Category Archives: Food Allergy

Retrospective on 3+ Years of Traveling with Food Allergies

Over the past 3 years, I’ve traveled a lot for work – and for fun. I’ve traveled nationally to San Francisco (CA), Tampa (FL), Whitefish (MT), Seattle (WA) and Boston (MA) a lot – plus some recurring trips inside Colorado where I live. I’ve traveled internationally to Italy, Calgary (Canada), Scotland (UK), and Barcelona (Spain). And I’m currently planning more… Chicago, San Diego, Mexico City, New Zealand, and maybe even Portland (Maine)? My boyfriend has joined me on many of these trips and even has done some of his own to Japan.

Even though I’m allergic to peanuts, tree nuts, sesame, shellfish, and fish, I’ve never had an allergic reaction while traveling. I’ve had a few close calls and one extremely angry waiter, but I’ve traveled freely and enjoyed every second. I think it’s easy to look at this and say – oh wow! Morgan’s got it in the bag. That’s not true. I also travel with plenty of anxiety about food and eating out. I’ve learned some tried-and-true tips that have helped me to manage food safely while traveling and to avoid bad consequences. 

So I wanted to share these practices that have kept me safe and also share some stories that help illustrate how & why it works.

Cadaqués, Spain

#1. Don’t Take Dumb Risks. 

Never had curry before? Don’t try it for the first time on a flight. In a small Irish pub in downtown Boston and they serve fish & chips, but their kitchen looks smaller than yours? Don’t eat the fries. Tell your waitress that you’re allergic to seafood and she says that other visitors with that allergy haven’t had any issues with the food? Don’t take her word for it. Don’t speak the language and you don’t have an allergy card? Don’t eat! Don’t speak the language but you do have an allergy card but you don’t understand their response? Don’t eat! 

These are broadly what I call “dumb risks.” They’re dumb! Use your head. Of all the principles and practices, this is the one that has kept me alive. I read news stories – ranging from sad to tragic – about people having allergic reactions or experiencing severe anaphylaxis because (broadly) they took dumb risks. 

This could also be called the Jungle Juice rule. If you attend a college fraternity party, they’re probably going to serve jungle juice, a cocktail that usually looks like it’s made in a bathtub… and tastes also like it was made in a bathtub. If you’re allergic to almonds, there are a lot of gins that contain almonds. And chances are somebody bought a cheap gin to make their jungle juice. Did you need to know all of that in order to avoid the jungle juice? Did you need to know the specific gin they used in order to decide not to drink the jungle juice?? No! The jungle juice is a dumb risk, period, whether or not you’re allergic to almonds. 

So, a few dumb risks I don’t take: 

  • Eating anything without telling the waiter about your food allergies
  • Eating fried foods at places that serve fried fish dishes 
  • Eating the bread provided, whether or not it has sesame seeds on it 
  • Eating dessert at a restaurant 
  • Drinking something where I can’t identify the ingredients
  • Eating meals prepared on a plane 
  • Eating anything where I can’t identify the ingredients on a proper label
  • Eating a meal that is usually unsafe but is promised “it is safe”
  • Taking the waiter’s word for it, particularly when there is a language barrier 
  • Eating at a restaurant where most of the menu is shellfish and there’s one “safe” looking option

I was out for a work trip in Boston and went out to dinner with the clients. We ate at a nice Italian restaurant. After sitting down and looking over the menu, we each ordered our dishes and my colleagues asked for an appetizer to share that was made with bread and pesto. Traditionally, pesto contains pine nuts, which I’m allergic to. I always give my normal spiel (allergic to this and that, please tell the kitchen, etc etc) and the waiter promised it was fine, everything will be processed with the kitchen, but even the appetizer should be okay. Pesto, historically, is not safe! It is a dumb risk to eat pesto while eating out. So in this case, guess what? I didn’t eat the pesto! Five minutes after the pesto and bread is served, the waiter comes back with a concerned look and says – “oh actually, yes the pesto does contain nuts, you haven’t eaten any, have you?”

Bread is the common culprit while traveling with a sesame allergy, but while I was in Barcelona, I was surprised to learn at one restaurant that their bread may contain tree nuts due to the way it’s prepared in the kitchen. I only found this out after ordering and agreeing for bread to be served to the table as a part of the appetizer…. and then mentioning my allergies. It would’ve been a very dumb risk to not mention my allergies or only mention a couple of them! 

This is a principle I have learned time and again will save my life. It sucks. Of course I’d like the ease and simplicity of hopping on a plane and eating whatever looks good. Of course I’d like to just hop into any hole-in-the-wall and eat what they offer me when I walk in. Of course I’d like to live a carefree life when it comes to food, drink, and travel. 

But I’d also very much like to return home and do it again in a few months, and every dumb risk I might take is a little guarantee that might not happen. 

Isle of Skye, Scotland

#2. Don’t Travel Internationally to Countries Where You Wouldn’t Eat at the Local Restaurant.

My boyfriend traveled to Japan last year with a close college friend. I would’ve loved to go. But historically Japanese food and my allergies do not mix well. The fish & shellfish-heavy cuisine, the sesame used both as a garnish and inside sauces, the hidden fish used as a base for broth (dashi), and so on. I’ve been able to make my own Japanese cuisine at home thanks to a well-curated recipe list, the endless patience of my boyfriend to verify if things “taste alright,” and a keen curiosity to taste things I’ve never had before. 

