and certainly younger peopleare having those thoughts as
well, but that's what I'm seeingoverall delaying intimacy
because of lack of clarityaround communication what the
real risks are.
Dr. Amanda Whitehouse (05:29):
Yeah, I agree.
And I think what I see happen isthe delaying intimacy.
Based on this fear and notvalues, and then somehow an
individual's personal value isgetting clouded with or shaped
by their food allergies ratherthan what, what are my goals for
my relationships and what are myvalues around age and timing of
intimacy so, Dr.
Sicher, talk about yourresearch, please, what you know
(05:52):
and where we stand today withthe science on this topic.
Dr. Scott Sicherer (05:57):
Well, first of all, let me thank you for the
invitation to join and to speakabout this topic, which is
actually a topic that I, I, I,I'm a researcher, but I'm also a
pediatric allergist.
I see children, I see teenagers,I see young adults.
I see some non young adults.
Uh, and this is a topic thatdoes come up and I bring this
topic up, at every visitactually with that age group
(06:21):
and, um.
I will have a parent leave theroom if they want to, or if they
don't want to, they can stay.
Or if it's an 18-year-old orolder, I will definitely have
the parent, um, step out of theroom for, for this conversation.
And I've seen actually that whenI bring the conversation up, um,
the parent is act is typicallyvery comfortable with it and the
(06:42):
teenager may or may not be.
Um, but, but it is a very commonthing and I, and I, I don't
ever, not.
Talk about some aspect of this,usually about the kissing part
of it.
There's not a lot of researchabout, um, exactly what the
risks are, but like everythingelse with food allergy, I.
Part of it depends on, on theperson's own allergy.
(07:04):
Uh, if you're incrediblysensitive to trace amounts of a
food, which is not the mostcommon thing, the average
person, for example, with apeanut allergy, reacts to
essentially a peanut kernel ormore of peanuts so that, you
know, contextualizes things.
I mean, not everybody isreactive to you know, virtually
like dust amounts of it.
(07:25):
And you know, that's somethingto discuss with your allergist,
but.
In a kiss, for example.
If someone had been eating thefood that you're allergic to, of
the food is still in the mouthof the person who ate it after
they've eaten it.
Um, it will decline with time,but for some amount of time it's
there.
If the kiss is on the cheek, uh,and I actually give a scenario,
(07:49):
I kind of change it to agrandparent scenario.
So here's what I usuallyactually say to people.
It's like, well, let's say yourgrandma had milk or your grandma
ate peanut then gave you a kisson the cheek.
Um, maybe your cheek will getred, maybe it won't, but I would
not expect a severe allergicreaction from that.
I that's the typical, you know,scenario I would answer.
(08:10):
Um, is there someone who's superduper sensitive where a kiss on
the cheek after grandma ate somepeanut butter would be a
problem?
Maybe.
But for the vast majority ofpeople, it's either gonna be a
red spot or nothing.
Um, many of my patients have hadskin testing done.
They get a bump where the skintest was.
That's way more exposure than akiss should be, right?
So it's not something thatshould be a high risk scenario.
(08:33):
Then I go on and I don't take abreak like that, but uh, then I
go on and I say, now, if grandmalicked your eye, don't know why
grandma was licking your eye,but your eye would probably
swell shut because that's sortof like an open area and having
your grandma had eat, eaten somepeanut or some milk or something
and, and then your eye, your eyemight swell shut.
(08:53):
I wouldn't expect that to becomean anaphylactic reaction.
There is exception to thatmaybe, but that's not typical.
Kissing mouth to mouth andexchanging saliva.
So some people call that frenchkissing or passionate kissing.
Then it's a different storybecause now what They ate is in
the saliva and now the saliva'sin your mouth.
So basically the food is in yourmouth, and then anything's
(09:14):
possible depends on how much wasleft in there.
And, you know, there could be aneven an anaphylactic reaction
from that situation.
So that's, that's sort of myoverview.
You can ask me more questionsabout it, but, but, but that's
how I, I get the conversationgoing.
Dr. Amanda Whitehouse (09:28):
When you age up to older kids and you're
having that conversation aboutkissing or French kissing, my
kids call it movie kissing,You've laid the groundwork that
there is a possibility of areaction that will range quite
widely based on a lot offactors.
How do you advise them to enterinto that safely with.
The person they might be kissingas far as time and how much is
(09:49):
consumed and all of thosedetails,
Dr. Scott Sicherer (09:51):
Sure.
Well there's two aspects tothis.
One is, um, the idea that youhave to be thoughtful about it,
You know, there aren't a lot ofstudies on this and the types of
studies that are out there arenot, you know, super perfect at
figuring out prevalence, butroughly five to 10% of people,
older people with food allergiesreport having had some reaction
(10:13):
from kissing, and it wasprobably a surprise to them when
it happened.
They may not have thought aboutit until it happened.
They may not have discussed itwith someone before it.
It's usually not severe, but itcould be as we talked about.
So as soon as I start thatconversation with my sort of
joking way of doing it to getthe ball rolling, um.
I think that, you know,someone's already protected
(10:35):
because they may not havethought about it before, but
once they think of it now, itcould be part of the process.
And what that means, and I dobring this up as we talk about
it, it means that you wouldn'tspontaneously start, and I'll
use the term making out withsomebody at a party who you
don't have any kind ofinteraction with other than,
Hey, I'm gonna start making outwith you.
(10:56):
They don't know you, they don'tknow your allergies, you don't
know them, you don't know whatthey've eaten.
It's not a relationshipsituation.
Now, I had, uh, long ago a sayto me, um, you know, boys wanna
kiss me and they're gonna dowhatever I tell them to do for
me to be safe, for them to kissme.
Right?
There was no concern that it'sgoing to be a, a, a relationship
(11:20):
breaker or something like thatto have to say, Hey, I have
allergies.
