Wednesday, May 13, 2009

Food Allergy Awareness Week: Going Public

Thank you to everyone who was so understanding of yesterday's grumpity post. It does seem like a good time to talk a little more about our forays into public spaces and how Harper's peanut allergy has influenced some of our decisions. I am going to address a couple of comments/questions specifically...

Anne mentioned that her twins go to a peanut free school, but the kids eat peanut butter for breakfast many mornings. They wash up after breakfast, but she wondered if they were putting allergic students at risk anyway (I'm paraphrasing!).

At the beginning of the school year we asked that the children in Harper's class who eat peanuts or peanut butter in the morning have their hands washed (with soap!), brush their teeth, and change their shirts. Whether everyone abides by this we have no way of knowing. The truth is that peanut protein can be stubborn. Hot water alone will not rid a surface of residual peanut residue. And it only takes a very little bit to cause a reaction.

So yes, there is a scenario in which the peanut butter a child eats at breakfast, if not cleaned up, could come to school on little hands. The hands touch a toy in the preschool room. The child with a peanut allergy plays with that toy and a contact reaction occurs. Or said child puts her hands in her mouth after playing with the toy and an ingestion (more serious) reaction occurs.

I think two ways about this:

1) If we want to make absolutely sure we never, ever run into peanut residue we can never leave our house. And we can never invite into our house anyone who has possibly eaten peanuts or peanut butter. Which, for us, for now, is not a realistic way to live. We take a calculated risk every time Harper sits in a shopping cart, picks up a library book, puts her hand on a playground swing, and goes to school.

2) I DO want parents to take the precautions seriously, like Anne does, because as unlikely as it may seem that Harper ends up reacting to something someone ate an hour ago for breakfast, it is possible. My worry is that parents are reading those notices (or not reading them at all I guess) and thinking that we're being too far fetched in our efforts and not following through on things like cleaning up after breakfast. This sort of dismissive attitude DOES put Harper at greater risk, no matter how small.

As much as we tell little kids NOT to put hands and toys (and the ends of crayons and the play food, etc.) in their mouths, they do, and that's why we ask for after breakfast tooth-brushing, too.

Giselle asked if we avoid particular public spaces because parents like her might pack PB&J for messy little kids to eat there.

The answer to that one is yes and no. I do try to avoid places, like a children's museum public eating area, that is likely to have LOTS of peanut residue. It is most often easier to eat at home and plan our excursions around meals. BUT there are plenty of situations where we do have to eat in public spaces and then we're talking again about risk management. I always carry wipes with me (plain water won't cut it, but baby wipes and clorox type wipes are pretty good) and wipe down tables and chairs where Harper would eat. We are extra careful with restaurant booster seats - even if the restaurant doesn't serve nuts, who knows what the previous client brought along for her toddler to munch on. I would NEVER let Harper place her food directly on the table in a public eating place.

In those kinds of situations I actually worry more that kids have eaten peanut butter for lunch, and not had their hands cleaned well before heading back to the play areas - as much as I'd like to, I can't go ahead and wipe down every touchable surface in a children's museum or on the playground.

I don't think any of you should feel bad about bringing peanut products into those kinds of public places (Although it REALLY bothers me when people bring food into "no food allowed areas", keep it in the cafeteria!). I do think it is good sense to attempt to clean up after yourselves and to clean your kids' hands before they head back out to play. I'm guessing most of you would do that anyway, without even considering the benefit to the children who may come along with food allergies. I will admit to having the occasional panicked moments in those types of public places!

If Harper started having many contact reactions (mild or severe) we would probably reevalute how we make our decisions about what is safe in terms of outings.

Chris wondered if eating at the field trip might have been like practice for the time when Harper won't be eating in a peanut-free environment.

It's true that eventually (most likely in grade school) Harper will have to eat lunch in a room where there are people eating peanut butter. We'll not think too much about that tonight, lest I begin to hyperventilate. But for most allergic kids sitting at a peanut-free table is precaution enough. It is possible to be so severely allergic that one would react to the peanuts someone was eating across the room. We don't believe that Harper's allergy is currently that sensitive (knock on wood). For some children their allergies are so severe they cannot attend a school where other students are consuming foods they are allergic to. We are thankful not to be in that situation (knock on wood, again).

