June 26, 2025 • 41 mins
This challenging and important episode concludes our spring season, "I Don't Want to Talk About It."
We tackle one of the most difficult questions food-allergic families may face: “Could I die from my food allergy?” Though we hesitate to bring it up, kids often overhear scary headlines, which there have been far too many of recently. When they ask, avoiding the topic or lying can erode trust and leave them unanchored.
I share why considering your responses ahead of time is important, give insight into how to recognize that the time is right, and walk through what conversations might sound like at different ages. Highlights include:
- Signs your child might be worrying, even if they haven’t asked
- Age‑appropriate guidance from preschoolers through teens
- Why clarity, calm, and validation are essential—and when to use them
- How parents can manage their own anxiety about the topic
- Tips for creating moments when kids feel safe bringing up “the hard stuff”
This episode offers practical tools and compassionate insight, helping families deepen connection, create emotional safety, and bring confidence and groundedness to an important and challenging conversation.
Fatal Anaphylaxis: Mortality Rate and Risk Factors - PMC
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..
Amanda Whitehouse, PhD (00:22):
Welcome back friends, and thank you for
joining me again for anotherepisode of Don't Feed the Fear
for What has been a DifficultSpring season, talking about all
the things we don't want to talkabout.
We've covered a lot of difficulttopics and I'm going to end the
season on a real doozy.
We talked about kissing, havingthe birds and the bees talk and
(00:44):
the additional information thatwe needed to throw in that
conversation when we aremanaging food allergies.
But today we're going to talkabout the conversation that food
allergy parents dread even morethan having the talk with their
kids, it's unfortunatelysomething that happens to most
of us, which is our kids askingus if they could die from their
food allergies.
This season we had threedifferent parents come and speak
(01:06):
to us on the show about theirheartbreak and grief over their
children's death from their foodallergies.
Thank you to each and every oneof them for helping to remind us
that this is an importantreality that we have to keep in
our awareness I'd like to startthe conversation with a reminder
how highly unlikely death fromfood allergies actually is.
(01:26):
A study from 2017 by Turner andcolleagues called Fatal
Anaphylaxis.
Mortality rates and riskfactors, which I will link in
the comments for You, indicatedthat even though food related
anaphylaxis is relativelycommon, food allergy related
fatalities remain extremely rarewith a reported range of
(01:47):
approximately 0.03.
To 0.3 deaths per million personyears in the general population,
To give you another statistic tocompare it to, the odds of being
struck by lightning in theUnited States during one's
lifetime are approximately onein 15,300.
The odds of being murdered inthe US are one in 18,989.
(02:11):
So while severe allergic reactions can be
life-threatening, deaths fromfood allergies are not common,
and the overall risk from deathand food allergies is considered
very low.
Knowing this information can behelpful, but doesn't magically
erase the fear that we carryabout it because as we talk
about constantly on this show,every near miss, every accident,
(02:33):
every reaction, no matter howserious it is, is a reminder
that the potential is there andcan be a trauma that our body
experiences and remembers.
So regardless of the chance ofthis actually happening, the
chance that you'll have to havethe conversation with your child
about this is 100%.
And the chance that your childis thinking about it or has
(02:54):
thought about it, is prettyhigh.
I can tell you as a food allergypsychologist who has worked with
so many families and childrennavigating food allergies,
whether or not your kids aresaying this out loud to you,
expressing these fears to you,they're thinking about it.
They're talking to me about itin session, and we wanna make it
safe for them to talk to youabout it too.
At some point they'll likelyhave an experience, whether it's
(03:15):
a food allergy experience orsomething that brings up the
concept of death in theirawareness, and it will bring
that possibility to mind.
They'll connect the dots andwhether or not you talked about
it, they will begin tounderstand So I want you to be
prepared.
I've had conversations withother food allergy parents about
how this conversation is notonly scarier than the birds and
the bees talk, but we could alsocompare it to that day you're
(03:39):
not ready for when your littleone looks you in the eye and
says, is Santa Claus real?
And for those of us parents whohave been through that, we know
kids don't usually ask thatquestion until they already
know, or at least stronglysuspect the truth.
We want to be prepared, but it'sso hard when we're caught off
guard to know what to say and togive a response that's loving
(04:01):
and supportive, acknowledgestheir feelings, and also takes
that new awareness that'sexpanding and makes it into a
positive thing.
I find in my experience that theway that you handled the Santa
Claus question, if you'vereached that point yet, is a
good indication of how you'relikely to respond if your child
asks you if they can die fromtheir food allergies.
What's natural for most of us isto lie.
(04:23):
We want to avoid causing ourkids any fear or pain at any
cost.
But if you're prepared, ifyou've thought through this and
you've taken the time toconsider your own values and
beliefs, your child's uniquemakeup and awareness, if you've
dealt with your own emotionsabout the topic and you know how
you wanna approach this when itcomes up, you've laid the
(04:43):
foundation, you've created thespace for difficult
conversations with love andsupport in your family, then it
will be much easier to respondto a difficult question in a way
that you feel confident aboutand that will validate and
support your child, even if theconversation itself is difficult
or upsetting.
Talking about death is justcomplicated.
(05:03):
Most adults will avoid thistopic and even when they're
faced with it, with the loss ofsomeone that they love, they
typically don't talk about itdirectly.
We talk around it.
We use euphemisms.
We spout beliefs that we maybedon't even carry the rest of the
time, So today I'm going to talkyou through age by age,
(05:23):
developmental level, bydevelopmental level, the
indications that your childmight be thinking about death
and wondering if they could diefrom their food allergies, what
it might look like in theirbehaviors, sound like in their
heads, And how you can talk tothem in an age appropriate and
developmentally appropriate waythat will be supportive and
loving for them.
(05:44):
Before we can ever be ready todiscuss this with our kids,
though, we have to face thereality that discussing food
allergy deaths with our kidstriggers our number one biggest
fear, If we don't work throughour own stuff and develop our
window of tolerance fordifficult emotions, then one of
the mistakes that we're likelyto make is avoiding this
(06:04):
conversation altogether.
If it hasn't come up yet, whywould we bring it up?
We don't wanna introduce fearsthat they're not already
thinking about, and you thinkyou're protecting your kids, but
the reality is that kids pick upon the danger under the surface.
They are so much smarter than wegive them credit for.
And they certainly pick up onour discomfort with a topic.
By not talking, we send themmessage that it's not something
(06:27):
that should be talked about.
And kids can feel emotionallyabandoned by that, or unseen,
lied to deceived in our omissionof these conversations.
This really does become adelicate balance of not throwing
this conversation at them, notintroducing a worry that they
don't already have in theirheads, but listening and paying
close attention to what they aresaying to help us gauge whether
(06:49):
this is something that's ontheir mind, even if they're not
saying it directly.
The way to do that is to be veryproactive, to have lots of
conversations that aren'tspecifically about death, but
that are preemptive check-ins.
Creating an environment and aculture within our homes and
families of open conversationand comfort and support around
(07:10):
difficult topics.
That can look like regularcheck-ins where we say, Hey,
sometimes you might worry.
I want you to know, and we canalways talk about it.
I can answer any of yourquestions if anything ever comes
to mind that's bothering you.
If we haven't dealt with our ownemotions, the opposite thing we
might do rather than avoid theconversation is to overshare or
(07:30):
flood our kids with our ownemotions inadvertently.
we don't want that all to comerushing out in an uncontrolled
way that will overwhelm ourchildren.
So it is certainly okay to showyour children that you have
feelings.
Then you can show and explain tothem how you cope.
They can see you putting thoseskills into action, what you do
to manage difficult things.
(07:51):
So we don't deny that it's scaryor that we worry or we're
afraid.
Sometimes we say things like,sometimes I feel scared about
that too.
This is what I have found helpsme.
And then we let them see usdoing those things.
This might take some explorationfrom you.
It might take some, Activeconsideration of how you are
coping, what you do on a regularbasis, or when things get
(08:14):
difficult, you might benefitfrom some therapeutic support
around that.
There might be some room forexploration of your individual
belief system, religion,spirituality, or whatever
approach brings you somesemblance of understanding or
peace around the topic of death.
That's individual for everybodyand usually never a completely
(08:35):
finished task.
But again, something that wewanna model for our children, an
active and healthy spiritualexploration If you are actively
involved in these processes ofself-awareness and
understanding, you'll be a lotbetter prepared to demonstrate
to your children that you havefeelings and be able to express
and show them what you're doingto manage it in healthy ways,
(08:56):
and then teach those to yourchildren.
So we don't wanna have aconversation that will leave our
children even more frightened,less sure of the situation by
oversharing and flooding, or byavoiding the conversation.
We don't wanna give the messageor the impression either way
that this is not a safe thingfor our children to talk to us
about.
Another common mistake that wecan make is being too vague or
(09:19):
too euphemistic, so a lot ofparents won't know what to say.
Again, it's not just with kids.
When we're speaking to otheradults, we don't know what to
say about death.
We say things like,, He's in abetter place, or these
euphemisms that help us tosidestep our discomfort.
We tend to do the same thingswith kids.
(09:39):
One of the most common ones, andyou've probably heard this
before, is not to tell childrenthings like they went to sleep
and they never woke up, becausethen we can create a fear of
sleeping.