But here’s the rub. If I’m not gonna eat at the local Chinese takeout place, I probably shouldn’t go to China. Is Chinese food all like the local Chinese takeout place? No! Actually famously, American Chinese takeout is very different than all of Chinese cuisine. But if you’re not gonna get the local version for fear of your own allergies – what are you gonna do when that’s the only kind of food around?

There are a few brave souls who go through the rigamarole of making it work. Maybe one day I’ll be one of those people carting around a hot plate, only eating rice and fresh veggies, and occasionally stopping into some American food joint that’s been exported into the city for a taste of home. But it also feels like a dumb risk going to a country where I can’t eat most of their food. 

My combo plate of allergies specifically rules out East and Southeast Asia… and also the Levant / the Middle East. Could I make India work? I don’t know, actually. I do know that there are some surprising uses of nuts in some Indian curries, but I don’t know enough to tell you the difference because I haven’t eaten at a lot of Indian restaurants in Denver! This principle hits the hardest because I love to travel and I’d love to see the shrines in Kyoto and the majestic mountains of Tibet and hop on a little motorcycle and careen through traffic in Bangkok. But it’s just not in the cards. I can’t even eat at my local Thai place. 

#3. Create a Shortlist of Options.

There are obviously many places to travel, nationally and internationally, that exist in a sort of “gray zone” when it comes to allergies and intolerances. This gray zone has been widened extensively in the last decade as travel and tourism has expanded as an industry. “Gluten-free” and “vegan” are not crazy concepts. Social media has vastly upgraded people’s awareness of these issues. Does that mean the owner of a small pasticceria in Venice is going to go through all the steps to make sure your food is safe for a dairy allergy? No, probably not. That’s a dumb risk. But it does mean that in some corners of the world, there is a surprising amount of awareness. 

I think of this like GPS. In order for your phone to work, it has to ping 3 satellites to find your exact location. So creating a shortlist of options is creating a GPS for a safe meal. I’m figuring out whether (1) the food looks good, (2) the restaurant can probably make a safe meal, and (3) it’s a dumb risk. While traveling in Barcelona, a lot of restaurants were ruled out in buckets 2 and 3. There were specific tapas menus that heavily featured seafood. There were nice, upscale restaurants that had a lot of nuts distributed throughout the menu. Is it possible to get a safe meal there? Maybe! I don’t know. But I’m pinging around my options, trying to create a shortlist of restaurants that I would actually like to eat at and seem relatively safe. 

Having this shortlist is so helpful when traveling in a group. I get pretty anxious when a group of friends just say “oh let’s check out this restaurant up the road!” Me? I’m Googling that, looking at their menu, assessing whether there might be a safe option, and whether it’s a dumb risk… all on the car ride over. I try and circumvent this and proactively offer an option from my shortlist. A response could sound like “oh! You know what, I’ve heard there’s this place not too far that serves incredible X, seems like a good stop, I was planning on trying it out.” In groups, there’s a lot of momentum toward someone who already has a plan. Proposing an option and saying “I was planning on trying it out” gets people to be enrolled in what you already wanted. 

When traveling Italy in a small town near Lake Como, I already had 4 restaurants on my shortlist. There were plenty more to eat at, but either the reviews looked bad, the food looked bad, or their ability to make a safe meal looked uncertain. We hit up those shortlist options to great success. 

When I was in Tampa for a work trip, I made a shortlist so I knew what food options I might have in the area of the event. It came in handy later that night when everyone was moving toward a restaurant I disqualified – and I quickly realized I would need an alternative. I was in a big group so I pulled aside a friend and said, “wanna skip the line? I’ve got another place.” We ended up having 5 or 6 join us. 

A quick aside – I actually developed this principle from trial-and-error (more error) while studying abroad in 2016. I was quick to realize that my friends were happy to wander around a city and just sit down somewhere to eat. That wasn’t going to work for me on a number of levels. They were wonderfully deferential about whether I felt safe at a restaurant, but I quickly learned that it was best to have a couple of options to suggest so we didn’t have to stop at multiple restaurants, only for me to say no. 

Ristorante Borgovino in Lake Como, Italy

#4. Get to Know Labelling Laws.

One excellent shortcut to eating out is buying your own food. It saves you money and saves you time (and probably anxiety) over eating out. The problem is, every country has their own labelling laws. 

Let’s start in the US. Liquor and booze is unlabeled. Manufacturers broadly get to decide whether they add the “may contain” or “manufactured in…” statements. We have our Top 9. And a label looks a certain way. 

That’s not always the case! While traveling in the UK, I noticed their labels look very different. Their nutritional values like calories and carbs look different. And the allergy notice, and which allergies are labeled, are different. Same was true in Italy, in Spain, and (from my boyfriend) in Japan. Japan is a curious example here – by law they’re required to label a Top 7 that includes crab, buckwheat, and egg. But it is optional to highlight or bold 27 (!) other allergens like banana, peach, salmon roe, and yam. You’re not gonna find “yam” highlighted in the US. 

I always look up labelling laws before traveling somewhere internationally. There is a lot of information out on the Internet about what they’re required to label, how it might look, and what their top allergens are. This is very useful when purchasing goods while on the go. I’m not an expert on these things. But it offers a degree of confidence that I wouldn’t otherwise have when I’m purchasing that bag of chips in the train station. 