We're, this is gonna be a littleodd, but I want to talk to you
before we would start, you know,kissing, uh, and, and so again,
not having a, you know, in myday it was spin the bottle kind
of thing, but not having just,you know, spontaneous kissing,
(11:40):
but in a relationship then yourfood allergy is known.
And so, uh, then I could givethe instruction, right, of what
would you tell a partner whoyou're going to be definitely
passionately kissing with whatshould they do, uh, to make that
safe.
And so, so part of theconversation is not having
(12:02):
spontaneous make out sessions.
The other part of theconversation as well, if you are
going to be passionatelykissing, what are the safety
rules?
And so this goes to a study thatwe did many years ago.
Where we said, Hey, you know,let's pick a food.
And we picked peanut.
We had people who are notallergic to peanut eat a full
serving of peanut, like a peanutbutter sandwich, ver amount of
(12:24):
peanut, um, like two tablespoonsof plenty of peanut.
And then we measured the peanutprotein in the saliva over time.
We had them do things like chewgum.
We had them do things like, um,brush their teeth.
Almost anything.
Uh, so first of all, you couldmeasure plenty of peanut in the
mouth after you've eaten apeanut butter sandwich.
So, you know, the saliva doeshave peanut in it.
(12:46):
It might vary person to person,but it's, it's plenty detectable
and plenty likely to cause aproblem.
If I gave this, uh, extremeexample of I just finished the
sandwich and now I'm gonna spitin your mouth, um, that, that
would have plenty of peanut andprobably cause most people to
react who are allergic topeanut.
However, with time itdissipates.
And we found that, you know,chewing gum, rinsing, brushing,
(13:09):
these are all things thatbrought the amount down
significantly and probably tothe point where it wouldn't be a
problem for most people.
But sometimes for some of thepeople that were in our study,
you could still pick up a littlebit of peanut left.
And so the thing that had thebest outcome in terms of us not
being able to detect the peanutin their mouth anymore was when
they had not ingested anythingelse for a few hours and then
(13:33):
ate a meal that.
Or a partial meal that had nopeanut in it, and then we tested
their saliva and we couldn'tfind anything.
So, so it is the case that, youknow, chewing gum or rinsing out
brushing and all that stuffhelps a lot, but the time period
and also eating another food,why would that be?
So, you know, when you've eatensomething and this was, you
(13:54):
know, peanut butter, so I'mgonna give you other examples,
but I.
With peanut butter, you knowthere's gonna be some between
your teeth and it's gonna leachout and you know, that type of
thing.
sure, the chewing gum gets moresaliva going.
You end up swallowing more,there's more saliva being
generated and, and gettingswallowed.
So it's a dilution processthere.
Rinsing your mouth, brushingyour teeth.
These are all dilution processeswhether you have brushed your
(14:18):
teeth well or not might be avariable.
Whether there was some peanutbutter leftover from the last
time you used your toothbrush,you know, all of those different
nuances may be there.
I think the reason that.
Waiting that longer time is, itjust gives more time for things
to dissipate and then eating a aallergen safe meal.
It gives you more time to havethings pass around your teeth,
pass over your mouth, um, havemore saliva come.
(14:39):
So it's really a, a combinationof physical movement and, and di
dilution effects.
So that's what I tell mypatients.
It's like if you, you know, soyou're in a relationship, you're
going to be, you know, kissingpassionately, uh, you are.
Partner is best off notingesting the food for a few
hours and then having somethingthat you also could eat that's
safe.
Now, questions that could comeup if someone's thinking about
(15:00):
this a lot would be, well, whatif there's like a little kernel
of a cashew stuck between theirteeth that's gonna come loose
while we're kissing?
You know, these are all.
Nuances, uh, that, you know,there hasn't been a study of
every single food or every, youknow, type of food or every
consistency of food, but Ithink, you know, the, the
(15:20):
general, uh, approach I gave youbefore about, uh, not eating it
for a few hours, eatingsomething else would probably
solve most of those concernsbecause you would've already
gotten, um, other food to knockout the food that had been there
before.
Dr. Amanda Whitehouse (15:37):
Thank you for sharing that.
A lot of kids then start tohave.
Like you said, the specificquestions about what if, what
if, and these outlying unlikelyscenarios, like you said, the,
the kernel stuck between theteeth.
I know there have been some casestudies where it is showing that
it does happen, but can youspeak to how rare that is in
your professional experience andwhat you've heard from your
(15:57):
colleagues?
Dr. Scott Sicherer (15:58):
Yeah, so anything that's unusual gets a
lot of press.
I.
And so there, there are lots ofconcerns and you know, Sloan
manages this as well.
Like there are families who areindividuals who have become so
with, so with food allergy, andagain, you have to talk to your
(16:18):
allergist and everyone isdifferent, but, for the, for
most people, casual exposureisn't going to be an issue.
And what do I mean by casualexposure?
I mean, I do have patients whoare worried, like, what if my
child touches a peanut?
Um, what if somebody breathes onthem after they had a peanut
cereal?
You know, these are kinds ofthings that people worry about
(16:39):
and it is important when youhave food allergy to be
cautious, right?
Label, reading screen, extremelyimportant.
Having a very, uh, detailedconversation in a restaurant.
And I spend a lot of time inour, you know, in, in my clinic
talking about these topics youcould ask me to talk about the
more I'm gonna stop myself fromdoing too much talking on those
topics.
But for the most part, um.
(17:00):
That's where the energy goes in.
Getting a safe meal, doing a lotof talking, reading the labels
every single time verycarefully.
But if you're worried that theremight be something on a doorknob
or someone's gonna breathe onyou or things like that, that's
getting too far, um, you'regoing to a baseball game,
someone you know in the next rowis eating something that you
can't eat and you're worriedyou're gonna have an allergic
reaction.