We don't wanna say things thatare really vague, like passed
away, crossed over, gone.
We lost them.
We need to make it clear to kidsthat that's what we're talking
(10:00):
about.
If we use language that's vagueor confusing, what kids will
often do is fill in the story intheir head.
They will make up the rest ofthe details that they don't
understand, and that typicallywill make things even scarier,
even worse than what the truthis.
Using the words they died sayingthe word death is factual and it
(10:23):
is as clear as we can possiblymake it for kids.
That doesn't mean that they canunderstand the concept of the
word, but at least we all knowwe're talking about the same
thing.
And after we've made that clearthat what we're talking about,
this big, scary concept that'sreally hard for any human to
wrap their minds around, if youdo have a belief system that can
be very helpful, it's okay touse that to shape this
(10:46):
conversation if it truly is yourbelief system.
But be honest and it's okay ifyou don't know or if you don't
have a specific belief.
If you're comfortable with it,you can explain that many people
believe lots of different thingsand talk about what some of
those are and admit to yourchild that you don't know for
sure what the truth is.
But sometimes it helps you toconsider those possibilities and
(11:07):
give them the opportunity toconsider what they believe.
And whether or not you have thatto support you through this
conversation, you can utilizewhat you know about regulating
your own nervous system to helpyou do a better job at this
conversation.
So in addition to doing youremotional work and your
self-exploration about yourbeliefs, your spiritual work,
(11:28):
you need to do your nervoussystem regulation work.
When you have grounding skillsand breathing skills that you
can use in the moment, you canachieve some regulation and loan
that to your child.
That's what co-regulation means,and your child's body can then
calm down via your body.
And your groundedness.
(11:48):
And that will help their nervoussystem settle in the moment and
learn how in the long term tosettle their own.
So before you have a toughconversation like this, it's
okay to use those skills veryopenly and point it out to your
kids.
You can even model and give aname for the words and the
regulation skills that you'reusing.
So for ex example, if they askyou a difficult question, you
(12:10):
can take a deep breath and tellthem, I'm gonna take a couple
deep, slow breaths because thismight be a tough topic for us to
talk about.
I'm glad you asked me and I hopeyou'll breathe with me to help
us stay calm and have a reallygood talk about this.
So considering all of thesepossible wrong turns that we can
make when we're having theseconversations, what can keep us
(12:30):
on track is always making surethat our responses, our words,
our behaviors, our actions arecentered on our child's needs
and emotions, not our own.
This shows children that you canhandle the hard stuff.
And so last a couple tips aboutmaking these conversations
easier..
When you wanna have really hardconversations like this with
(12:51):
your kids, the last thing wewanna do is sit them down, face
to face, and have a seriousconversation across the table,
it's very confronting and it'svery dysregulating for most
people, not just for kids.
We wanna choose natural momentslike when we're walking side by
side, when we're doing chores,when our hands are busy, when
our bodies are moving, whenthere's food, or when we're in
(13:13):
the context of play.
Anything that we can do to makeit feel less intense and
activity that naturallyregulates the nervous system and
makes us more open to somethingthat might be difficult.
And then we want to askopen-ended questions.
Not a yes or no question, not aquestion that suggests that we
already know the answer, butvery open questions the
(13:34):
question, how did that make youfeel is an open question, but
it's very difficult for a lot ofkids and adults to answer
directly.
A lot of people don't have thefeeling expression skills to
answer that one, and it might betricky.
Whatever answers our childrengive us, we want to normalize
and validate what they feel,emphasize that it is okay to
(13:55):
feel difficult emotions.
We can do that by staying calm,most importantly, and present
with them, restating whatthey've said to us, using their
own words to show them that wereally understand it and
agreeing with them.
It sounds like you felt reallyafraid when that happened.
It makes sense that you wouldfeel upset about that.
I can understand why you wouldbe angry.
(14:15):
It doesn't seem fair.
What we wanna do instead is jumpto the thing that we think will
comfort our child.
But it's okay, honey, you weresafe the whole time.
I was protecting you at thephase of the conversation where
they're sharing their feelings,we don't negate them with
promises of safety because itfeels like we're telling them
that they're wrong or feelingthe way that they do.
(14:36):
So again, anytime you're havingthese difficult conversations,
the key is to listen, not talk,and avoid steering the
conversations off track ormissing the opportunity to hear
and understand our kids'thoughts and feelings by.
Thinking that, expecting that wealready know or can anticipate
what they're thinking orfeeling, instead of giving them
the opportunity to tell uswhat's actually on their minds.
(14:57):
And another side note here,remember the siblings, siblings
often think and worry about foodallergy safety and food allergy
death, even more than the kidswith food allergies, because the
siblings are the ones watchingfrom the outside helplessly when
scary things happen.
They're the ones who are alittle bit removed from the
(15:17):
situations, but watching, unableto help, seeing the ambulance
arrive, seeing the facialexpression that mom or dad is,
is giving, seeing the physicalsymptoms that their sibling is
displaying when they're notfeeling well.
And oftentimes having peoplerush outta the house without a
full explanation of what's goingon and their minds are left to
wander as well.
(15:38):
It's so natural for us asparents in an emergency to focus
all that energy on the childwho's having the emergency, of
course, and making them safe.
But in all of that franticnessand stress and concern, a lot of
times it's difficult to rememberto come back and be with that
sibling and process theexperience.
It's usually best to do thatseparately with each child and
(15:59):
the family alone, rather thaneverybody together like a big
family talk, because eachperson's perspective is going to
be different.
Their thoughts can be extremelydifferent from one another.
And again, if one of them sharesa worry, we don't wanna
introduce that to someone else.
We wanna have all of ourone-on-one attention to give
each child when we're talkingabout something so difficult.
(16:21):
So next let's go age by agethrough what's typical in terms
of both kids' understanding ofdeath and then what I've seen as
a food allergy psychologist interms of behaviors and questions
and concerns specific to foodallergies.
We can go very quickly throughthe infant and toddler stage
because of course children atthis age have a very limited
(16:44):
understanding.
They will certainly experiencethe distress if there's
something concerning going onaround them, but they won't
understand the concept of deathWhat's most important at this
phase is just that emotionalregulation when stressful things
are happening and of course,being really aware of the
language that we're modelingwhen we discuss anything related
to safety, death, food,allergies, any of those topics.
(17:07):
If there's a scary or atraumatic experience, we want to
reassure that child, nurturethem, stick to routine, to make
them feel safe and cared forlots of physical touch and
co-regulation, and allowchildren a way to act out their
difficult feelings through play.
Preschool age kids are what wecall magical thinkers.
(17:28):
They often just simply cannotgrasp the concept that death is,
Permanent.
They believe it's temporary orreversible.
And they'll have this magicalthinking to explain it because
if they can't see the concept ofsomeone being dead and staying
dead forever, then they have noway to understand that concept
in their head.
So at this age, they mayunderstand and even bring up the
(17:50):
concept of potentially dyingfrom a food allergy, but that
doesn't necessarily mean thatthey would have panic and fear
about it because they may notunderstand the finality of it.
The way that things would mostlikely show up at this age would
be through clinginess and fearof separation, difficulty
sleeping, irritability, tempertantrums.
(18:11):
Pretty tough to sort out fromwhat might be going on with them
anyway, because a fear like thismight be just as big as a fear
about losing a stuffed animal ornot wanting to eat something
that they're offered that theydislike.
It's going to blend in with alot of the other stuff that
they're mastering at this age,but.
It is very possible, and I'veseen it many times where kids in
(18:32):
this preschool, 3, 4, 5,6-year-old range would begin to
ask repetitive questions andcuriosity about death.
This is unlikely to be triggeredby something that happened by
their food allergies.
However, this would more likelycome up through exposure to the
concept of death elsewhere.
So if a pet has died, if thegrandparent or a loved one has
(18:53):
died, if they saw or heardsomething on television in a
show.
Again, because that concept isso abstract to them, they're
very unlikely to tie it tosomething very specific.
Like their food allergies or thesymptoms that they've
experienced when they've had anallergic reaction.
We don't wanna talk about foodallergies in terms of death.
We just wanna say being healthyor making sure that they don't
(19:14):
feel very sick.
We do wanna communicate theseriousness of it, but it's most
likely not necessary to drawthat connection for them at this
age unless they've specificallyasked you.
So in addition to that, opendiscussion and patient
explanations.
Be prepared for a lot ofrepetition.
Kids at this age will ask thequestion they have in their mind
(19:36):
over and over and over again,and.
It might feel like they'retesting you or they don't
believe you, but really theywant structure around it, and
they wanna make sure that everytime you ask the answer is the
same.
That helps'em to feel safer andmore reassured in that
information.
If we are talking about death,even at this young age, we do
want to, as I said, use thosevery clear words, death or
(19:57):
dying.
And if they ask us what deathis, we can say that it's when
someone or something's bodystops working and explain to
them that it's forever, Onething that you might have to
clarify at this age, is that ifsomeone has died, kids may
anticipate that they can catchthat.
Remember that kids associatesick with something like
catching a cold from someone orthe flu I.
(20:18):
And germs.