#5. Get to Know the Culture Before Going.

I’m actually not just talking international here. What’s the famous regional dish? What do people like to eat? How do people like to eat? Are there a lot of a certain kind of restaurant in the city? 

You don’t need to be a cultural anthropologist to get a sense of these answers. Sure, in the US, you might get some similar patterns. But we all know there are regional differences! Austin (TX) is a taco city and famous for its restaurant scene with hip fusion restaurants. Boston (MA) has a lot of pubs and not a lot of breakfast spots. Whitefish (MT) is a big ski resort town so they have a lot of classic American food centered around burgers. Scotland loves its fish & chips. Barcelona cannot get enough tapas. 

In the US, chances are there is always a shot at a local safe fast-food or fast-casual spot that can satiate your food needs if you’re eating out. Traveling internationally, much less so. Watching a few YouTube videos and trying to piece together what people like to eat will help you navigate the culture while abroad. German food has a lot of safe options for me, surprisingly. Thai? Not so much. Knowing these differences helps you navigate common situations you might run into – and make better decisions, especially when creating a shortlist. 

I traveled for about 3 weeks in total in the UK (split between London and the wide open country in Scotland). I never once ate fries – “chips” in British parlance. It just wasn’t worth it. Could I have convinced some poor pub to fry me a separate batch? Yeah, sure. But fish & chips are so pervasive in the culture that it was unlikely I’d ever get a fresh, safe batch. The local Village Inn (an actual place I stayed at) in rural Scotland isn’t going to have an extra fryer on hand. Why go through the bother? I know that, in a principled manner, it’s supposed to be true that we are able to eat the things we want in a safe and reliable manner. In practice, knowing the culture is an easy way to find paths of least resistance and ask for the steak pie instead (after checking on allergies). 

Canmore, Alberta, Canada

#6. Don’t Drink Unfamiliar Drinks.

You may not drink alcohol at all! That’s probably the easiest solution. But if you are to imbibe while traveling – and this is especially true while traveling inside the US – don’t try things that are unfamiliar. This is a dumb risk. But I wanted to call it out specifically for a couple reasons. 

In the US, we have a growing culture of “craft cocktails.” These are a step beyond your classics. They use fancy liqueurs, custom syrups, bitters… all sorts of ingredients that are rife for allergy issues. Plus, the cross contact issue in bars can be exceptionally troublesome. Many normal restaurants are making every drink (using gins that contain almonds, whisky made from wheat, sesame syrups, nut-flavored rums) in the same containers and only rinsing them in between with water. Upscale establishments are much more hygienic, but also pricier and harder to get into. I’ve spent years deeply understanding liquor, wine, and beer to feel safe while drinking. I probably know more than a few sommeliers about the production process, the aging, and the final product of a lot of liquors – I wish I was kidding here. Some of that knowledge has been fueled by visits to producers while in Italy, Scotland, and Spain. But a lot of it is simply internet research and YouTube. It’s one of the reasons I know so many gins use almonds as a botanical. 

If I’m out at a bar and I have the option to choose between a fancy craft cocktail that uses an ingredient I’ve never heard of before (let’s say, Italicus) and a glass of wine – I’m gonna go wine. First of all, they usually pour the wine from a bottle into the glass, keeping it much safer from cross contact issues. Second of all, I’m not gonna sit at the bar and look up Italicus and try to see if there are ingredients for it! That’s a dumb risk to drink a cocktail in which I don’t understand the ingredients… let alone all the other cross contact issues. 

At more upscale establishments, you might have some leeway. In Denver, there is a world famous bar (Death & Co) and while traveling in Barcelona, we went to Stravinsky’s, another world famous bar. Stravinsky’s only serves cocktails and I noticed some items on the menu I didn’t recognize. At Death & Co, when I explain my allergies, they actually go through a whole separate process to ensure no cross contact issues, which is lovely. So I brought it up with my waiter at Stravinsky’s, explained my allergies, and he got it! Not only did he get it, he also understood the cross contact issues and noted that it would be handled properly. It was a great experience. 

#7. Be Sheepish if You Have To.

Don’t feel confident explaining your allergies? Or, just really really tired after a long day and not feeling like explaining it to somebody new for the third time that day? Act sheepish.

“I’m sorry to be a pain in the ass but it’s really important…”

“I’m sure you get a lot of folks like me…”

“Look I know this is kind of a pain…”

There is an undeniable toll on mental energy when you’re traveling with food allergies. Acting sheepish is a great way to shortcut my own inner resistance to bringing it up for the fifth time in the same day. Because I’ve had to live through all five experiences in the same day! The waiter in front of me hasn’t, and it’s just as important to mention it for this meal as the last one. Ultimately, your food allergies are not a pain in the ass to deal with! They are not an inconvenience! 

But at the end of a three week trip in Scotland and the UK, I really just wanted to curl up at home and not have to worry about these damn things for the hundrendth time. So this was my shortcut. I told the waitress “Look I’m sorry to be a pain in the ass but I’ve got severe food allergies and I really just want to have a safe meal” (I laid in all of my actual physical exhaustion into this statement). She listened closely as I explained my allergies, smiled, and told me that the kitchen would know and everything I ordered should be safe, but she’d let me know. I felt better – it was the fifteenth explanation that week – and I noticed how useful it was. 