For the vast, vast, vastmajority of people, that is
(17:22):
nothing that they need to worryabout.
And you just need to, you know,talk to your doctor.
There might be age-relatedissues.
There might be, you know, otheraspects.
But for the vast majority of ofpeople, those are not things
that they'd have to worry about.
So within that context, um, Iwouldn't want someone to be, you
know, that concerned that theywould be delaying having a
(17:43):
relationship over this.
Or that they would not behaving, um, physical, uh,
contacts.
Um.
Of kissing of sex or, oranything else based on, on a
worry like this, it should bemanageable and it shouldn't be
high risk once you know thesecret, so to speak.
Right?
Like, if you don't know aboutthese things and you hadn't
thought of it before, that'swhere a surprise might come.
(18:05):
But, but knowing about it, Ithink is, is the biggest part of
that.
And I have.
You know, additionalconversations about many topics
of casual exposure.
Like I'm going, you know, with afriend to the baseball game, or
I'm going to, um, be at a barwhere there's, you know, nuts
on, you know, in a bowl on thecounter.
(18:28):
All of these things, you know,typically we're focused on
making sure that what you'reeating doesn't have the, the
food in it, the protein in it.
It's not seeing it from adistance.
We did a study with peanutbutter where, because we, you
know, there are people who werepoor reactions and, and anything
is possible and there couldalways be exceptions, but we
took 30 children who were.
(18:49):
Very strongly positive to peanuton testing and whose families
felt that they reacted fromcasual exposure and we had them
sniff peanut butter for 10minutes.
We rubbed the peanut butter onthem.
in this study we did it in adouble-blind, placebo controlled
fashion where they didn't knowand the doctor didn't know when
we were rubbing real peanut orfake peanut, or when they were
(19:10):
sniffing real peanut or fakepeanut.
of the 30, uh, children who wentthrough this procedure, um,
there was only one reaction.
To sniffing that was likebreathing.
Trouble, and it happened to haveoccurred during placebo.
So they weren't actuallysniffing anything.
It was just nervousness.
And in the touching part of thestory, a third of, so we're
(19:33):
rubbing peanut
Sloane Miller (Allergic G (19:34):
Yeah.
Dr. Scott Sicherer (19:35):
their back or we're, we're rubbing not
peanut butter that had somehistamine in it to make it itchy
Anyway.
And a third of the people whowere rubbed with peanut got a
little redness there, but thatwas it.
And two thirds didn't even getredness because your skin
barrier usually blocks that.
Now your eye doesn't do that sowell, which is why I gave that
example earlier.
you know, I use that informationto just try to add some context.
(19:58):
are other situations where likeif you're milk allergic and
you're near like a.
One of those machines that boilsthe milk cappuccino or whatever.
I mean, aerosolizing milk byboiling, it can cause an
allergic reaction.
'cause you're actually blowingit into the air.
It's like someone with pollenallergy, it's in the air.
It makes them sneeze and itchand can have problems.
So it's not like food can'tcause a problem through non
(20:21):
ingestion exposure.
It's just that it's usually.
Like more unusual scenarios likeboiling something like if you're
allergic to beans and you'reover a pot of boiling or
shellfish, like if, if there'sjust cold shell shellfish on the
table, I wouldn't expectparticles to be.
around.
Just like they don't pop off ofpeanut butter.
But if you're cooking shellfish,boiling it, frying it, or fish
(20:41):
for that matter, then the steamcoming off of that does carry
protein and you could havesymptoms.
So I go through all of thesedifferent scenarios with people
if they're asking and if they'reconcerned about it.
And it's usually for people whoare more reactive.
'cause not everybody, like Isaid before, not everybody's
super sensitive.
Getting that question that youasked about case studies, so I
think, you know, most peopledon't recognize that what
(21:05):
happens in the medical litliterature is if you see
something unusual, um, you, youwrite it up and you send it to a
journal and maybe they'llpublish it and those might
collect.
So if it's something that islike.
Creating multiple of those, thenyou end up with case series, um,
and then you might end up withlike more and more information
(21:27):
about it.
But when things are pretty rareand unusual.
And grab media attention, youend up with a scenario where I
think that what we usually thinkof as a case report, so an
example of that would be, um,many years ago there was a bunch
of reports about someone who,where it was labeled as the kiss
(21:49):
of death.
You know, there was thisteenager who kissed their
boyfriend and died it made somuch headline and everything,
and then I.
It caused a lot of, you know,worry among people, which, you
know, it is what it is.
But then like a long time afterit came up like, oh, this person
had very severe asthma.
There was a not under control,it was an asthma attack and it
(22:11):
had nothing to do with beingkissed.
There's a report of a deathfrom, um, oral sex where.
The giver had eaten peanutbutter, and so the idea would be
that mu uh, exposure to thepenis from the oral mucosa of
(22:34):
the person who ate the, the oralsurface of the person who ate
peanut butter caused asignificant reaction for the
person that they were givingoral sex to.
However, you could read thatreport and say, are we sure?
You know, there's one reportlike that, it seems like.
That person's like, I would'vethought like that person's penis
(22:55):
should have become incrediblylike swollen and rashy.
And that's never mentioned inthe report.
So I'm not saying it's not atrue case.
I'm just saying that it's suchan unusual thing.
It made it to the news.
Have I ever had a patient eversay that that happened?
Maybe they wouldn't want to sayit happened, but I haven't had
anyone say it happened.
(23:15):
When, when have reactions tofoods, moms who are
breastfeeding will often say,well, I've been eating that
food.
Do I need to stop eating it?
a small amount of the proteinthat the mother is ingesting in
immunologically intact formmakes it into breast milk.
But it's a very small quantity,and so that same baby who
(23:38):
reacted pretty violently topeanut didn't react to the
mother's breast milk.