So it's very important for themto understand that they can't
catch death or catch somethingthat would lead to death in the
way that we talk about illness.
It can be helpful to use play towork through these things.
So if this is a concept thatyour child really seems to be
exploring, you already have lotsof tools handy in the house to
(20:38):
help you with this, but you wantto just give them the open
opportunity for you to sit down,have your attention, give them
humans and pets or somethingthat can represent living things
and see what theme they act outin their play.
Follow their lead.
Take what you can from what theyact out and their questions, and
then you can respond to that ina way that's helpful.
(20:59):
So, for example, what that mightlook like in play is if you and
your child are acting somethingout with two bunnies and they
said that the toy bunny went tosleep and it didn't wake up, you
would repeat those words.
You, in this case, you would usethe same words that they said.
He didn't wake up.
I wonder why he didn't wake up.
And then you would try to engagethe child further in a way that
(21:20):
that would allow them to explainor further elaborate on what
they're thinking or what theirunderstanding of that concept
that they're playing throughmeans.
If the child has theircharacter, ask your character
something you would.
In turn, ask their character thesame thing and give them the
opportunity to expressthemselves.
So if their character asks yoursabout worries, you would ask
(21:41):
them about worries too.
And do all of those validationand opening lists, open
listening skills that we talkedabout previously, but just in
the context of play in stayingcharacters.
And then depending on how thatgoes, you might move that later
into a conversation between you.
Do you ever wonder about someonenot waking up?
Reference it back to the playand the child feels in control
(22:03):
because they know that that wassomething that they initiated if
the child does ask you veryspecifically, can food allergies
make someone die?
What I would like you to do isfirst acknowledge the feeling
that they're having, whatthey're expressing with that
question.
It sounds like you're feelingscared about that, or it seems
like you're asking me becauseyou might be worried about that,
and that's really common forkids to worry or wonder these
(22:25):
things, and then you can move onto answering the question very
simply and very directly, butwith age appropriate language.
If someone eats a food thatthey're allergic to, it can make
them very sick and die if theydon't get their medicine.
And that won't happen to youbecause we always check your
food and we keep yourepinephrine with us wherever we
(22:46):
go.
The next phase is between about six to
eight years of age, These kidshave more cognitive skills and
have a clearer understanding ofdeath, and They can start to
understand concepts likepermanence, the universality and
foreverness of death, they mightstart to fear the broader
implications of this.
(23:07):
Kids are developing logical andreasoning skills, and they're
decentering.
They are realizing that they'reunique.
They're starting to haveempathy.
They do begin to grasp thefinality of their own life and
mortality, this is gonna show upin ways that are really curious,
like wanting to watch TV showsabout death playing zombies.
Sometimes that can feel reallymorbid to us, but it's actually
(23:29):
a good way to let themexperiment with this and think
through it.
But they still are not gonnahave that abstract thinking
that's necessary to fullyunderstand the concept at this
age.
It's really important to just behonest and to be patient and
repeat.
They might start checking theirfood labels very frequently at
this age, or exhibiting thosebehavioral signs of food allergy
(23:50):
worries.
If it's specific to the foodallergies, they might start
asking and double checking withyou or another adult if a food
is safe with them, even if it'ssomething that they eat all the
time and they already read thelabel and they checked it before
they took the food out of thebox and they already eat a bite
of it, but they wanna checkagain.
They can have more logicalthinking that can follow a step
to step process in their head.
(24:11):
So for example, I will have kidsthink things like, I don't wanna
play with that toy.
And again, this is where ourlistening skills come in really
handy.
What makes you not wanna playwith that toy?
Well, Joe touched it.
What makes you not wanna playwith that toy if Joe touched it,
They'll come up with theseelaborate, loosely connected
explanations of how.
(24:32):
The last time they saw thatchild, they were eating
something and it might have beenon their hands and they weren't
sure if they washed them.
And then they came over to ourhouse and maybe they eat that
thing all the time.
And so if they touch that toyand if I played with that toy
later, and somehow, then I wouldhave a allergic reaction to that
food from playing with the toyagain.
Even if your child shares anelaborate story like that, that
(24:53):
expresses that they're feelingafraid, do not assume that it's
about the possibility that theywould die.
Most of the time when kids atthis age range begin to talk
about this thing, what they'rereally afraid of is using their
epinephrine and having to use aneedle.
They're afraid of seeing theirparents feel scared.
They're afraid of ambulances andhospitals, and a lot of times
throwing up in public can be avery big fear if that's part of
(25:16):
their history of allergicreaction.
Sometimes it's I don't wannamiss school, or I'm supposed to
go to grandpa's this weekend,and I'm afraid that I would miss
that.
So even if it's a very, veryscary story that the child is
weaving inside of their headabout what might be worrisome,
unless they say that they'reafraid that that can make them
die, that might not necessarilybe the question.
(25:38):
So again, use your goodlistening skills.
Don't feed them words.
So here's how we can respond Wewanna do a lot of noticing out
loud to our children.
I noticed you've been startingto try to read the labels.
That's a really good thing toknow how to do if you have food
allergies.
And I've noticed you're doing ita lot more times for the same
food than you used to do.
(25:59):
What do you feel when you readthe label?
What are you looking for on thatlabel, on the food?
What are you thinking about whenyou decide to check that label
again, even after you've alreadystarted eating it?
If they're asking repetitivequestions, we can say things
like, I noticed that you askedme that even after I told you
that your ice cream was safe andthat you kept asking me about it
when we were eating.
(26:20):
A lot of times people ask aquestion over and over again
when they're feeling worried,how are you feeling?
And then once you've presentedthat question to them, you want
to listen to understand withoutinterrupting them.
Any response that you giverepeats the child's language
back to them to show them thatyou're listening, ask for
further clarification.
Again, this is not a stage wherewe wanna jump in and reassure
the child right away, or wemight not get a full grasp of
(26:42):
what it is they're actuallythinking or feeling.
Once we've really listened andvalidated what they're saying to
us, we can say things like, itsounds like you're feeling
afraid that you could get verysick from an allergic reaction,
and if they say yes, or if theysay no, we don't tell them that
they're wrong, we never tellthem how they feel.
They are the expert on how theyfeel.
(27:04):
So even if we have a more matureand thorough understanding of
what's probably happeningemotionally for them, we don't
ever wanna tell them thatthey're not feeling the way that
they said they're feeling.
And thank them for telling us.
I'm so glad you told me this sothat I can help you with it.
You're safe.
So at this elementary schoolage, what's important is making
it normal for their feelings toebb and flow, to feel afraid and
(27:26):
to be reminded that we're herehelping them.
We can encourage physical playas an outlet for when they're
having these difficult feelings.
Allow creative play through artstories, music.
And if we've done all theseskills and the underlying fear,
genuinely and truly is death,and they're asking about that,
then we use straightforward,honest language.
(27:47):
At this age, kids are old enoughto understand something very
specific.
If they heard about a child whodied from food allergies, we can
explain to them exactly whatwent wrong in the body that
caused that to happen.
They weren't able to breathe,and so their heart stopped
beating.
We don't need to give them along, detailed explanation but
we can explain that directly ifthat is truly the underlying
(28:10):
fear.
we wanna help kids strike thatbalance by both reassuring them
that it's unlikely, but alsohelping them to take it
seriously and to understand theweight of this risk.
And then making that tangible tothem by giving'em the steps we
take to reduce that likelihoodof danger as much as we can.
(28:31):
Next up, we have those trickytweens, those 10, 11, 12 year
olds, maybe even into 13.
Kids in this age range are nowable to understand deeper
concepts related to the idea ofdeath and the impact of it.
They'll have a lot morequestions about details and
discussions, a much more broadsense of wonder about what death
(28:52):
means, and kids can often getreally stuck thinking about this
because they have this newfoundcapability to think about some
Really mind-bending conceptslike eternity and different
spiritual beliefs that theymight have been exposed to, but
they might not have theemotional capacity to comprehend
those things and how it makesthem feel when they start to
(29:12):
consider those ideas.
So this can get really tricky atthis age.
This is most likely the timewhen you'll be talking more
directly about death from foodallergies, because kids again,
also have that cognitivecapacity to connect the dots
about what food allergies cancause in the worst of scenarios.
A lot of times kids at this agewill start a conversation like
(29:34):
that, not even coming from aplace of fear, but just a place
of curiosity.
But then the more they get theirbrain going and they talk
through these big ideasthemselves and they expand
outward more and more, they pullin different concepts and more
and more different ideas.
That's when the emotions startto get going.
As they start chewing on thesetopics that they aren't ready to
emotionally digest, And theymight start wanting a lot of
(29:58):
specifics.
How many kids died from foodallergies?
What's the chance of thathappening to me?
There's a strong possibilitythat they're going to ask us
questions that we don't know theanswers to one trick that you
can always use when kids areasking tough questions is, what
makes you wanna know?
Or Why do you ask that?
And try to get a betterunderstanding of the motivation
(30:19):
behind what they're asking.
A lot of times these things willcenter around their social
experiences, worrying about whatmight happen when they're with
others, the fear of a reactionfrom other people to what is
happening to them.