Harper probably could have stayed and had lunch with her classmates, but we are constantly evaluating risk. Matt knew that they were finished with the exploring/learning part of their field trip and that Harper wouldn't be missing anything besides lunch if they left early. Better safe than sorry!

Whew! That's enough for this post, if anyone is still reading! There are more great questions to address and feel free to add thoughts in the comments. I am incapable of being short-winded when it comes to this allergy stuff, so you'll have to bear with me this week. Thanks!


jill said...

i make candy every year at christmas and i make peanut butter and chocolate fudge. ever since i found out that one of our friends is allergic to peanut butter (after I gave her some, I'm assuming she took one whiff and gave it away, I didnt find out until much later she was allergic) I started making the chocolate first, then washing all the utensils and such and making the peanut butter, and keeping them completely away from each other. then, i make up some stuff for her without peanut butter stuff in it, using a knife clean out of the dishwasher or sink (well, drawer, but you get it, its clean) and make up her stuff and close the container and THEN open the peanut butter stuff and make up containers for everyone else. am I doing a good enough job, or should I find something else to give her when i give her something at the holidays?

Mommy Daisy said...

This was VERY informative. As a parent of a non-alergic child, I learned a lot from reading this post. And many of these are things I've wondered about.

It's stressful enough being a parent, let alone one with a medical issue like this.

Anonymous said...

The thing that strikes me with these posts is the fragile nature of our babies and the seemingly inhuman strength you have. I know it's something you just have to do, have to handle and deal with on a daily basis, but I sit here shaking my head thinking about how strong you are to not just FLIP OUT all the time.

Emily said...

This is really helpful information. I think of Harper every single time we eat peanut butter - and I'm always insistant about Katy washing her hands and face well after she eats it, because I would hate to think that our house wouldn't be safe for Harper or any other kid to come and play. I also convinced our MOMS Club meetings to be peanut free, because I thought we should be welcoming to a new mom who might be checking out the group and asking about allergies. Keep the answers coming!

MamaK said...

I'm basically agreeing with everyone else-- totally admiring your ability to deal.... soakingup the info... and have changed a bit of our behavior.

I work with kids programs at a church, and we've gently moved away from relying on pnut butter snacks or sandwiches when it's an option. And when a mom came to us with a dairy-allergy child, we added a "safe" dish as one of the options.

PLUS, I often find myself talking about this at our moms group, etc. Regarding the non-compliant parents, somone was wondering if a huge, color "no peanut" sign (similar to non-smoking) hung up on the class door (or bus, or wherever you're meeting) would do the trick in reminding folks you're serious?

Unless you can get them to watch a DVD of someone else's reactions. Like an "infomercial" on parent night!!

Rita Arens said...

Hi Kelsey-

I lost your e-mail address, but you won the puzzle book contest on Surrender, Dorothy: Reviews. Please send me your address!

Rita Arens

samantha said...

I love reading this. This is so informative it's unreal. And I just can't believe you have to be on high alert all the time.

I'm so glad you are bringing awareness to this issue. I get eye rolls and pathetic nods when I flip out about offering Theo peanut butter now since he's still too young since I'm OBVIOUSLY over-reacting. It makes me burn.

samantha said...

Hope you get some more traffic :-)

Melissa said...

Here via samantha's link on Twitter. :) Thanks for all the information!! This is much more common than most people know!

I have a peanut allergy, albeit a relatively mild one, so my son's pediatrician recommended that we wait until he's 3 or 4 before trying anything peanut-related. He's going to be 3 this summer, but we're still not planning on letting him near it anytime soon! Thankfully my family and friends are already accustomed to watching out for ME, so he's been in a fairly controlled environment so far. My fingers are crossed that he'll escape the allergy...

Hillary or Ryan said...

Here's another question....Is it possible that Harper would someday "grow" out of her pb allergy? Or could it lessen in severity? Can that happen to children?

Kate said...

Can you tell us about other nuts and their risk-- nutella made of hazelnuts or sesame seeds, sunflower seeds, almond butter, etc., other related foods. Are tree nuts any different for some kids?