Trick OR Treat?! The TRICKS to avoiding food allergies and how to TREAT them

Halloween can be a nightmare for kids with food-based allergies and the parents who have to monitor for them. This seemingly simple holiday is not as easy for some as a knock on the door and getting a treat; it can mean life-threatening anaphylaxis and a trip to the ER.

I have been unlucky enough to be on both sides of Halloween hypervigilance. As a child, I was very allergic to chocolate and peanuts. I know...right??!!! Can there be worse on Halloween than the build-up and excitement of waiting to see what sweet treasure gets dropped in your treat bag only to unload the majority into "the parent's stash" later that night? I was stuck with candy apples, popcorn balls and some sweet tarts. No full sized Snickers or 2 pack Reese's peanut butter cups here! When all was said and done, I had a handful of candies and my parents' bucket overflowed.

Fast-forward a few decades to our oldest son.....allergy laden from birth thanks to the wonders of genetics. He was allergy tested before he was 2 years old...as I prayed that the massive hive on his scratch test site was not a chicken nugget allergy (as that was all he lived on back then), we were somewhat surprised to hear "He is allergic to peanuts...here is a booklet with instructions and an EpiPen...." He had not even eaten peanuts at that point in his life, so we really did not know what his reaction would be. He is our firstborn, and very type A, so he grew to be very aware of what his food was cooked in, manufactured in a factory with, or possibly containing. Even with the best efforts, he has had a few exposures. Each exposure has brought much worse symptoms than the last. Halloween is now his watchful holiday; I was lucky enough to outgrow my food allergy and the "parent stash" has come full circle for me...Snickers and Reese's for me and my hubby and sweet tarts and Epipen on hand for my son!!

As I was writing this article, I reached out to Dr. Purvi Parikh, MD. She is an adult and pediatric allergist and immunologist with The Allergy & Asthma Network. Many children are diagnosed after they have been exposed and have a reaction to a known or unknown substance and receive further testing. Testing is routinely done by an allergist/ immunologist in the office by either scratch test or blood draw and serum markers. A diagnosed food allergy can obviously benefit the health and welfare of your child, however, even with known allergy, the presentation may worsen or change with repeat exposure. Parents, caregivers should be aware of risks and signs and symptoms of food allergies even if the child is not known to have an allergy at present. One risk factor for developing a food allergy is, "having just one parent with any allergies. This can increase risk in a child by 50 percent", according to Dr. Parikh. Some of the biggest food allergy culprits in Halloween candy are milk, eggs, wheat, tree nuts, peanuts and soy. The most common allergic responses noted by Dr. Parikh are, "Rash or swelling which is isolated or can be accompanied by trouble breathing, vomiting, diarrhea, stomach cramps or loss of consciousness. Anything more than a rash can be a sign of a dangerous allergic reaction called anaphylaxis."

Dr. Parikh encourages, " all parents: allergies can be life-threatening, please take them seriously even if your own child does not have them, their friends may. If your child or another appears to be suffering from any of the above symptoms, Dr. Parikh recommends, "using an epinephrine autoinjector if your child has one and seek medical attention to be a sure reaction not progressing. If you do not have one seek medical attention so that you can be treated asap in case the reaction is progressing." Keep in mind while trick-or- treating or during holiday parties that "the only food or candy you have control over is what you prepare yourself. The safest thing for food allergic kids is to not eat the candy they obtain. They can still participate and dress up but don't eat it. Parents - have safe candy or toys for your food allergic child as a substitute. Educate kids who have food allergies to not consume food given to them by outsiders." Also keep in mind, "often even candy that may seem safe could be packaged in an area near allergens and cross-contamination can occur".

With a few modifications, your child with a food allergy can still have as much fun as all other children. Being alert and aware of potential hazards and having safety precautions and techniques on hand, can be life-saving for a known or even unknown allergy exposure. Talk to your child, your children's teachers and friend's parents regarding your child's restrictions. Remind them all of how serious food allergies can be, and when possible find alternatives to known allergy foods. Some safe options and revisions can make Halloween a fun and Emergency free holiday!! And parents...keep the "parent-of-an-allergic-kid" yummy stash out of reach or hidden from your kids to avoid any temptations, while you make sure not to waste their hard-earned procurements...wink, wink!

Dr. Purvi Parikh is an adult and pediatric allergist and immunologist with The Allergy & Asthma Network She completed her fellowship training in allergy and immunology at Albert Einstein College of Medicine's Montefiore medical center. Prior to that, she completed her residency at The Cleveland Clinic Foundation in Cleveland, OH and she is board certified by the American Board of Internal Medicine as well as the American Board of Allergy and Immunology. She completed her B.A. in political science at Emory University and received her M.D. from St. George's University.