They're thinking about thingslike school events, sleepovers,
social gatherings, and havingsome nervousness about going and
(30:40):
feeling at risk there, but notwanting to miss out on social
experience as wanting to fit in,and then feeling torn between
those two difficult things.
Kids can start to feel likethey're in a no-win situation
with some of these worries atthis age, so for those tweens,
we wanna keep an eye out forthings like avoiding social
experiences, backing out ofplans and obligations, stopping
(31:03):
activities that they used toenjoy, avoiding eating in
certain situations and what.
Seems like kind of acontradictory response of
wanting responsibility, notwanting to be reminded by
parents told what to do, and yetfeeling emotionally overwhelmed
at the thought of doing itthemselves or having difficulty
following through withcompleting that themselves.
(31:25):
We have to be really careful atthis age that we're empowering
them and we're treating themlike they are individuals who
are capable of problem solving,and we are here to support them
in doing that, This is a pointwhere kids are finding
themselves more and more able toexpress their thoughts and their
feelings verbally so we canstart to have a lot better
conversations about this, wherethey're able to express to us
(31:48):
their questions and theiremotions and welcoming them to
talk to us.
We can say things like, how doyou think we're doing handling
all your food allergy stuff?
Is there anything you wanna talkabout?
We can even directly ask them,is there anything that worries
you that you want me to knowabout, because I wanna help you
with things like that.
Most of the time they're gonnasay no when you put them on the
(32:08):
spot like that and ask themdirectly, but just the act of
asking and accepting anyresponse that you get from them
lays the groundwork that theycan come and talk to you, that
you do care.
You wanna hear and you'll listenwhen they do speak up to you
about something that worries orconcerns them.
And if we continue to check inin these ways, we make it more
likely that they will open up tous.
(32:29):
And when they do, we don't wannajump to our first reaction,
which again, is to reassure themand make them feel better right
away.
We want to reflect theirfeelings and show them that we
fully understand what they'refeeling, what their experience
is like, and that's valid.
We say things like, it makessense that you would feel like
that., We wanna let them leadthe conversation, treat them as
(32:52):
if they have good ideas, andthey might help us figure that
out because they do.
So that's something that looksand sounds like questioning.
What do you do when this gets onyour mind?
What have you tried at schoolwhen that happens?
Is there anything that helpswhen you start thinking that
way?
Conversations like that don'trush to a sense of resolution
and immediate calm for the kids,but it gives them a sense of
(33:14):
agency and clarity about theirthoughts and their feelings.
And then feeling involved in theplanning helps to reduce those
vague anxieties they havebecause they feel empowered.
For most of the things thatthere's an actual risk for,
there's also an actual solution,and they're more likely to
utilize that if we help themcome to that conclusion on their
own with our support, ratherthan us constantly telling them
(33:37):
what to do.
when we get to the teenageyears, we have a lot more
complex emotion, a lot moreintense emotion due to hormonal
changes teens are absolutelycapable of understanding nuances
of really difficult topics.
They might start having deepphilosophical questions and
(33:58):
conversations about the meaningof life, or Why am I here?
What's my purpose on earth?
Concepts like justice andfairness and all of these things
that they couldn't grasp before.
And yet they're still holdingonto some of that teenage
distance from the concept eventhough they recognize that
they'll die someday It's so faroff that they can't even
(34:18):
imagine.
And so they may exhibit what wehear often about as a concern
within food allergy community,those risk taking behaviors.
Because even though theyunderstand these concepts at a
big thinking type of level, theynever believe that it could
happen to them.
They think that they would bethe exception.
So those teens might take thoserisks, particularly in social
(34:39):
situations, feeling like it cannever happen to me.
The kids will start sayingthings like, I'll be fine.
They'll minimize or ignore orconveniently forget safety
rules.
I don't need it.
I'm just, I'm just not going toeat anything while I'm there, so
I don't need to take myepinephrine.
The other extreme is that theymight take this very, very
seriously and they mightwithdraw from those social
scenes.
(34:59):
they really do take worst casescenarios, very extreme,
unlikely things that they thinkare going to happen, and then
they might be avoiding thingslike social experiences and
dating and relationships whenall their friends are entering
into that phase of life Eitherway, teens are likely to fall
into some kind of an extremearound this, and therefore we
(35:20):
might get a lot of resistance totalking about it when tough
subjects come up.
It can be outright and spoken.
They can say no.
I'm not gonna talk about thiswith you.
Or we might just get thatchecked out, glazed over.
Look in their eyes, the slouchand staring off into the
distance.
When we try to have theseconversations, what's really
going on there is that naturaldevelopment of a sense of
(35:41):
autonomy At these years, there'ssome shame or embarrassment in
talking about food allergyrelated safety in any kind of
social or romantic context orcontinuation of those preteen
years where their socialidentity is such a big part of
what they're going throughdevelopmentally.
Another way that this can showup really indirectly is avoiding
planning the future, avoidingtalking about it.
Avoiding taking concrete stepstoward the next phase of life.
(36:05):
So this age of life, kids reallywanna be treated like adults and
they almost are.
So we want our conversationswith them to really sound the
way we would talk with anotheradult or with a peer.
This is an okay to age, to justask directly.
And we can ask and we can saythings to them too, like, I know
it's weird for you to talkabout, but I'd love to know if
you'd ever thought about whatcould happen in this scenario.
(36:26):
And this is when it'sparticularly important for us to
point out the risks ifnecessary, explaining to them
that death is a possibility ifthey don't take their precaution
seriously.
But we still wanna do that withthe concept of bringing them
into the equation as the headproblem solver.
Buddy, I know it's hard to hear,but there are kids who have died
(36:47):
from kissing someone who atetheir allergens, and that's not
something that we're gonna lethappen to you.
So what feels reasonable to you?
What do you think is manageablein approaching this?
How can I support you in doingthat?
So we can avoid that very rare,but real risk.
We wanna make sure we'reacknowledging and including an
awareness of how important theirsocial experiences are to them.
(37:08):
It's totally valid.
Every teen wants to have normalexperiences.
They don't wanna feel likethey're standing out in any way.
So again, let's talk about,together about what might help
you do this safely in a way thatyou don't feel left out, You can
never say enough to them whileyou're having these
conversations.
You're right.
I can see how you feel.
Thank you for sharing that.
Thank you for trusting me withall of this.
(37:30):
I really appreciate it when youtalk to me, I always wanna know
what's going inside of yourhead.
It matters so much to me.
We want them to know that we'relistening and.
We're going to listen withoutjumping to discount their
feelings or tell them what todo.
To us, that feels likereassuring them and taking the
fear away but to them, it justfeels like we're saying, you're
wrong.
The most important part aboutapproaching it this way with
(37:53):
teenagers is that it helps themto learn, to self-advocate, to
show acceptance and a sense ofteamwork with them around this
problem solving.
It creates a foundation foremotionally healthy
independence.
We give them a sense that webelieve in their ability to
handle this on their own, andthat that doesn't mean not
relying on us for any help,Having gone through all those
(38:15):
age ranges trying to give you ageneral idea to help you with
some sort of structure aroundthis.
Obviously all kids aredifferent, and then if we factor
in any kind of developmentalcommunication, social skills,
differences, anything uniquethat our kids might be dealing
with that can change what mightbe showing up even more.
So I want to remind you, it'snot as simple as finding the
(38:36):
point in this conversation whereI said, your child's age, and
following that guidance.
Or if your child does have somecognitive difference and you've
been told that they're aroundthis mental age, then following
the guidance for that age range,it's just not that simple.
All children really have aunique profile and combination
of where their cognitiveunderstanding is compared to
(38:56):
where their emotional capacityto understand is, what their
emotional regulation skills are,their curiosity, their
communication skills, bothexpressing themselves and
understanding, and the uniqueway that this combines into one
individual and the way that theycommunicate and cope with
things.
I want you to take all of thisin and then trust your gut.
(39:19):
I hope that this conversation,has helped you visualize a
little bit better how you canhandle this in your own home and
family within your individualbelief system for the individual
children that you have and whattheir needs are.
I welcome any follow upquestions or conversation about
this tough topic.
I will do some posts on myInstagram page at the food
(39:40):
allergy psychologist and I'mhappy to answer any more
specific questions that peoplemight have about this, I've been
so thankful for all of the greatguests that we've had this
season.
I'm amazed at the way that thepodcast is growing.
Even though this was a difficultseason full of difficult
conversations, I'm glad that Itook the leap because m ore and
more of you are listening andit's showing me that you wanna
(40:02):
really have deep in depthconversation about topics that
matter, even when they're hardto hear.
So thank you for listening andsticking with me for that.
The statistics on the show aredemonstrating to me that even
though I've got all theseamazing guests on consistently,
the episodes where I speak aloneget the most downloads.
(40:22):
And so I'm going to try to keepincorporating more of that for
you into the show.
Thank you for finding value inall of the amazing guests that
I've had on the show.
And it seems also in what I'msharing with you.
It means so much to me thatyou're listening I look forward
to talking with you more,beginning with our next episode
for our summer season, all aboutthe exciting and hopeful and
(40:44):
optimistic things that are aheadof us in the allergy and asthma
world.
Many, many choices are on thehorizon.