I’m not saying you should run around using this line with everyone, but when you’re feeling it, use it. It’s helped me stay consistent in always telling the waitstaff my allergies! 

Barcelona, Spain

#8. Deal with the Unexpected.

There’s an old saying that’s goes “expect the unexpected.” Great advice when it comes to a delayed train in the UK, not great advice when the stewardess starts serving nuts on a nut-free flight. I’m much more proactive in my approach: deal with the unexpected. 

When we were in Barcelona, we went to a tapas restaurant that had indicated it was a safe option from their website. Turns out, their menu was seasonal. The menu we were presented once we sat down was very, very different than the one online. It had all sorts of fusion cuisine, there were nuts and fish all over the menu. I thought to myself… “Hm we might need to walk out, but let’s see.” Our waitress María approached the table and asked if we were ready to order. I replied (in Spanish) that I first had a question, and I went about explaining my allergies. As I went down the list, her eyebrows furrowed deeper and deeper. At the end she said, “Okay let’s take a look.” And then to my absolute delight and surprise, we went jointly through the menu and figured out which dishes would be safe to eat. She knew every hidden ingredient like oyster sauce in their eggplant dish or sesame oil in their pork gyoza. They even went so far to replace one sauce from one dish with another (safe) sauce from another dish. She even came back with bad news about one dish, saying the sauce had a “may contain” statement with one of their ingredients. 

Turns out María also works the kitchen in the mornings. That helped. She was also very fluent in English – that also helped. But I also proactively told her about my allergies before ordering, because I wanted to know: is there anything safe for me to eat here? If not, that’s okay, we can go elsewhere, this was unexpected. But she absolutely made it work. (Shoutout María at The Sopa Boba in Barcelona, you were incredible). 

By proactively dealing with the unexpected – speaking up, establishing clear boundaries, saying something is okay or not okay, and clearly explaining what’s going – I’m able to make sure the unexpected is more of a friend than an enemy. I’ve never had a perfect travel experience. I was surprised to have nuts served on a train trip while in Italy (for me, not a big deal since I’m not airborne allergic but still very unexpected). I was surprised to learn a pub in Boston fried their chicken in the same friers as their fish even though they barely served fish. I was surprised to learn a small burger joint in San Francisco used nuts in one of their sauces. I was surprised to learn Delta Airlines likes to serve pistachios to their business class clients. I was surprised to learn a dinner joint in Whitefish MT was completely safe for me to eat even though I had a lot of doubts. I was even surprised to learn a sandwich joint down the street from where I live was completely a nut- and sesame-free kitchen! 

Anyway. My point is that the “unexpected” is always going to crop up. You might expect it, sure, but the stakes on allergies are much higher than a missed train or a delayed flight. It’s best to stay proactive and let the journey take you where it may. For what it’s worth, that might include a stop at a 2nd restaurant that’s actually safe for you to eat at. 

#9. Don’t Fake the Language.

Ah, a tale where I totally messed up.

I learned pretty quickly traveling in Italy that it was easier to explain my allergies in Italian than in English. Something about the language barrier there just left me ill-at-ease explaining my allergies in English. So I figured out how to explain what I was allergic to in Italian.

Here’s the scene: we hit up a local joint while in Venice. After we order a small snack and a couple drinks, I explain to the waiter (in Italian) my allergies. He says something that sounds a lot like what I’ve heard previously – that they use sesame in the kitchen but it won’t be on the food. I said that was fine. When the food was served, the bread had sesame all over it! I realized my mistake immediately. I whipped out my translate app, I apologized for the misunderstanding, but queried again about the allergies. And he came back in mostly-broken English, but sounding plenty frustrated: “I told you the bread had sesame! You said it was fine!” Whoops. We sent back the food, finished our drinks, and moved on. 

Lesson learned. Moving forward, I told future waiters: “I don’t know how to respond to this in Italian,” then used my Italian phrase for my allergies, and then looked at them expectantly. That seemed to do the trick! I always got a response that intermingled the Italian words for the allergies with English explaining the dishes and they did a much better job handling everything. 

When I traveled to Barcelona, I did not make the same mistake. I was practicing Spanish for plenty of time before visiting and I felt comfortable carrying on a conversation. I knew the context clues while ordering and I understood what people would say (in their infinite variations) even if I wasn’t totally fluent. That served me very well again – I felt very safe ordering, every waiter or waitress immediately understood my order, and we could carry on a short conversation about what was safe/why/etc. 

So don’t fake the language. 

A supplemental idea here – learn how to talk about your allergies in the local language. The core concept here is I want clear communication. If their English isn’t fluent, I think it’s a dumb risk for them to understand the English words for my allergies. I want to explain to them, in their language, about my allergies. That’s clear communication. In Spain this was superbly important because every single waiter understood los frutos secos or frutos de cascara (tree nuts) – it’s a top allergen to be labeled on food. Soy alergíco a los fruto secos… is a great a way to get their attention. You’re saying: this is important! If I said “I have an allergy, to all tree nuts” it’s possible I wouldn’t achieve the same amount of clarity. They may hear “nuts” and think nueces which in Spanish is technically only walnuts (although there’s some regional variation about whether that translates to just walnuts). 

