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For the parents of a food allergic child, you have enough to worry about with reading labels, avoiding the offending allergens . . . and then the words “cross contamination” enter your vocabulary.

When it comes to food allergies, it is difficult to be careful enough. The same knife used to cut a peanut butter sandwich and a cheese sandwich can leave enough residues on the cheese sandwich to cause a serious allergic reaction. In fact, a Canadian girl died from this minimal amount of peanut exposure back in the mid-1990’s.

Cross-contamination occurs when a safe food comes in contact with a food allergen such as peanuts, tree nuts, milk, fish, or anything that your child is allergic to. For those with severe food allergies, eating even the slightest trace of an allergenic food can cause a potentially life threatening or fatal reaction. Although not everyone with food allergy is this sensitive, it’s still important to be very careful and follow precautions.

We had a peanut-allergic adult friend who had a secondary exposure to peanuts. He purchased a glazed donut at a local donut shop and after eating a few bites realized he was having a severe allergic reaction. He was able to self-administer his epinephrine kit and go to the hospital. He traced back his reaction to the donut’s preparation. It was cooked in the same vegetable oil that had been used to first cook a peanut covered donut. This exposure was enough for him to sustain a serious reaction.

We are extremely careful of fryers in restaurants. An order of French fries can be cooked in the same oil as fried shrimp, which is disastrous for the shellfish allergic. For the milk and wheat allergic child, breaded chicken or fish can be cooked in the same oil as French fries, also causing cross contamination.

We have a chef card that we give to the waiter/waitress at restaurants that explains this minimal amount of exposure, and we explain our need to know what is fried in any shared oil. For an example of this chef card, please purchase our e-book on “Traveling and Eating Out with Food Allergies.” More information is available here.

We take the following precautions at home to avoid cross-contamination of our son’s allergens:

No nuts or peanuts allowed in the house. If we receive a gift from someone that contains nuts, we immediately remove the item from our house.

Peanut butter was eaten by my husband for years; however he no longer does, now that we better understand the severity of peanut allergies. When the sandwich was prepared at home, our son was told to stay away from the countertop. The knife used in the peanut butter was not used in the jelly jar. A separate spoon was used to obtain the jelly. The knife was washed with a paper towel, which can be disposed of. The countertop was cleaned off with a paper towel after the sandwich was made. When we packed a picnic, no peanut butter sandwiches were allowed. Some people have banned peanut butter or their child’s allergen from their home entirely. However, I feel there was some benefit for my son to recognize the smell of peanut butter (since he does not have airborne reactions). He can recognize what to stay away from. One AllergicChild.com visitor suggested another way of dealing with the jelly jar: she buys the squeeze bottles of Welch’s jelly for her peanut allergic daughter to use. No knives can get into the squeeze bottle, and only her daughter is allowed to use it!

We do not allow our son to eat food prepared at other people’s houses. If he goes to someone’s house, he brings his own food. We tell people ahead of time about his allergies in case they have recently made a peanut snack. This allows them to clean off counter tops or play areas.

We tell people (waiters, waitresses, and counter people) in restaurants about his allergies upon ordering food using his chef card. We ask them to not allow his food to get near his allergens.

My husband and I do occasionally eat salmon, crab or shrimp at home. We use extreme precautions of washing counter tops and dishes with hot, soapy water after contact with shellfish. We wash our own hands after the meal and brush our teeth before any contact with him.

We use a separate spatula for the grill when grilling salmon and steak (our son’s favorite!) We keep the fish and the steak completely separated on the grill also.

My son’s classroom at school is peanut/nut free; however the entire school is not. Therefore, other teachers do use peanuts/nuts in their classrooms for various projects and for snacks. There were several children in the elementary school with nut allergies, and extreme caution was taken with hand washing in the classroom so that communal bathrooms were not affected. Also, the projects weren’t allowed outside of the classrooms that included peanuts/nuts. These projects are becoming much rarer as more and more children are diagnosed with food allergies.

Sesame seeds are virtually impossible to control, and therefore we don’t have any products in our home that have sesame seeds on top. Our son has had reactions after eating at McDonald’s, and we believe it was from an errant sesame seed that he ate. We steer clear of delis and sandwich shops that have sesame seeds on some of their bread. There’s just too much chance of a seed landing on our son’s food.

Other families have created a safe shelf in their kitchen cabinets or in their refrigerator for safe allergen-free foods for their child(ren) with food allergies. Or you can label foods with a sticker for the food allergic child’s safe foods.

Manufactured products can also have the problem of cross contamination. The statement, “may contain peanuts” is one way that manufacturers alert consumers that products are being run on contaminated lines, but these statements are voluntary. Bakeries that claim they are gluten-free or peanut-free may actually not be. All of the ingredients that go into the company’s products may not be gluten or allergen-free causing reactions with their customers. The FDA continues to work on a definition of how many parts per million is allowed for a food manufacturer to claim their product is gluten-free or allergen-free. Purchasing a “gluten-free” pizza in a pizza parlor that also makes flour crust pizzas is almost sure to be contaminated with gluten!

If we see that a manufacturer has a peanut butter cookie product and a chocolate chip cookie product, we will suspect that the two cookies are likely to be run on the same lines. I always call customer service at the company to discuss the likelihood of cross contamination. Occasionally, I get a nice surprise, and find that the two cookies are run completely separate. Most of the time, it has been my experience that a peanut butter cookie in the product line ruins our chances of eating any other cookies by that manufacturer.

Purchasing items from bulk bins is VERY dangerous because of cross contamination issues. Sure, there may be safe chocolates in the bin currently, but what was contained in the bin prior to that? How much cleaning occurred between the two food products? It’s just not worth the risk for us because of our son’s sensitivity level toward his food allergens.

If your child is extremely sensitive to certain foods, it’s worth the extra vigilance to ensure that cross contamination cannot occur with any foods that are eaten. Cooking from scratch, in your own kitchen, is one sure way to know exactly what your child is eating!