And or who reacted to egg didn'treact to the mother ingesting
egg and breastfeeding, eventhough there's some small amount
in there.
Are there case reports orreports of babies getting sick
from the allergen that's in themother's breast milk?
Yes, there are.
And there, there I would say isprobably more reason to expect
(24:02):
that there's some protein fromthe foods that the mother eats
in the mother's breast belt tobe there.
Now, if we're gonna starttalking about sperm o r
ejaculate having the food thatthe person was eating in it, or
if we're gonna be talking aboutvaginal, lubrication, having the
protein that the person ate init.
(24:24):
Theoretically, yes, but theamount would presumably be close
to not measurable drugs.
Are not proteins.
'cause proteins are largemolecules.
Drugs are often not largemolecules, and they get into,
um, juices of your body more,more easily than proteins do.
(24:48):
So, for example, um, right?
Like if you have an eyeinfection, usually get eye
drops.
It's harder for like a pill youtake to help your eye.
Actually, that goes for, forallergy too.
I mean, when you take anantihistamine.
It might help your eye but notso much.
'cause it's harder for the drugto get into the secretions of
your eye.
(25:09):
But some does get there and so,but those are small molecules.
Proteins are harder to do that.
I see
Sloane Miller (Allergic Girl) (25:16):
I do have, I do have a quick
question.
I just had an asparagus thought,just like a random asparagus
thought, right?
So if we're talking about, um,both vaginal secretions and
seminal secretions, I.
For, there are many of us whoeat asparagus, and then like the
next time you pee,
Dr. Scott Sicherer (25:34):
Yeah, that's an organic molecule.
It's not a
Sloane Miller (Allergic G (25:36):
okay.
Dr. Scott Sicherer (25:37):
so similarly, it's exactly this.
So thank you for that example.
'cause it's exact, exact sametheme when you smell peanut
butter.
You smell a very strong smell.
And a lot of people who areallergic to peanut get ill from
that.
I put it similar to a protectiveeffect.
Like if ibr, if I into a roomwith a gun and pointed at your
head, you're gonna have avisceral response.
(25:59):
You're probably gonna shake, youmight, you know, you might wet
yourself.
You know, like anything'spossible with that kind of fear.
'cause you know that this is adangerous situation.
Right.
And then if I showed you, wellwait a minute.
You know, this is a plastic toy.
What are you worried about?
You know.
So, so yeah, there's aprotective response when you
smell peanut, but that's anorganic odor that has no protein
(26:19):
to trigger an allergic reaction.
Now getting back to this examplewith, um, drugs, there are some
reports of people having areaction from secretions the
person's body secretion goes tothe person who's got the drug
allergy, and they have somewhatkind of response to that.
So that I would say isincredibly rare.
(26:41):
Unusual, but it's more likelikely than where it's the
protein has to get into theseplaces, so it's harder for the
protein to get into thoseplaces.
But the, but, but the example ofbreast milk is, is, is one of
these things.
So, so I would say that.
You know, we have not generallytold people, oh, you know, you
(27:02):
can't, you know, sperm in youfor like X number of hours since
that person ate the food.
You know, like that's not aninstruction that we have.
You know, typically givenpeople, now you could say, well,
gee, you know, like.
How do you know for sure thatthat's not something to worry
about?
I guess I would say, I don'tknow.
(27:24):
It's, uh, we did try to measurefood protein in ejaculate before
and just can't do it becausethere's too much gunked up
protein there to be able to usean assay on.
But, um, but in real life wehaven't gotten this kind of
scenario and it seems like itwas, would be very, very
unusual.
(27:45):
the, the kissing is much more.
Understandable.
The food is in the mouth and soit's, you know, it's not really
ha, it's not like it has to gothrough digestion and get
processed, get to thebloodstream, find its way from
the bloodstream to a secretionand you know, like there's so
many extra steps there.
I.
So I think that that's justdifferent.
there are people who haveallergies to sperm.
(28:06):
Uh, actually usually theejaculate fluid, not so much the
sperm itself.
And those allergies are alsorare in and of themselves.
Um, and they are treatable.
either by using a condom so thatthere's not direct contact or by
doing a desensitization therapy,which is kind of an unusual one,
but gradual, uh, introduction tothe sper of the sperm.
(28:30):
but, but that's a different kindof thing.
It's not attributed to what theperson has ingested.
Sloane Miller (Allergic Girl (28:35):
So I, I wanna, can we go back, um,
a few steps?
Well, firstly, thank you so muchfor doing that original peanut
study that basically all of usout here in the field are still
using and.
To help people understand.
I use it personally.
I use it with I, my partnerknows the study because he knows
(28:56):
once he eats my allergen, youknow, that's probably it for the
night.
In terms of kissing, he also hasa beard and food is, and
particles are transmittedthrough the beard to my skin.
I'm, I've sensitive skin and Iwill definitely get hives.
From that.
So it's usually a shower in afew hours from that study, which
(29:17):
was very, very helpful.
So thank you.
Um, if we could go back totalking about spontaneity
because for young people, youngadults, um, people in their
twenties who are able tocommunicate, like that young
person who was like, boys wannakiss me and I will tell them,
(29:38):
what they need to do.
Fantastic.
Like that is an idealconversation.
It's like ideal, right?
A lot of people are not likethat.
Um, of all genders are just notcommunicating that clearly and
or they wanna be spontaneous.
And I get that question a lottoo about like how to be
spontaneous and, and my phrasefor that is like, I can
(30:00):
absolutely be spontaneous withpreparation.
So that's my version ofspontaneity.
How, but how can we.
How can we help young peoplefeel spontaneous, um, and
understand risk and understandwhat to do if, if in the tiniest
(30:21):
chance there is a problem?