I want them to be able to go back to the kitchen and clearly communicate the same thing I told them, and if that requires a little bit of extra work on the front end to learn some context words, and practice it a few bajillion times, then I’m going to do it. Still – don’t fake the language! 

Iceland

#10. Use Your Tools.

Whip out that translator app. Hit up the local grocery store. Stay at hotels with a kitchen (or at Airbnbs that don’t have outrageous fees). Mark your allergy with the airlines. Bring a backpack and carry a snack. Ask questions. Invite friends over instead of going out. Eat at the local fast casual place you know has a safe option.

When I travel to Boston for work, I usually stay in an Airbnb instead of a hotel. It’s usually more cost appropriate and I get a kitchen. I can walk to a local grocery store, buy food for (at least) breakfasts for the week, and store them in the fridge. I travel by myself for those work trips, so this makes it really easy to always have a safe breakfast option without having to navigate a local cafe. There are some hotel chains that also offer a kitchen ensuite, which would suffice. 

I think of my planning decisions for a trip – the type of hotel, the airline, the location, the activities – as building a “menu of possibilities.” Depending on my choices, I get different menus. The hotel I stayed at in Whitefish? Had a mini-fridge and a small sink for dirty glasses. That meant all of my food was going to be at restaurants or takeaway. Meanwhile when I was traveling Scotland, I stayed at a beautiful little Airbnb with a full kitchenette. I stopped by the local co-op to pick up food for the days I was staying there and now I didn’t need to worry about food unless I was out hiking some munroe. 

Making sure you have everything you need beyond the basics of your medication is so crucial to ensure the trip goes well. I did not walk around Barcelona without having the Spanish and Catalan languages fully downloaded inside my Google Translate app. It’s a tool! I might need to use it.

When I was in Tampa, I found a local Chipotle to eat at for a pre-meeting meal. A classic, safe option for my food allergy set. I knew they’d have safe options. Could I have hit up a local joint? Yeah, maybe. But I wasn’t in the mood and I thought – why not use the tools in front of me? Let’s go to Chipotle. 

En Fin

None of these rules or principles have prevented me from running into trouble. 

I still have waiters reject orders at restaurants, saying they aren’t safe. I still have to explain my food allergies everywhere I go. I still need to read ingredient labels. I still have those couple minutes of anxiety, trying something new that I’ve never had before and wondering if somebody messed up. 

Those things never really go away. That’s life. That’s just how it is. Yes, colleagues who don’t have any prior knowledge of my allergies always ask about it once I bring it up with the waiters. Is it tiring to explain it for the 5,000th time in my life? To answer their questions about how severe it is, when I first learned about it, and whether I carry an auto injector? Actually yeah. It is, a bit. But I also know that it comes from a place of curiosity and care. So I share a bit more than I feel like and our bond grows a little bit deeper. 

I know I’m lucky that I don’t have such severe allergies that it might prevent me from hopping on a plane in the first place. I know a lot of this is possible because I like to spend an inordinate amount of time on research. But these things have kept me safe and I hope they help you on your next trip! 

Bon voyage 🙂 

PS – Here are a few other ideas that didn’t make the final cut for this article but I do feel are important to mention:

  • Be mindful of what your date is eating, it will become important later in the night (if the date goes well) 
  • Always carry a snack that you know is safe, even if it means bringing it through TSA 
  • Bring Rx paperwork just in case 

If you want to read more about international travel, eating out, and other previous experiences, check out:

  • Preparing for my studying abroad experience & navigating foreign universities, here
  • Backpacking Iceland for 2 weeks, here
  • Navigating hip upscale restaurants and fusion food, here
  • Traveling in Italy for 2 weeks, here

Outgrowing Almond Allergy!

When my son, Morgan, was a little boy he continued to add more and more food allergies. He started with a peanut allergy reaction – breaking out in hives from touching a peanut butter sandwich at the age of 9 months. Thankfully, he didn’t eat it!

He added an egg allergy after a reaction to the MMR vaccine, and subsequent testing at 18 months old confirmed egg and also confirmed a severe peanut allergy. Our allergist suggested that he not eat tree nuts because of the likelihood of cross contact in the manufacturing process with peanuts.

Then, at the age of 3, he had full body hives and we went back for more testing to determine what food was causing the issue. To our dismay, he added another allergy – shellfish, but he hadn’t eaten shellfish the day of the hives, so we began to suspect sesame as the cause of the hives, but didn’t get that confirmed until a later allergy testing. We had further testing completed a few more times as he got older in the hopes that he would have outgrown a few of these allergies. While he did appear to outgrow egg allergy, it wasn’t until he was in high school that he was willing to go through a food challenge for eggs, which he passed. That was the only food allergy he had outgrown during his childhood.

He wasn’t supposed to be allergic to fish, as per one of the allergy testing results, yet had full blown anaphylaxis to one bite of trout on a camping trip a few years after this testing. That was a shock to say the least! So we added that food to his ever-growing list of food allergies.

He was managing peanut, tree nuts, shellfish, fish and sesame allergies from middle school through college and out into the work world. We basically had given up on him ever outgrowing any of these food allergies.

It has been 13 years since that last food challenge (he’s 28 years old now), and Morgan recently got brave enough to test for almonds, which had come back negative in two previous allergy testing results. A food challenge can be very anxiety producing, and we’ve found that Morgan has to REALLY want to eat the food to make the process worthwhile.