Treatments are available, newtreatments are in the works and
will be soon available, and weare going to explore all of
those choices that didn't existfor us five, 10, or 15 years
(41:04):
ago.
It's a very exciting time andI've got an amazing lineup of
episodes to help you sortthrough the many decisions that
are on your plate or that youmay find on your plate in the
near future, which can beexciting, but can also be a
little bit difficult to sortthrough.
So I'm going to be here to helpyou get started with that next
week.
Thanks for listening.
(41:26):
the content of this podcast isfor informational and
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..
Amanda Whitehouse, PhD (00:22):
Welcome back friends, and thank you for
joining me again for anotherepisode of Don't Feed the Fear
for What has been a DifficultSpring season, talking about all
the things we don't want to talkabout.
We've covered a lot of difficulttopics and I'm going to end the
season on a real doozy.
We talked about kissing, havingthe birds and the bees talk and
(00:44):
the additional information thatwe needed to throw in that
conversation when we aremanaging food allergies.
But today we're going to talkabout the conversation that food
allergy parents dread even morethan having the talk with their
kids, it's unfortunatelysomething that happens to most
of us, which is our kids askingus if they could die from their
food allergies.
This season we had threedifferent parents come and speak
(01:06):
to us on the show about theirheartbreak and grief over their
children's death from their foodallergies.
Thank you to each and every oneof them for helping to remind us
that this is an importantreality that we have to keep in
our awareness I'd like to startthe conversation with a reminder
how highly unlikely death fromfood allergies actually is.
(01:26):
A study from 2017 by Turner andcolleagues called Fatal
Anaphylaxis.
Mortality rates and riskfactors, which I will link in
the comments for You, indicatedthat even though food related
anaphylaxis is relativelycommon, food allergy related
fatalities remain extremely rarewith a reported range of
(01:47):
approximately 0.03.
To 0.3 deaths per million personyears in the general population,
To give you another statistic tocompare it to, the odds of being
struck by lightning in theUnited States during one's
lifetime are approximately onein 15,300.
The odds of being murdered inthe US are one in 18,989.
(02:11):
So while severe allergic reactions can be
life-threatening, deaths fromfood allergies are not common,
and the overall risk from deathand food allergies is considered
very low.
Knowing this information can behelpful, but doesn't magically
erase the fear that we carryabout it because as we talk
about constantly on this show,every near miss, every accident,
(02:33):
every reaction, no matter howserious it is, is a reminder
that the potential is there andcan be a trauma that our body
experiences and remembers.
So regardless of the chance ofthis actually happening, the
chance that you'll have to havethe conversation with your child
about this is 100%.
And the chance that your childis thinking about it or has
(02:54):
thought about it, is prettyhigh.
I can tell you as a food allergypsychologist who has worked with
so many families and childrennavigating food allergies,
whether or not your kids aresaying this out loud to you,
expressing these fears to you,they're thinking about it.
They're talking to me about itin session, and we wanna make it
safe for them to talk to youabout it too.
At some point they'll likelyhave an experience, whether it's
(03:15):
a food allergy experience orsomething that brings up the
concept of death in theirawareness, and it will bring
that possibility to mind.
They'll connect the dots andwhether or not you talked about
it, they will begin tounderstand So I want you to be
prepared.
I've had conversations withother food allergy parents about
how this conversation is notonly scarier than the birds and
the bees talk, but we could alsocompare it to that day you're
(03:39):
not ready for when your littleone looks you in the eye and
says, is Santa Claus real?
And for those of us parents whohave been through that, we know
kids don't usually ask thatquestion until they already
know, or at least stronglysuspect the truth.
We want to be prepared, but it'sso hard when we're caught off
guard to know what to say and togive a response that's loving
(04:01):
and supportive, acknowledgestheir feelings, and also takes
that new awareness that'sexpanding and makes it into a
positive thing.
I find in my experience that theway that you handled the Santa
Claus question, if you'vereached that point yet, is a
good indication of how you'relikely to respond if your child
asks you if they can die fromtheir food allergies.
What's natural for most of us isto lie.
(04:23):
We want to avoid causing ourkids any fear or pain at any
cost.
But if you're prepared, ifyou've thought through this and
you've taken the time toconsider your own values and
beliefs, your child's uniquemakeup and awareness, if you've
dealt with your own emotionsabout the topic and you know how
you wanna approach this when itcomes up, you've laid the
(04:43):
foundation, you've created thespace for difficult
conversations with love andsupport in your family, then it
will be much easier to respondto a difficult question in a way
that you feel confident aboutand that will validate and
support your child, even if theconversation itself is difficult
or upsetting.
Talking about death is justcomplicated.
(05:03):
Most adults will avoid thistopic and even when they're
faced with it, with the loss ofsomeone that they love, they
typically don't talk about itdirectly.
We talk around it.
We use euphemisms.
We spout beliefs that we maybedon't even carry the rest of the
time, So today I'm going to talkyou through age by age,
(05:23):
developmental level, bydevelopmental level, the
indications that your childmight be thinking about death
and wondering if they could diefrom their food allergies, what
it might look like in theirbehaviors, sound like in their
heads, And how you can talk tothem in an age appropriate and
developmentally appropriate waythat will be supportive and
loving for them.
(05:44):
Before we can ever be ready todiscuss this with our kids,
though, we have to face thereality that discussing food
allergy deaths with our kidstriggers our number one biggest
fear, If we don't work throughour own stuff and develop our
window of tolerance fordifficult emotions, then one of
the mistakes that we're likelyto make is avoiding this
(06:04):
conversation altogether.
If it hasn't come up yet, whywould we bring it up?
We don't wanna introduce fearsthat they're not already
thinking about, and you thinkyou're protecting your kids, but
the reality is that kids pick upon the danger under the surface.
They are so much smarter than wegive them credit for.
And they certainly pick up onour discomfort with a topic.
By not talking, we send themmessage that it's not something
(06:27):
that should be talked about.
And kids can feel emotionallyabandoned by that, or unseen,
lied to deceived in our omissionof these conversations.
This really does become adelicate balance of not throwing
this conversation at them, notintroducing a worry that they
don't already have in theirheads, but listening and paying
close attention to what they aresaying to help us gauge whether
(06:49):
this is something that's ontheir mind, even if they're not
saying it directly.
The way to do that is to be veryproactive, to have lots of
conversations that aren'tspecifically about death, but
that are preemptive check-ins.
Creating an environment and aculture within our homes and
families of open conversationand comfort and support around
(07:10):
difficult topics.
That can look like regularcheck-ins where we say, Hey,
sometimes you might worry.
I want you to know, and we canalways talk about it.
I can answer any of yourquestions if anything ever comes
to mind that's bothering you.
If we haven't dealt with our ownemotions, the opposite thing we
might do rather than avoid theconversation is to overshare or
(07:30):
flood our kids with our ownemotions inadvertently.
we don't want that all to comerushing out in an uncontrolled
way that will overwhelm ourchildren.
So it is certainly okay to showyour children that you have
feelings.
Then you can show and explain tothem how you cope.
They can see you putting thoseskills into action, what you do
to manage difficult things.
(07:51):
So we don't deny that it's scaryor that we worry or we're
afraid.
Sometimes we say things like,sometimes I feel scared about
that too.
This is what I have found helpsme.
And then we let them see usdoing those things.
This might take some explorationfrom you.
It might take some, Activeconsideration of how you are
coping, what you do on a regularbasis, or when things get
(08:14):
difficult, you might benefitfrom some therapeutic support
around that.
There might be some room forexploration of your individual
belief system, religion,spirituality, or whatever
approach brings you somesemblance of understanding or
peace around the topic of death.
That's individual for everybodyand usually never a completely
(08:35):
finished task.
But again, something that wewanna model for our children, an
active and healthy spiritualexploration If you are actively
involved in these processes ofself-awareness and
understanding, you'll be a lotbetter prepared to demonstrate
to your children that you havefeelings and be able to express
and show them what you're doingto manage it in healthy ways,
(08:56):
and then teach those to yourchildren.
So we don't wanna have aconversation that will leave our
children even more frightened,less sure of the situation by
oversharing and flooding, or byavoiding the conversation.
We don't wanna give the messageor the impression either way
that this is not a safe thingfor our children to talk to us
about.
Another common mistake that wecan make is being too vague or
(09:19):
too euphemistic, so a lot ofparents won't know what to say.
Again, it's not just with kids.
When we're speaking to otheradults, we don't know what to
say about death.
We say things like,, He's in abetter place, or these
euphemisms that help us tosidestep our discomfort.
We tend to do the same thingswith kids.
(09:39):
One of the most common ones, andyou've probably heard this
before, is not to tell childrenthings like they went to sleep
and they never woke up, becausethen we can create a fear of
sleeping.
We don't wanna say things thatare really vague, like passed
away, crossed over, gone.
We lost them.
We need to make it clear to kidsthat that's what we're talking
(10:00):
about.
If we use language that's vagueor confusing, what kids will
often do is fill in the story intheir head.
They will make up the rest ofthe details that they don't
understand, and that typicallywill make things even scarier,
even worse than what the truthis.
Using the words they died sayingthe word death is factual and it
(10:23):
is as clear as we can possiblymake it for kids.