Dr. Scott Sicherer (30:24):
I think there's a few things there.
So, kissing is not the onlyinstruction.
I'm talking to teenagers about.
Um, we talk about alcohol.
I always bring alcohol up, evenwhen, so my joke on that one is
like, whatever their age is, Isay like, well, you've got.
Six more years before you'relegal to drink, but sometimes
people accidentally get alcohol.
Um, and so, you know, I open theconversation that way typically
(30:45):
and point out that alcohol is aproblem with someone who has a
food allergy for reasons thatthe person doesn't.
Think about actually.
And so you know, if you are, sothe first thing that people
probably think about is, well,there's some allergen in the
alcohol that I have to worryabout.
But the bigger problem is thatif you're ine, well one of the
bigger problems is if you'reinebriated, you might eat
something that you wasn't reallysafe.
(31:07):
'cause you just like.
Are not inhibited and, um, youmay not realize you're having a
reaction.
And on top of all of that,alcohol acts as what we call an
augmentation factor or aco-factor.
It makes reactions worse.
It makes the protein, uh, getinto the body quicker.
I.
Without as much digestion, andso it makes a worse reaction.
I explain to people like, ifthis much cashew is, you know,
(31:30):
ingested without alcohol, it'salmost like you ate that much
cashew with the alcohol, and soit's a worse reaction.
And so, you know, giving thatkind of thing is also a
spontaneity theme because youknow, you have to think about
where you are, what you'redoing, You know, as you said,
Sloan spontaneity, I'm, I couldbe spontaneous with some
(31:50):
preparation.
I mean, I think it's the samething this way.
So, you know, like if, ifyou're, if someone is coming up
to you, you know, to give you aspontaneous kiss, you could say
over here, you know, you mighthave eaten something I'm
allergic to, or let's just, youknow, elbow it since, uh, I have
some allergies and, and justlike you're laughing about it
now the person who you know is.
(32:12):
In charge, which is the personwith the allergies could make it
like a, a laugh, a laugh moment,you know, just to lighten it.
But, you know, I, I don't think,you know, I, one of the things I
say is that your friend, likewhen I say to teenagers.
So, side, side point, right?
Teenagers are at higher risk forfatal reactions, mostly because
they may be less likely to tella friend they're getting sick,
(32:35):
uh, tell a friend that theycan't eat this, um, try to hide
their issue and then not useepinephrine, right?
So with that in mind, I, I focuson, you know, people that
you're.
Interacting with your peers.
Don't want you to be sick.
They're, they, the last thing inthe world they want is for you
to start having allergicreaction in front of them.
That is what they do not want tohappen and it's way, they would
(32:58):
be way more disappointed, nothearing you speak up for
yourself and let them know thatyou have the allergies and what
you need done then to end upwith a problem.
And so, you know, for you tosay, Hey, I'm sorry I just can't
find anything to eat here.
Uh, I'm just gonna have a coke.
Um, or to say, Hey, I'm sorry.
I know you wanted to give me akiss and a hug, but how about an
(33:19):
elbow today?
Because I'm worried aboutwhatever.
You know, they're gonna behappier to know that, um, and to
not have something happen.
They don't wanna be responsiblefor causing you to be sick.
So, I I, I also throw that intomy counseling.
Sloane Miller (Allergic G (33:33):
also, partners do not want to be the
cause of sickness or witnesssomething terrible happening,
and so arming potential romanticpartners.
With information, with realrisks and real information.
Also, here's my EpiPen.
This is what to do in case ofemergency is, is a gift to say
(33:55):
this is how to help me.
And you know, it doesn't have tobe a big deal, but there are
real risks here and here's whatto do.
And it's like a three really,it's, it can be a three sentence
conversation, which is one ofthe things that I talk about in
coaching is that this doesn'thave to be paragraphs and
paragraphs.
It's really.
You are in charge of you andyour body.
(34:16):
You know the risks, you knowwhat you're allergic to.
As long as you know you areletting someone in to that part
of you just in case.
But also'cause no one wants tosee you, hurt your friends, nor
does, nor a romantic partner.
They really don't wanna hurt youand any way they wanna be close
to you and intimate with you.
Dr. Amanda Whitehouse (34:36):
I think that the way that Dr.
Sicherer, described having thoseconversations.
The way that people receive itis the way that they will then
carry it forward into being theones to initiate the
conversation.
So what you modeled anddescribed about starting young
and adding piece by piece askids get older is I think how it
more naturally happens inrelationships too, right?
(34:56):
When people have had thoseconversations, then they would
communicate.
Differently and a less amount ofinformation to a buddy on the
basketball team with them thanthey would to someone that they
were dating.
So I think we model that in ourconversations, and I think you
set a good example of that, Dr.
Sicherer
Sloane Miller (Allergic Gi (35:10):
Well also even bringing it up about
grandparent, because if we'retalking to parents on this
podcast about their youngchildren and the parents are
having, let's say, challengeswith in-laws or their own
parents accepting a child'sallergy and saying, well, it's
just I ate, I just had a peanutbutter sandwich.
A little kiss on the cheek won'thurt.
(35:33):
I think.
For parents to model thatconversation.
Well, actually there's somerisk.
It might cause some itching orsome discomfort.
And for even a child as young astwo to say, no, what did you
eat?
Grandma, uh, or grandpa or auntor uncle and, and teaching a
child and, and we talked aboutthis, um.
(35:54):
About body autonomy, right?
That and agency and the like.
The soonest you can get thoseconversations going about, this
is my body and this is my.
Um, medical condition that Iwant to understand and know how
to communicate the better.
And I think parents can modelthat conversations they're
having with grandparents for thechild and help the child learn
(36:17):
to advocate to adults aroundthem, whether it's a teacher
that wants to kiss them or afriend of the whomever it is,
and they're like, no, no.
What'd you eat?