Here is Morgan’s summary of the food challenge as posted on his LinkedIn account:

You can probably imagine how excited we all were with this development! I suppose the moral of the story of food allergies is: never give up on outgrowing a food allergy!

Morgan has begun eating almonds in all kinds of foods (always ensuring that there is no cross contact with any other tree nuts since he still has those allergies), and also drinking almond milk. It has expanded his diet enormously and we are so thrilled!

Eye Ointment made with Peanut Oil!

I have long been challenged with dry eyes. My optometrist and I continue to look for ways to mitigate my scratchy eyes and blepharitis (inflammation in the eyelids where the oil glands become blocked). I had another flare of my dry eyes recently, and my doctor suggested a new product: Optase HyloNight. I was excited that not only would the product help my dry eyes, but would also help the blepharitis. Too many times, a product that helps one issue causes the other issue to get exacerbated.

I carefully read the Amazon page about the product and ordered it. I’ve learned with all of my food allergies and other sensitivities to be thorough in vetting any new product I’m going to introduce, especially if I’m going to be putting it into my eye.

When I received the eye ointment, I read the box and the Instructions for Use that was inside the box. Imagine my surprise when I read the statement, “May Contain Peanut Oil” in both places!

The first thing I did was to go back to the Amazon product page to re-read the Inactive Ingredients that were listed there to make sure I hadn’t missed the information. Here’s what I found:

As you can see in the Inactive Ingredients, there is no mention of peanut oil! I was shocked.

For those of you not versed in the language of peanut oil, there is cold-pressed peanut oil which should be avoided by anyone who has peanut allergies, such as myself. There is also highly refined peanut oil, which shouldn’t contain the protein that creates the IgE reaction in those people with the allergy. However, your doctor can best inform you whether you should refrain from ingesting either form of peanut oil, depending upon your specific circumstances.

There is no indication on the box what kind of peanut oil was used. I reached out to the seller of the product to provide feedback, and never received a response. Therefore, I decided it best to not use the product at all.

I also informed Amazon that the product page is not complete, yet I did so weeks ago and there has been no change to the information on the page. I also provided a review of this product so that other potential buyers with peanut allergies would not purchase it.

It took several phone calls and messages to get a refund on the product since a refund is not generally given from Amazon on eye ointments. I had to explain that the product page is not accurate.

This situation is a good reminder to ALWAYS read the information of any product that you’re going to use on yourself or your child with food allergies. You can never be too cautious!

New book on all things Allergic

There’s a brand new book out called Allergic: Our Irritated Bodies in a Changing World by Theresa MacPhail. Theresa is a medical anthropologist – who knew there was such a thing ?! – and has done an admirable job covering topics from the medical discovery of allergies, diagnoses, where allergies might source from, treatments, research and more. I’ve just finished reading the book, and I’ve enjoyed reading it, and thought that my AllergicChild readers might benefit from what I found helpful in the book.

I’ve been in the Allergy World all my adult life, and have had years of experience with my own allergies and those of each of my children. Yet, I still learned more about the immune system and how it operates by reading this book. I also learned more about Dupixent and how it came into being. That was a fascinating part of the book to me. I’ve been wondering if it would be a good drug for me to try to combat my Eosinophilic Esophagitis (EoE) diagnosis. This book gave me more details than I’ve been able to find elsewhere. And my conclusion is that the price of the drug is still prohibitive for me!

Ms. MacPhail has interviewed literally dozens of the most esteemed allergists, scientists and researchers for the various topics she covers in this book. If you’ve been part of the Allergy World, you will likely recognize almost all of these individuals. It felt comforting to me that she went to the experts who shared their experience and specific research.

And beyond just the experts, she also interviews parents and advocates who have created groups and non-profits that help individuals in the Allergy World. I liked reading about these individuals, especially since I know them and have met them at food allergy conferences through the years. I respect them tremendously, and reading about them in the book only made me have even more appreciation for them and everything they have done for our community.

If you’re looking to learn more about food allergies, pollen allergies, your immune system and treatments that are on the horizon, I’d definitely suggest you read this book!

(PS – I’m not receiving any remuneration to provide you this review, nor do I know the author. But I would love to have more conversations with her if I ever did get to speak with her!)

Food Without Fear

What a great name for a new book by Dr. Ruchi Gupta! And the book contents are also wonderful, and well worth reading. The subtitle to the book is “Identify, Prevent, and Treat Food Allergies, Intolerances, and Sensitivities,” and it is these extra topics that make the book so enjoyable to read.

In case you haven’t heard of Dr. Gupta, here is a snippet from the bio on her website for the book: “Ruchi Gupta, MD, MPH, is a Professor of Pediatrics and Medicine at Northwestern University Feinberg School of Medicine and a Clinical Attending at Ann & Robert H. Lurie Children’s Hospital of Chicago. Dr. Gupta has more than 17 years of experience as a board-certified pediatrician and health researcher and currently serves as the founding director of the Center for Food Allergy & Asthma Research (CFAAR). She is world-renowned for her groundbreaking research in the areas of food allergy and asthma epidemiology, most notably for her research on the prevalence of pediatric and adult food allergy in the United States.”