That doesn't mean that they canunderstand the concept of the
word, but at least we all knowwe're talking about the same
thing.
And after we've made that clearthat what we're talking about,
this big, scary concept that'sreally hard for any human to
wrap their minds around, if youdo have a belief system that can
be very helpful, it's okay touse that to shape this
(10:46):
conversation if it truly is yourbelief system.
But be honest and it's okay ifyou don't know or if you don't
have a specific belief.
If you're comfortable with it,you can explain that many people
believe lots of different thingsand talk about what some of
those are and admit to yourchild that you don't know for
sure what the truth is.
But sometimes it helps you toconsider those possibilities and
(11:07):
give them the opportunity toconsider what they believe.
And whether or not you have thatto support you through this
conversation, you can utilizewhat you know about regulating
your own nervous system to helpyou do a better job at this
conversation.
So in addition to doing youremotional work and your
self-exploration about yourbeliefs, your spiritual work,
(11:28):
you need to do your nervoussystem regulation work.
When you have grounding skillsand breathing skills that you
can use in the moment, you canachieve some regulation and loan
that to your child.
That's what co-regulation means,and your child's body can then
calm down via your body.
And your groundedness.
(11:48):
And that will help their nervoussystem settle in the moment and
learn how in the long term tosettle their own.
So before you have a toughconversation like this, it's
okay to use those skills veryopenly and point it out to your
kids.
You can even model and give aname for the words and the
regulation skills that you'reusing.
So for ex example, if they askyou a difficult question, you
(12:10):
can take a deep breath and tellthem, I'm gonna take a couple
deep, slow breaths because thismight be a tough topic for us to
talk about.
I'm glad you asked me and I hopeyou'll breathe with me to help
us stay calm and have a reallygood talk about this.
So considering all of thesepossible wrong turns that we can
make when we're having theseconversations, what can keep us
(12:30):
on track is always making surethat our responses, our words,
our behaviors, our actions arecentered on our child's needs
and emotions, not our own.
This shows children that you canhandle the hard stuff.
And so last a couple tips aboutmaking these conversations
easier..
When you wanna have really hardconversations like this with
(12:51):
your kids, the last thing wewanna do is sit them down, face
to face, and have a seriousconversation across the table,
it's very confronting and it'svery dysregulating for most
people, not just for kids.
We wanna choose natural momentslike when we're walking side by
side, when we're doing chores,when our hands are busy, when
our bodies are moving, whenthere's food, or when we're in
(13:13):
the context of play.
Anything that we can do to makeit feel less intense and
activity that naturallyregulates the nervous system and
makes us more open to somethingthat might be difficult.
And then we want to askopen-ended questions.
Not a yes or no question, not aquestion that suggests that we
already know the answer, butvery open questions the
(13:34):
question, how did that make youfeel is an open question, but
it's very difficult for a lot ofkids and adults to answer
directly.
A lot of people don't have thefeeling expression skills to
answer that one, and it might betricky.
Whatever answers our childrengive us, we want to normalize
and validate what they feel,emphasize that it is okay to
(13:55):
feel difficult emotions.
We can do that by staying calm,most importantly, and present
with them, restating whatthey've said to us, using their
own words to show them that wereally understand it and
agreeing with them.
It sounds like you felt reallyafraid when that happened.
It makes sense that you wouldfeel upset about that.
I can understand why you wouldbe angry.
(14:15):
It doesn't seem fair.
What we wanna do instead is jumpto the thing that we think will
comfort our child.
But it's okay, honey, you weresafe the whole time.
I was protecting you at thephase of the conversation where
they're sharing their feelings,we don't negate them with
promises of safety because itfeels like we're telling them
that they're wrong or feelingthe way that they do.
(14:36):
So again, anytime you're havingthese difficult conversations,
the key is to listen, not talk,and avoid steering the
conversations off track ormissing the opportunity to hear
and understand our kids'thoughts and feelings by.
Thinking that, expecting that wealready know or can anticipate
what they're thinking orfeeling, instead of giving them
the opportunity to tell uswhat's actually on their minds.
(14:57):
And another side note here,remember the siblings, siblings
often think and worry about foodallergy safety and food allergy
death, even more than the kidswith food allergies, because the
siblings are the ones watchingfrom the outside helplessly when
scary things happen.
They're the ones who are alittle bit removed from the
(15:17):
situations, but watching, unableto help, seeing the ambulance
arrive, seeing the facialexpression that mom or dad is,
is giving, seeing the physicalsymptoms that their sibling is
displaying when they're notfeeling well.
And oftentimes having peoplerush outta the house without a
full explanation of what's goingon and their minds are left to
wander as well.
(15:38):
It's so natural for us asparents in an emergency to focus
all that energy on the childwho's having the emergency, of
course, and making them safe.
But in all of that franticnessand stress and concern, a lot of
times it's difficult to rememberto come back and be with that
sibling and process theexperience.
It's usually best to do thatseparately with each child and
(15:59):
the family alone, rather thaneverybody together like a big
family talk, because eachperson's perspective is going to
be different.
Their thoughts can be extremelydifferent from one another.
And again, if one of them sharesa worry, we don't wanna
introduce that to someone else.
We wanna have all of ourone-on-one attention to give
each child when we're talkingabout something so difficult.
(16:21):
So next let's go age by agethrough what's typical in terms
of both kids' understanding ofdeath and then what I've seen as
a food allergy psychologist interms of behaviors and questions
and concerns specific to foodallergies.
We can go very quickly throughthe infant and toddler stage
because of course children atthis age have a very limited
(16:44):
understanding.
They will certainly experiencethe distress if there's
something concerning going onaround them, but they won't
understand the concept of deathWhat's most important at this
phase is just that emotionalregulation when stressful things
are happening and of course,being really aware of the
language that we're modelingwhen we discuss anything related
to safety, death, food,allergies, any of those topics.
(17:07):
If there's a scary or atraumatic experience, we want to
reassure that child, nurturethem, stick to routine, to make
them feel safe and cared forlots of physical touch and
co-regulation, and allowchildren a way to act out their
difficult feelings through play.
Preschool age kids are what wecall magical thinkers.
(17:28):
They often just simply cannotgrasp the concept that death is,
Permanent.
They believe it's temporary orreversible.
And they'll have this magicalthinking to explain it because
if they can't see the concept ofsomeone being dead and staying
dead forever, then they have noway to understand that concept
in their head.
So at this age, they mayunderstand and even bring up the
(17:50):
concept of potentially dyingfrom a food allergy, but that
doesn't necessarily mean thatthey would have panic and fear
about it because they may notunderstand the finality of it.
The way that things would mostlikely show up at this age would
be through clinginess and fearof separation, difficulty
sleeping, irritability, tempertantrums.
(18:11):
Pretty tough to sort out fromwhat might be going on with them
anyway, because a fear like thismight be just as big as a fear
about losing a stuffed animal ornot wanting to eat something
that they're offered that theydislike.
It's going to blend in with alot of the other stuff that
they're mastering at this age,but.
It is very possible, and I'veseen it many times where kids in
(18:32):
this preschool, 3, 4, 5,6-year-old range would begin to
ask repetitive questions andcuriosity about death.
This is unlikely to be triggeredby something that happened by
their food allergies.
However, this would more likelycome up through exposure to the
concept of death elsewhere.
So if a pet has died, if thegrandparent or a loved one has
(18:53):
died, if they saw or heardsomething on television in a
show.
Again, because that concept isso abstract to them, they're
very unlikely to tie it tosomething very specific.
Like their food allergies or thesymptoms that they've
experienced when they've had anallergic reaction.
We don't wanna talk about foodallergies in terms of death.
We just wanna say being healthyor making sure that they don't
(19:14):
feel very sick.
We do wanna communicate theseriousness of it, but it's most
likely not necessary to drawthat connection for them at this
age unless they've specificallyasked you.
So in addition to that, opendiscussion and patient
explanations.
Be prepared for a lot ofrepetition.
Kids at this age will ask thequestion they have in their mind
(19:36):
over and over and over again,and.
It might feel like they'retesting you or they don't
believe you, but really theywant structure around it, and
they wanna make sure that everytime you ask the answer is the
same.
That helps'em to feel safer andmore reassured in that
information.
If we are talking about death,even at this young age, we do
want to, as I said, use thosevery clear words, death or
(19:57):
dying.
And if they ask us what deathis, we can say that it's when
someone or something's bodystops working and explain to
them that it's forever, Onething that you might have to
clarify at this age, is that ifsomeone has died, kids may
anticipate that they can catchthat.
Remember that kids associatesick with something like
catching a cold from someone orthe flu I.
(20:18):
And germs.
So it's very important for themto understand that they can't
catch death or catch somethingthat would lead to death in the
way that we talk about illness.
It can be helpful to use play towork through these things.
So if this is a concept thatyour child really seems to be
exploring, you already have lotsof tools handy in the house to
(20:38):
help you with this, but you wantto just give them the open
opportunity for you to sit down,have your attention, give them
humans and pets or somethingthat can represent living things
and see what theme they act outin their play.
Follow their lead.
Take what you can from what theyact out and their questions, and
then you can respond to that ina way that's helpful.