You know?
Dr. Scott Sicherer (36:27):
Well, actually your, you know, your
example moved the age group downand so it is, um, it is a
conversation with.
like when there's food around,um, a, a, a well-meaning, uh,
parent who ate something andthen blows raspberries on the
baby's belly, you know, is gonnafind that they're blowing some
hives onto the baby's belly.
(36:49):
Um, again, may not be asserious, you know, exposure, but
it's still, you know, is ununsightly.
And then it's like, oops.
And you know, as you mentionedbefore about the beard, you
know, that's another examplewhere sometimes dads will, you
know, have something stuck or.
For some reason, it's always thedads who are eating cashews and
wiping their mouth on some towelin the kitchen.
(37:10):
And then the towels used to likewipe something off the young
child and then they have hivesfrom that.
So like those kinds of transferof, uh, allergen, you know,
again, they're not typicallysevere reactions, but they could
be, you know, uncomfortable.
And it does take.
Conversations, we actually talkabout ages and stages, and so
you know, what we're giving,like what I'm talking to
(37:32):
families about for an a, a babyversus a toddler who can grab
food versus, you know, themiddle where they start to have
more autonomy and they're, youknow, they, they have to be
around more peers who are eatingthings and have, you know,
decisions about what they cancontrol or not.
And then the high school yearswhere it's a whole other story,
you know, like each, each ofthese ages and stages has its
(37:53):
own.
Um, things to talk about for,for managing allergy.
So kissing comes up in a varietyof age groups.
Sloane Miller (Allergic Girl (38:02):
It does and and it should.
It's enjoyable and people withfood allergies.
should have and hopefully have afull range of wonderful
experiences, including intimacythat is at the level and the
safety that they want.
And one of the takeaways thatI'm hearing from you, um, which
(38:24):
is great, is that the, the realrisk of anaphylaxis, of, of
going into really severefatality danger zone is really,
really tiny.
Is really, really tiny, and it'sreally an outlier.
Did I get that correctly?
Dr. Scott Sicherer (38:40):
I think you do.
So you always talk to yourallergist.
There's always an exception.
There's, you know, people whoare listening podcasts like this
probably have a, you know, more,uh, significant past history.
So, but I think talking in thecontext of your own allergies
with your allergist, but I, Istill would say that on a
epidemiologic basis, um, it'swhat's what you're getting in
your mouth and eating is themost.
(39:01):
Significant risk and kissingpresents the potential for that.
Um, although again, most of thetime even, you know, any kind of
simple, you know, non saliva tosaliva kind of kiss is not going
to that significance of a, of adanger.
Sloane Miller (Allergic Gi (39:19):
And, uh, by, by the bye on a personal
note.
I have had a range of thoseexperiences, um, where I will
have from getting a cheek kissfrom someone who has dogs and
touches their dogs and thentouches their face.
I'm allergic and asthmatic todogs instant hives.
(39:41):
I've had experiences where aguy, we had the conversation,
very clear conversation, heunderstood my food allergies.
He had eaten cashews earlier inthe day, and I talk about this
in my book and I.
was, we figured afterwards itwas probably in his beard, but
he didn't, he had, it had beenhours, he had brushed his teeth,
(40:02):
he'd eaten something else.
We'd had dinner together of asafe meal and still I had hives
everywhere and asthma.
And again, it luckily it didn'tprogress.
Um, and it was a mistake eventhough we had had the
conversation and even though he,you know, it had been a long
time, that beard, that beard is.
Dr. Scott Sicherer (40:23):
beard, beard.
Beard is an extra
Sloane Miller (Allergic Girl (40:25):
be beard is an extra, or, and body
hair is an extra scenario.
However, again, it was a honestmistake.
I had all my medicationsnecessary.
We, I took, I did what I neededto do to stay safe, and we had a
very positive, it was a positiveexperience.
It wasn't like he ran screamingfrom the apartment.
He is like, what can I do?
we need to do?
(40:45):
And we, we figured it out.
So.
had a range of those experiencesfrom saliva to beard.
Um, and, I've had all theconversations too.
And so I, I think the reason I'msaying this is because mistakes
can happen.
Even when you are the mostcareful and you've explained the
(41:07):
risks and you've had all theconversations, and that's why
you have your anaphylaxis actionplan.
That's why you have all yourmedications.
That's why you've spoken to yourallergist about the real risk
for you.
Um, and, and you just.
That's part of intimacy is thatsometimes things happen and
that's okay, and that is notsomething to be afraid of.
(41:28):
Uh, but that's, I think, part ofthe normal part of anyone's
intimate experience, um, thatthings happen that are
unexpected.
And as long as you arespontaneous and prepared that
you can have a safe and positiveexperience.
Dr. Amanda Whitehouse (41:43):
You used the word earlier, Sloan, that
it's enjoyable, and I also thinkit's beyond that.
To have close relationships isan essential part of the human
experience and of having ahealthy, well-rounded life.
I certainly don't mean to say.
Everyone must have arelationship.
Some people choose not to, andthat's okay.
But for the most part, I thinkit really is central to our
wellbeing.
Not just romantic relationships,but to feel safe and connected
(42:06):
to people without this layer offear and protection.
And that's not really a healthyway to navigate relationships.
So to find a way through that Ithink is really important
socially and emotionally.
Sloane Miller (Allergic G (42:15):
Yeah.
Yeah, the avoidance, certainlywhen I was a kid.
Um, and.
You know, EpiPen didn't exist.
Epinephrine existed andepinephrine was given in the
hospitals, but EpiPens didn'texist yet.
So, um, what I was told by theallergist was, avoid, avoid your
allergen and if you haveexposure, go to the hospital.
(42:37):
That's what, that was, what washappening in the seventies and
early eighties.
And what I did was, um, Iglobalized that.