It was Dr. Gupta’s research in 2019 that found that over 10% of adults in the USA are estimated to have a food allergy. It was also Dr. Gupta whose research estimated that 8% of children in the USA have a food allergy, and to make things even more personal for her, she is a food allergy mom.

I have been in the food allergy community for over 20 years helping my son to manage his life threatening allergies. I can’t remember a book I’ve read on the topic of food allergies that also includes: FODMAPs, FPIES, EoE, OAS, GERD, Autoimmune disorders, Alpha-Gal, and Chemical Sensitivities. Some of these topics are taboo in the medical world, but Dr. Gupta tackles all of them, and she gives information that I haven’t read before anywhere.

She also goes into the Microbiome and its affect on the immune system – one of my favorite topics! She delves into the question of whether we Moms are to blame for our children having food allergies, and lets us all off the hook. Thank goodness!

There is great information about the Western diet and its impact on inflammation in our body and the gut-brain axis. Additionally, she discusses the nervous system and the vagus nerve, which is such a welcome subject when discussing the immune system, and is only recently being discussed by Western medicine doctors.

The only topic that I wish was discussed in the book was Mast Cell Activation Syndrome (MCAS). So many people mistake the symptoms of MCAS with food allergies, and there is a definite difference. You can read more about MCAS on my website here.

Even if you’ve been in the food allergy community for years, I think you’ll find this book educational, and you will likely learn something new!

Note: I was not paid in any way to write this review of the book. As with any book featured on my website, I personally read the book and decide whether it fits my AllergicChild.com audience and also meets the standards of truth necessary for any family managing food allergies.

What the FASTER Act Means to Us!

You have likely heard of the Faster Act of 2021, but just in case you need a little more information about how it will affect those with sesame allergies, let me just say – it has been a long time coming.

First, a little history: When my son, Morgan, was diagnosed at 18 months old in 1997 with food allergies, there was no labeling law in affect. We went home from the doctor’s office with a diagnosis of peanut and egg allergies, and I decided to start making as much of his food from scratch, because I couldn’t trust that the label on any food accurately listed the correct ingredients. And any type of cross contact during the manufacturing process was an even further dream of getting that information!

The Food Allergen Labeling and Consumer Protection Act (FALCPA) of 2004 went into effect on January 1, 2006. According to the FDA website, “Congress passed this Act to make it easier for food allergic consumers and their caregivers to identify and avoid foods that contain major food allergens. In fact, in a review of the foods of randomly selected manufacturers of baked goods, ice cream, and candy in Minnesota and Wisconsin in 1999, FDA found that 25 percent of sampled foods failed to list peanuts or eggs as ingredients on the food labels although the foods contained these allergens.” Good thing I was being cautious about labels on food products!

The ‘major food allergens’ that were required to be listed in plain English with FALCPA were: peanuts, tree nuts, eggs, milk, wheat, soy, fish and shellfish. These are known as the Top 8 in the USA. Other countries required different foods to be labeled on products manufactured in their country, and some of those countries included sesame.

Morgan got diagnosed with a sesame allergy after he endured a severe hive reaction from eating chicken nuggets at McDonald’s. We had a skin prick and blood allergy test performed by our allergist, and she wanted to see if he was allergic to sesame, since those little sesame seeds can appear in food and be almost undetectable. Sure enough, he was severely allergic, and we have been monitoring labels and calling customer service telephone numbers for food manufacturers for the last 20+ years. And let me tell you, it is VERY difficult to find a bread that doesn’t have cross contact issues with sesame!

At one time, I tried to make my own gluten-free bagels since our daughter was diagnosed with Celiac disease. I figured that these bagels would also work for Morgan, and we would know that they didn’t have any sesame in them, nor any possible cross contact in our safe kitchen. After hours of work trying to make a masterpiece, the bagels turned out less than ideal – better for use as a hockey puck or a door stop than for eating!

Since then, we searched for a safe bread in the grocery store, hoping to find one that didn’t also have sesame seeds on a different bread in their manufacturing line. We would then call the company and ask if there was ANY chance that the bread would cross with sesame in their plant. Sometimes we would find out that there was another product that contained sesame that was also run on the same lines. Sometimes we’d be lucky and find a safe bread! For years, Morgan used Roman Meal bread for sandwiches and for a hamburger bun because we couldn’t find any safe hamburger buns in any of our local grocery stores.

The FASTER Act – Food Allergy Safety, Treatment, and Research Act – not only requires that food manufacturers list sesame on a label beginning January 1, 2023, but also provides for more research on the prevalence and economic costs of food allergies. The food label must list sesame in ‘plain language’ and will become the ninth food allergen to be labeled, allowing those of us in the USA to rename the Top 8 to the Top 9!

President Biden signed the Act into law on April 23, 2021.

Morgan and I cheered upon hearing that! And he so looks forward to being more confident of his food choices knowing that sesame will soon be labelled!

Not Today, Butterflies! A Book About Food Allergy Anxiety

A great new book by Nicole Ondatje was published this week. Read below for an interview with Nicole about this great new children’s book!

Nicole, you have a new book out called, “Not Today, Butterflies! A Book About Food Allergy Anxiety.” What gave you the idea to write this book?