(20:59):
So, for example, what that mightlook like in play is if you and
your child are acting somethingout with two bunnies and they
said that the toy bunny went tosleep and it didn't wake up, you
would repeat those words.
You, in this case, you would usethe same words that they said.
He didn't wake up.
I wonder why he didn't wake up.
And then you would try to engagethe child further in a way that
(21:20):
that would allow them to explainor further elaborate on what
they're thinking or what theirunderstanding of that concept
that they're playing throughmeans.
If the child has theircharacter, ask your character
something you would.
In turn, ask their character thesame thing and give them the
opportunity to expressthemselves.
So if their character asks yoursabout worries, you would ask
(21:41):
them about worries too.
And do all of those validationand opening lists, open
listening skills that we talkedabout previously, but just in
the context of play in stayingcharacters.
And then depending on how thatgoes, you might move that later
into a conversation between you.
Do you ever wonder about someonenot waking up?
Reference it back to the playand the child feels in control
(22:03):
because they know that that wassomething that they initiated if
the child does ask you veryspecifically, can food allergies
make someone die?
What I would like you to do isfirst acknowledge the feeling
that they're having, whatthey're expressing with that
question.
It sounds like you're feelingscared about that, or it seems
like you're asking me becauseyou might be worried about that,
and that's really common forkids to worry or wonder these
(22:25):
things, and then you can move onto answering the question very
simply and very directly, butwith age appropriate language.
If someone eats a food thatthey're allergic to, it can make
them very sick and die if theydon't get their medicine.
And that won't happen to youbecause we always check your
food and we keep yourepinephrine with us wherever we
(22:46):
go.
The next phase is between about six to
eight years of age, These kidshave more cognitive skills and
have a clearer understanding ofdeath, and They can start to
understand concepts likepermanence, the universality and
foreverness of death, they mightstart to fear the broader
implications of this.
(23:07):
Kids are developing logical andreasoning skills, and they're
decentering.
They are realizing that they'reunique.
They're starting to haveempathy.
They do begin to grasp thefinality of their own life and
mortality, this is gonna show upin ways that are really curious,
like wanting to watch TV showsabout death playing zombies.
Sometimes that can feel reallymorbid to us, but it's actually
(23:29):
a good way to let themexperiment with this and think
through it.
But they still are not gonnahave that abstract thinking
that's necessary to fullyunderstand the concept at this
age.
It's really important to just behonest and to be patient and
repeat.
They might start checking theirfood labels very frequently at
this age, or exhibiting thosebehavioral signs of food allergy
(23:50):
worries.
If it's specific to the foodallergies, they might start
asking and double checking withyou or another adult if a food
is safe with them, even if it'ssomething that they eat all the
time and they already read thelabel and they checked it before
they took the food out of thebox and they already eat a bite
of it, but they wanna checkagain.
They can have more logicalthinking that can follow a step
to step process in their head.
(24:11):
So for example, I will have kidsthink things like, I don't wanna
play with that toy.
And again, this is where ourlistening skills come in really
handy.
What makes you not wanna playwith that toy?
Well, Joe touched it.
What makes you not wanna playwith that toy if Joe touched it,
They'll come up with theseelaborate, loosely connected
explanations of how.
(24:32):
The last time they saw thatchild, they were eating
something and it might have beenon their hands and they weren't
sure if they washed them.
And then they came over to ourhouse and maybe they eat that
thing all the time.
And so if they touch that toyand if I played with that toy
later, and somehow, then I wouldhave a allergic reaction to that
food from playing with the toyagain.
Even if your child shares anelaborate story like that, that
(24:53):
expresses that they're feelingafraid, do not assume that it's
about the possibility that theywould die.
Most of the time when kids atthis age range begin to talk
about this thing, what they'rereally afraid of is using their
epinephrine and having to use aneedle.
They're afraid of seeing theirparents feel scared.
They're afraid of ambulances andhospitals, and a lot of times
throwing up in public can be avery big fear if that's part of
(25:16):
their history of allergicreaction.
Sometimes it's I don't wannamiss school, or I'm supposed to
go to grandpa's this weekend,and I'm afraid that I would miss
that.
So even if it's a very, veryscary story that the child is
weaving inside of their headabout what might be worrisome,
unless they say that they'reafraid that that can make them
die, that might not necessarilybe the question.
(25:38):
So again, use your goodlistening skills.
Don't feed them words.
So here's how we can respond Wewanna do a lot of noticing out
loud to our children.
I noticed you've been startingto try to read the labels.
That's a really good thing toknow how to do if you have food
allergies.
And I've noticed you're doing ita lot more times for the same
food than you used to do.
(25:59):
What do you feel when you readthe label?
What are you looking for on thatlabel, on the food?
What are you thinking about whenyou decide to check that label
again, even after you've alreadystarted eating it?
If they're asking repetitivequestions, we can say things
like, I noticed that you askedme that even after I told you
that your ice cream was safe andthat you kept asking me about it
when we were eating.
(26:20):
A lot of times people ask aquestion over and over again
when they're feeling worried,how are you feeling?
And then once you've presentedthat question to them, you want
to listen to understand withoutinterrupting them.
Any response that you giverepeats the child's language
back to them to show them thatyou're listening, ask for
further clarification.
Again, this is not a stage wherewe wanna jump in and reassure
the child right away, or wemight not get a full grasp of
(26:42):
what it is they're actuallythinking or feeling.
Once we've really listened andvalidated what they're saying to
us, we can say things like, itsounds like you're feeling
afraid that you could get verysick from an allergic reaction,
and if they say yes, or if theysay no, we don't tell them that
they're wrong, we never tellthem how they feel.
They are the expert on how theyfeel.
(27:04):
So even if we have a more matureand thorough understanding of
what's probably happeningemotionally for them, we don't
ever wanna tell them thatthey're not feeling the way that
they said they're feeling.
And thank them for telling us.
I'm so glad you told me this sothat I can help you with it.
You're safe.
So at this elementary schoolage, what's important is making
it normal for their feelings toebb and flow, to feel afraid and
(27:26):
to be reminded that we're herehelping them.
We can encourage physical playas an outlet for when they're
having these difficult feelings.
Allow creative play through artstories, music.
And if we've done all theseskills and the underlying fear,
genuinely and truly is death,and they're asking about that,
then we use straightforward,honest language.
(27:47):
At this age, kids are old enoughto understand something very
specific.
If they heard about a child whodied from food allergies, we can
explain to them exactly whatwent wrong in the body that
caused that to happen.
They weren't able to breathe,and so their heart stopped
beating.
We don't need to give them along, detailed explanation but
we can explain that directly ifthat is truly the underlying
(28:10):
fear.
we wanna help kids strike thatbalance by both reassuring them
that it's unlikely, but alsohelping them to take it
seriously and to understand theweight of this risk.
And then making that tangible tothem by giving'em the steps we
take to reduce that likelihoodof danger as much as we can.
(28:31):
Next up, we have those trickytweens, those 10, 11, 12 year
olds, maybe even into 13.
Kids in this age range are nowable to understand deeper
concepts related to the idea ofdeath and the impact of it.
They'll have a lot morequestions about details and
discussions, a much more broadsense of wonder about what death
(28:52):
means, and kids can often getreally stuck thinking about this
because they have this newfoundcapability to think about some
Really mind-bending conceptslike eternity and different
spiritual beliefs that theymight have been exposed to, but
they might not have theemotional capacity to comprehend
those things and how it makesthem feel when they start to
(29:12):
consider those ideas.
So this can get really tricky atthis age.
This is most likely the timewhen you'll be talking more
directly about death from foodallergies, because kids again,
also have that cognitivecapacity to connect the dots
about what food allergies cancause in the worst of scenarios.
A lot of times kids at this agewill start a conversation like
(29:34):
that, not even coming from aplace of fear, but just a place
of curiosity.
But then the more they get theirbrain going and they talk
through these big ideasthemselves and they expand
outward more and more, they pullin different concepts and more
and more different ideas.
That's when the emotions startto get going.
As they start chewing on thesetopics that they aren't ready to
emotionally digest, And theymight start wanting a lot of
(29:58):
specifics.
How many kids died from foodallergies?
What's the chance of thathappening to me?
There's a strong possibilitythat they're going to ask us
questions that we don't know theanswers to one trick that you
can always use when kids areasking tough questions is, what
makes you wanna know?
Or Why do you ask that?
And try to get a betterunderstanding of the motivation
(30:19):
behind what they're asking.
A lot of times these things willcenter around their social
experiences, worrying about whatmight happen when they're with
others, the fear of a reactionfrom other people to what is
happening to them.
They're thinking about thingslike school events, sleepovers,
social gatherings, and havingsome nervousness about going and
(30:40):
feeling at risk there, but notwanting to miss out on social
experience as wanting to fit in,and then feeling torn between
those two difficult things.
Kids can start to feel likethey're in a no-win situation
with some of these worries atthis age, so for those tweens,
we wanna keep an eye out forthings like avoiding social
experiences, backing out ofplans and obligations, stopping
(31:03):
activities that they used toenjoy, avoiding eating in
certain situations and what.