Avoidance and ended up avoidinga lot because of my allergens.
And that's what really promptedme to start my practice and
write this book because didn'twanna live like that anymore.
(42:58):
I didn't wanna live.
An avoidant lifestyle.
And I didn't want avoidance tobe my only coping mechanism.
And, um, and to your point thatyes, this is part of a whole
human the whole breadth of humanexperience and that we need more
tools in our toolbox other thanavoid, of course, avoid your
(43:21):
allergen.
Of course, however, as a globalcoping mechanism, there are
other, there are other thingsthat you can do.
Dr. Scott Sicherer (43:31):
Well, I mean, just to very briefly, uh,
pick up off of that point, um.
The past couple of decades,there wasn't much more out there
other than avoiding and having abackup plan of, of epinephrine.
And now there really are moreconversations going on in
doctor's offices because thereare possible therapeutics,
(43:51):
whether it's uh, you know, aninjected biologic like
Omalizumab or doing oralimmunotherapy.
Uh, and there's a lot more inthe pipeline that's coming
there.
You know, there are, um, other,other options other than just
avoidance for people.
For, for many of the people withfood allergies, happily.
Dr. Amanda Whitehouse (44:08):
Yeah, which is very exciting My son,
has done a combination of OITand Slit, and so these
conversations.
Us.
He's only 13, but obviously westart young and we talk early.
These conversations are quitedifferent because there's still
risk.
We're managing it.
But as you said, it's soindividual to each patient,
depending on their history andwhat they've done.
So back to the importance oftheir doctors talking to them
(44:29):
about it.
I love the way that youdescribed that you do this.
In my experience, this is nothappening very frequently.
Uh, no one's had thatconversation with my son.
A lot of my clients, I'm thefirst one to mention to them,
you know.
What do you know?
What's your plan?
Please go talk to your doctorabout it.
What are your thoughts on that?
Dr. Scott Sicherer (44:49):
I, I think I'm like always having this
conversation and I, I know thatthe parents, I.
Love that, you know, this isbeing discussed during their
visit.
Um, so again, some kids might beembarrassed.
Um, you know, especiallystarting around, I probably, I
probably start doing around age13, 14 ish.
(45:10):
Um, it drives me crazy whensomeone disappears for several
years and then comes back andhasn't seen that.
'cause I say like, you, youshould have a yearly visit.
And what goes into the mind ofmany families is well.
Like, I'll skip a year for testsand then they end up skipping
two or three years becausethey're like, well, it's just
the tests.
And they don't remember that wetalked for an hour.
(45:32):
So it's like, well, tests aretests, but you know, the
discussion about the allergy isthe more important part of the
visit in my point of view.
So, so it gives me theopportunity to talk about all of
these other things.
And this is, I mean, I also talkabout.
Drugs.
Um, and I joke about that, that,you know, well, not heavily
joke, but it's sort of likethere's drugs out there and, you
know, that could also, uh, cloudyour, you know, ability to pick
(45:56):
up the right food or make youmore hungry to eat the wrong
food and then not realize you'rehaving a reaction.
So I.
That only took three seconds forme to say, but like putting all
of that into a package jail, Idon't know what to tell you
about.
Every allergist doesn't coverit.
There's, you know, there's a, alot that has to be done in, in a
visit and there's a lot to talkabout, um, I guess for a family
(46:16):
listening to this, or a parentor anyone listening to this to
feel comfortable bringing it upwith your doctor.
Um, not to put the burden ofstarting the conversation on the
family instead of on the doctor,but, uh.
You know, there's the, theliterature is out there and it
is part of most of ourinstruction forms, and it's in a
sentence somewhere, almosteverywhere that the doctors can
(46:38):
see.
But whether they find the timeto do it, I guess, is, is, is
the question here?
we're we, the three of us couldspread the word and, and
Sloane Miller (Allergic Girl) (46:46):
I think for a lot of families,
like I never raised this with myallergist, my pediatric
allergist or my adult allergist,they never raised it with me.
And I think there's probably anassumption like it's being taken
care of elsewhere, like your GPor a pediatrician is doing it,
or so.
So a question, so a, you'resaying it's appropriate for
families to bring it up?
Um, now if your allergist, yourpediatric allergist, or your
(47:09):
regular allergist, if you're anadult, doesn't know the answer,
it, would it be your gp, wouldit be like, like who has the
information?
I.
Dr. Scott Sicherer (47:21):
You know, we're speaking about a niche
area within allergy that as you,as you asked me, is this a
common thing to ha be a problem?
And among adults, you know, fiveor 10%.
So, so the majority of peoplewho have food allergy maybe
never thought of this, neverexperienced a problem with it
and never will.
For me, who specializes in foodallergy, it's a part of every
(47:42):
visit that I have with ateenager, among other things
that we talk about as teen forteenagers.
So, you know, all I can say is Iwish it were a more open thing
if, if a, if a listener saidlike, where could I read about
stuff like this?
I mean, probably, I don't know.
Uh, if your book has it, my bookhas it.
Um, you know, it does, but youknow, then you'd have to know
(48:03):
to, to read more.
A t the Jaffe Food AllergyInstitute, we do a weekly, I'm
sorry, a monthly, uh, communityengagement thing like on Zoom or
in person.
Actually tonight when we'rerecording this thing, we have a
bunch of our, um, researchersare doing, uh, in a live
presentation of our researchwork and what's out there for
(48:24):
treatments.
Uh, now and in the near future.
We similarly have.
Um, these talks on exactly thistopic.
Um, I I do an ask me anythingother thing.
So, so I think there are places,if you're interested in looking,
you're gonna find theinformation.
If you're just paying attentionto an occasional newspaper
article that might be blowingthings outta proportion, then
(48:46):
the answer is talk to, talk toyour trusted allergist about it.