My nine-year-old daughter has severe anaphylactic food allergies. At age four, she started experiencing anxiety about her annual allergy skin prick tests, attending birthday parties, visiting family, and eating at restaurants. Searching online, I could find children’s books regarding food allergies and a handful of children’s books regarding anxiety, but there weren’t books that specifically and directly addressed food allergy anxiety in children. So, I started researching techniques to help children manage their anxiety, and testing which approaches helped my daughter the most.

 When she turned five, my daughter enrolled in a clinical trial for the peanut patch, adding blood draws and food challenges to her long list of anxiety-provoking situations. My approach was to help her write and illustrate a story in which she overcame her fears of going to her peanut patch appointment by being brave (and getting a sweet treat afterwards). She felt that the story, called “Rosy Goes to the Doctor,” helped her prepare for future appointments. That is how I was inspired to write a children’s book to help my daughter and other children like her who struggle with the daily challenges of living with a food allergy.

The illustrations in the book are wonderful. Did you do the artwork also?

I love the illustrations! Bumblebee Books and Olympia Publishers provided me with an illustrator named M. Das. I felt that it was important that the illustrations were somewhat realistic and included imagery of a human child to whom children could truly relate, rather than a fictitious animal character. My daughter and I worked together to provide the illustrator with detailed descriptions of each character in the book and what we wanted to see on every page. It was really neat to see our words come to life in the drawings that came back to us.

As the parent of a child with food allergies, how much of the book was written from you or your daughter’s personal experiences?

All of it! Both my husband and I have an anxiety disorder that we have to manage, and we experience additional anxiety about our daughter’s food allergy. Our daughter has experienced terrible anxiety in anticipation of her allergy appointments, going to play dates and birthday parties, being different from her friends and schoolmates, and speaking up to friends as well as strangers about her allergy. It breaks my heart that she lives each day with this nagging fear about the lurking danger of her food allergy. Our approach has always been to educate and empower her to learn what she can do to keep herself safe. As a family, we have tried all of the “Ways to Help Your Child Manage Anxiety” included in the back of the book (except the proximity food challenge and happy visit), and we’ve practiced them for many years to learn what techniques help us the most.

 I love the birthday party situation in the book where Quinn has to speak up for herself. I felt butterflies for her! How did you teach your daughter about handling such a situation?

It started with reading a lot of children’s books about food allergies together and having an open dialogue with her. In fact, our first ever food allergy book was your book “Allie the Allergic Elephant: A Children’s Story of Peanut Allergies”. We read books that encourage speaking up about your food allergy, like “The Peanut Pickle” by Jessica Jacobs, and “Food Allergies and Me: A Children’s Book” by Juniper Skinner. We read books that help you prepare for a social event and learn how to stay safe, like “The No Biggie Bunch” series by Dr. Michael Pistiner, and “Joey Panda and His Food Allergies Save the Day” by Drs. Amishi Murthy and Vivian Chou. We read other books about calming anxiety in children, like “Don’t Panic, Annika” by Juliet Clare Bell and “Sea Otter Cove: A Relaxation Story” by Lori Lite. We also encouraged our daughter to practice speaking to strangers about her allergy by having her place her order at restaurants and ask about their food allergy practices, and by participating whenever we trained friends, family, school staff, and caregivers on managing her food allergies (in fact, these were practices we learned from you and Morgan!).

 It took several years and many birthday parties before any of us felt reasonably calm about the experience. We still follow the same process of checking with the party planner ahead of time on what food will be served, reading all of the ingredient labels, staying away from foods without a label, and making sure we have two epinephrine auto-injectors with us. As my daughter has gotten older, it upsets her more to bring her own safe treat and eat something different from the other kids at the party. Sometimes we are able to work with the other parent or bakery to ensure the shared party treats are safe for my daughter to eat. But we continue to work on helping her accept being “different” from her peers. Maybe that will be my next book topic!

In the Notes to Parents in the back of the book, you mention teaching a child mindfulness. What’s the best way that you’ve found to have a child be willing to try this skill?

Number one is finding the right tools, and number two is setting an example by practicing mindfulness yourself in front of your child. I’ve included a number of mindfulness tools for kids in the back of the book, but two additional tools that we love are “The ABCs of Yoga for Kids” learning cards and “50 Mindfulness Activities for Kindness, Focus, and Calm” cards. We practice these cards together, often before bed. A great book to help teach your kids about mindful belly breathing is “Sea Otter Cove: A Relaxation Story” by Lori Lite. We sit and practice different breathing techniques together, starting when we are already calm. As a parent, I absolutely loved Dr. Kristen Race’s “Mindful Parenting” book along with all of her amazing techniques for busy parents and the entire family. My child has witnessed firsthand how I can maintain more peace and levelheadedness when I am disciplined with my daily meditation practice. When I am feeling particularly frustrated or stressed in front of my child, she sees me stop, pause, and take a breath, or blow out an elongated breath, or remove myself from a heated situation and find ways like reading, listening to music, or taking a bath to calm myself. She also sees me push myself to do something in spite of my fear, and I help her recognize all of the instances in which she has been brave despite her food allergies.

Is there anything else you’d like to tell us?

I truly hope that this book helps children and families with food allergies. It’s based on my own personal experience, research that I’ve done through books, conferences, webinars, and meeting with a child psychotherapist whose own child has food allergies. Before publication, it was vetted by that same psychotherapist as well as my child’s board certified asthma and allergy doctor.

Thank you.

Thank you Nicole!