Seems like kind of acontradictory response of
wanting responsibility, notwanting to be reminded by
parents told what to do, and yetfeeling emotionally overwhelmed
at the thought of doing itthemselves or having difficulty
following through withcompleting that themselves.
(31:25):
We have to be really careful atthis age that we're empowering
them and we're treating themlike they are individuals who
are capable of problem solving,and we are here to support them
in doing that, This is a pointwhere kids are finding
themselves more and more able toexpress their thoughts and their
feelings verbally so we canstart to have a lot better
conversations about this, wherethey're able to express to us
(31:48):
their questions and theiremotions and welcoming them to
talk to us.
We can say things like, how doyou think we're doing handling
all your food allergy stuff?
Is there anything you wanna talkabout?
We can even directly ask them,is there anything that worries
you that you want me to knowabout, because I wanna help you
with things like that.
Most of the time they're gonnasay no when you put them on the
(32:08):
spot like that and ask themdirectly, but just the act of
asking and accepting anyresponse that you get from them
lays the groundwork that theycan come and talk to you, that
you do care.
You wanna hear and you'll listenwhen they do speak up to you
about something that worries orconcerns them.
And if we continue to check inin these ways, we make it more
likely that they will open up tous.
(32:29):
And when they do, we don't wannajump to our first reaction,
which again, is to reassure themand make them feel better right
away.
We want to reflect theirfeelings and show them that we
fully understand what they'refeeling, what their experience
is like, and that's valid.
We say things like, it makessense that you would feel like
that., We wanna let them leadthe conversation, treat them as
(32:52):
if they have good ideas, andthey might help us figure that
out because they do.
So that's something that looksand sounds like questioning.
What do you do when this gets onyour mind?
What have you tried at schoolwhen that happens?
Is there anything that helpswhen you start thinking that
way?
Conversations like that don'trush to a sense of resolution
and immediate calm for the kids,but it gives them a sense of
(33:14):
agency and clarity about theirthoughts and their feelings.
And then feeling involved in theplanning helps to reduce those
vague anxieties they havebecause they feel empowered.
For most of the things thatthere's an actual risk for,
there's also an actual solution,and they're more likely to
utilize that if we help themcome to that conclusion on their
own with our support, ratherthan us constantly telling them
(33:37):
what to do.
when we get to the teenageyears, we have a lot more
complex emotion, a lot moreintense emotion due to hormonal
changes teens are absolutelycapable of understanding nuances
of really difficult topics.
They might start having deepphilosophical questions and
(33:58):
conversations about the meaningof life, or Why am I here?
What's my purpose on earth?
Concepts like justice andfairness and all of these things
that they couldn't grasp before.
And yet they're still holdingonto some of that teenage
distance from the concept eventhough they recognize that
they'll die someday It's so faroff that they can't even
(34:18):
imagine.
And so they may exhibit what wehear often about as a concern
within food allergy community,those risk taking behaviors.
Because even though theyunderstand these concepts at a
big thinking type of level, theynever believe that it could
happen to them.
They think that they would bethe exception.
So those teens might take thoserisks, particularly in social
(34:39):
situations, feeling like it cannever happen to me.
The kids will start sayingthings like, I'll be fine.
They'll minimize or ignore orconveniently forget safety
rules.
I don't need it.
I'm just, I'm just not going toeat anything while I'm there, so
I don't need to take myepinephrine.
The other extreme is that theymight take this very, very
seriously and they mightwithdraw from those social
scenes.
(34:59):
they really do take worst casescenarios, very extreme,
unlikely things that they thinkare going to happen, and then
they might be avoiding thingslike social experiences and
dating and relationships whenall their friends are entering
into that phase of life Eitherway, teens are likely to fall
into some kind of an extremearound this, and therefore we
(35:20):
might get a lot of resistance totalking about it when tough
subjects come up.
It can be outright and spoken.
They can say no.
I'm not gonna talk about thiswith you.
Or we might just get thatchecked out, glazed over.
Look in their eyes, the slouchand staring off into the
distance.
When we try to have theseconversations, what's really
going on there is that naturaldevelopment of a sense of
(35:41):
autonomy At these years, there'ssome shame or embarrassment in
talking about food allergyrelated safety in any kind of
social or romantic context orcontinuation of those preteen
years where their socialidentity is such a big part of
what they're going throughdevelopmentally.
Another way that this can showup really indirectly is avoiding
planning the future, avoidingtalking about it.
Avoiding taking concrete stepstoward the next phase of life.
(36:05):
So this age of life, kids reallywanna be treated like adults and
they almost are.
So we want our conversationswith them to really sound the
way we would talk with anotheradult or with a peer.
This is an okay to age, to justask directly.
And we can ask and we can saythings to them too, like, I know
it's weird for you to talkabout, but I'd love to know if
you'd ever thought about whatcould happen in this scenario.
(36:26):
And this is when it'sparticularly important for us to
point out the risks ifnecessary, explaining to them
that death is a possibility ifthey don't take their precaution
seriously.
But we still wanna do that withthe concept of bringing them
into the equation as the headproblem solver.
Buddy, I know it's hard to hear,but there are kids who have died
(36:47):
from kissing someone who atetheir allergens, and that's not
something that we're gonna lethappen to you.
So what feels reasonable to you?
What do you think is manageablein approaching this?
How can I support you in doingthat?
So we can avoid that very rare,but real risk.
We wanna make sure we'reacknowledging and including an
awareness of how important theirsocial experiences are to them.
(37:08):
It's totally valid.
Every teen wants to have normalexperiences.
They don't wanna feel likethey're standing out in any way.
So again, let's talk about,together about what might help
you do this safely in a way thatyou don't feel left out, You can
never say enough to them whileyou're having these
conversations.
You're right.
I can see how you feel.
Thank you for sharing that.
Thank you for trusting me withall of this.
(37:30):
I really appreciate it when youtalk to me, I always wanna know
what's going inside of yourhead.
It matters so much to me.
We want them to know that we'relistening and.
We're going to listen withoutjumping to discount their
feelings or tell them what todo.
To us, that feels likereassuring them and taking the
fear away but to them, it justfeels like we're saying, you're
wrong.
The most important part aboutapproaching it this way with
(37:53):
teenagers is that it helps themto learn, to self-advocate, to
show acceptance and a sense ofteamwork with them around this
problem solving.
It creates a foundation foremotionally healthy
independence.
We give them a sense that webelieve in their ability to
handle this on their own, andthat that doesn't mean not
relying on us for any help,Having gone through all those
(38:15):
age ranges trying to give you ageneral idea to help you with
some sort of structure aroundthis.
Obviously all kids aredifferent, and then if we factor
in any kind of developmentalcommunication, social skills,
differences, anything uniquethat our kids might be dealing
with that can change what mightbe showing up even more.
So I want to remind you, it'snot as simple as finding the
(38:36):
point in this conversation whereI said, your child's age, and
following that guidance.
Or if your child does have somecognitive difference and you've
been told that they're aroundthis mental age, then following
the guidance for that age range,it's just not that simple.
All children really have aunique profile and combination
of where their cognitiveunderstanding is compared to
(38:56):
where their emotional capacityto understand is, what their
emotional regulation skills are,their curiosity, their
communication skills, bothexpressing themselves and
understanding, and the uniqueway that this combines into one
individual and the way that theycommunicate and cope with
things.
I want you to take all of thisin and then trust your gut.
(39:19):
I hope that this conversation,has helped you visualize a
little bit better how you canhandle this in your own home and
family within your individualbelief system for the individual
children that you have and whattheir needs are.
I welcome any follow upquestions or conversation about
this tough topic.
I will do some posts on myInstagram page at the food
(39:40):
allergy psychologist and I'mhappy to answer any more
specific questions that peoplemight have about this, I've been
so thankful for all of the greatguests that we've had this
season.
I'm amazed at the way that thepodcast is growing.
Even though this was a difficultseason full of difficult
conversations, I'm glad that Itook the leap because m ore and
more of you are listening andit's showing me that you wanna
(40:02):
really have deep in depthconversation about topics that
matter, even when they're hardto hear.
So thank you for listening andsticking with me for that.
The statistics on the show aredemonstrating to me that even
though I've got all theseamazing guests on consistently,
the episodes where I speak aloneget the most downloads.
(40:22):
And so I'm going to try to keepincorporating more of that for
you into the show.
Thank you for finding value inall of the amazing guests that
I've had on the show.
And it seems also in what I'msharing with you.
It means so much to me thatyou're listening I look forward
to talking with you more,beginning with our next episode
for our summer season, all aboutthe exciting and hopeful and
(40:44):
optimistic things that are aheadof us in the allergy and asthma
world.
Many, many choices are on thehorizon.
Treatments are available, newtreatments are in the works and
will be soon available, and weare going to explore all of
those choices that didn't existfor us five, 10, or 15 years
(41:04):
ago.
It's a very exciting time andI've got an amazing lineup of
episodes to help you sortthrough the many decisions that
are on your plate or that youmay find on your plate in the
near future, which can beexciting, but can also be a
little bit difficult to sortthrough.
So I'm going to be here to helpyou get started with that next
week.
Thanks for listening.
(41:26):
the content of this podcast isfor informational and
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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