I do think the board certifiedallergists are the right doctor
to know this information, and Ithink probably most of them do.
They may just not have time tohave this conversation or think
of it when, when the family,when they're trying to teach,
when to use the epinephrine, howto use the epinephrine.
Do you call nine one one?
Do you not call 9 1 1?
What about the label reading?
(49:07):
I mean, I do spend.
Way more time talking aboutlabel reading and restaurant.
I spend more time than any ofthose other topics.
'cause that's the trickiest partfor most of, most of my patients
is, is, is through therestaurants.
I could talk about that for anhour.
So, so I think, you know, thismight take back seat to some of
those other things and I don'tthink it should take back seat,
but, but you know, we are insort of like a.
(49:29):
A topic that maybe doesn't comefront of mind to most of the
families when they're in theoffice wondering like, is the
test gonna be better this year?
Or, you know, what do I do ifthere's an allergic reaction and
they're not thinking about this?
Which as we're admitting is notthe highest risk aspect of
living with a food allergy, butis something that could be
impactful on quality of life.
I will say that.
(49:50):
Um, in these conversations, the,the deeper questions, so to
speak, the ones that are notjust about kissing.
So the ones that are askingabout, you know, oral sex, um,
and stuff like that, thosetypically don't happen unless
the.
Parent is out of the room.
So
Sloane Miller (Allergic G (50:06):
Yeah.
Dr. Scott Sicherer (50:07):
so I usually get the ball rolling with
kissing and stuff while theparent's still there.
And then after the parent's out,I'll say, do you have any other
questions?
And if there are otherquestions, it's usually what
we've already covered today.
Um, it's, it's like, well, do Ihave to worry about sperm,
vaginal secretions?
And, you know, that's, that'susually the, the next thought
(50:27):
that people start to have.
Sloane Miller (Allergic Girl (50:29):
I, wanna make a plug, just a quick
plug for Centers of Food AllergyExcellence because also, um, and
this is my personal experience.
I've had wonderful allergists,but they're allergist
immunologists.
And food allergy is not theirspecialty necessarily.
And so, um, I think it's, if youcan get to a food allergy center
(50:52):
of excellence near you in thecountry, that that will really,
um, support your family andunderstanding these issues and,
uh, on a deeper level as well ashave an allergist at home near
you that you can see.
But.
Dr. Scott Sicherer (51:10):
Yeah, it's a good point.
I mean, I, I would say that allallergists are trained to take
care of food allergy, but you'reright that it's not necessarily
the focus for all allergists.
And so, you know, food allergyresearch and education or FARE,
does have like this FAREclinical network that, uh, lists
about 50 places that are extrathoughtful about food allergy.
And a lot of my patientsactually have two allergists.
(51:32):
They have me or my colleagueshere at Jaffe Food Aller
Institute.
Also their local allergist whomaybe is spending more time with
them for their hay fever orasthma.
And then, you know, they'll havetheir once a year visit for the
food allergy.
And, and there are a lot ofthings involved with a good food
allergy evaluation.
There's, uh, super medicallysupervised feeding tests and a
(51:54):
lot more talking and things likethat.
So, so yeah, I think your pointwell taken.
Dr. Amanda Whitehouse (51:59):
Do you wanna leave us with any last
thoughts
Dr. Scott Sicherer (52:00):
I mean, for me, I think I'm, I think I've
covered everything that you guyswere interested in talking
about, and I, I'm, I'm glad, uh,we focused on this area, which
is incredibly important andprobably under discussed.
Dr. Amanda Whitehouse (52:13):
I agree.
Sloan, any last thoughts thatyou wanna add?
Sloane Miller (Allergic G (52:16):
Thank you.
Thank you both.
Uh, I'm so glad to see and hearand have shed more light on this
topic.
And I'm, I'm really thrilledthat you bring this up, um, with
your clients and with yourpatients rather.
And I.
I would hope that thisencourages more families to know
that this is something that theyshould be bringing up, uh, to
(52:38):
their, um, allergist to exploreit.
That there is stuff to beexplored here that's really good
information and that your kidsdo wanna know and will need to
know as they age.
Dr. Amanda Whitehouse (52:51):
Thank you so much to both of you for
taking the time to share yourthoughts and your experience and
your insights.
I appreciate it so much.
Sloane Miller (Allergic G (52:58):
Thank you.
Dr. Scott Sicherer (52:59):
for the invitation.
Dr. Amanda Whitehouse (53:00):
Yeah.
Thank you for joining us forpart one of this two part series
on food allergies and physicalintimacy.
Stay tuned for part two nextweek where Sloane Miller and I
will be back to dive deeper intothese topics Together we'll
explore how to apply the advicethat Dr.
Sicherer gave us in real lifesituations.
How to communicate iteffectively with our children
and how to address the social,emotional, and mental health
(53:22):
aspects of navigatingrelationships and intimacy with
allergies.
In the meantime, if you want tokeep learning, you can read Dr.
Sicherer's book, the CompleteGuide to Food Allergies and
Adults and Children.
You can read Sloane Miller'smemoir Allergic Girl, and you
can reach out to me for the freeguide that I've created for you
based on this series of talks tohelp you navigate these
(53:42):
conversations and situations.
You can access that by followingme on Instagram at the Food
Allergy Psychologist andmessaging me asking for the free
guide.
Or you can visit my website atthe food allergy
psychologist.com and reach outto me through the contact option
I appreciate you listening, andwe will talk again soon.
the content of this podcast isfor informational and
(54:04):
educational purposes only, andis not a substitute for
professional medical or mentalhealth advice, diagnosis, or
treatment.
If you have any questions aboutyour own medical experience or
mental health needs, pleaseconsult a professional.
I'm Dr.
Amanda White house.
Thanks for joining me.
And until we chat again,remember don't feed the fear.
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