Siblings Without Allergies

by Amanda Painter, South Chapter Coordinator 

Should I allow my non-allergic child to eat the other child’s allergens? 

How do I introduce allergens to younger siblings?
 
Many parents of kids with food allergies face these questions, myself included.  Advice from both our allergist and pediatrician was that we introduce all foods (including my daughter’s allergens- milk, peanut, tree nut, sesame & mustard) to my son and keep them in his diet with some regularity. 
 
Making the decision to introduce allergens is a situation that is very family specific, unique to the diagnosed allergies and should be discussed with an allergist.  I often hear of families restricting allergens in the diets of the non-allergic child 100% of the time.  Yet going to this extreme isn’t necessarily in the child’s best interest.
 
Introducing an allergen to a non-allergic younger sibling is challenging and worrisome.  It becomes more complicated if you have a home that is free of allergens.  Currently, allergens are not eaten in our home (with a few minor exceptions).  Not all families choose to have allergen free homes.  Much of it depends on the allergens; age of children, nutritional needs of others, and many other reasons (this is a blog topic for another day).  But if you do have an allergen-free home and are faced with the challenge of introducing allergens to younger siblings and including them in your non-allergic child’s diet, here are some tips from how we managed this for our family.
 
When my son turned 1, it was time to introduce cow’s milk.  Figuring out how to do this in our milk-free house was a bit unnerving.  For this situation, we introduced my son to milk for the first time at home while my daughter was out for the day.  I also did it right before my son was going to take a nap.  I cleaned him up well afterwards, brushed his teeth and then he slept.  While we know that all of those things won’t get rid of 100% of the milk proteins in his mouth, we hope that it lessens them.  We also took this opportunity to really focus on teaching our daughter to not put things in her mouth; toys, crayons, etc. and why it was important, since sometimes her brother eats foods she’s allergic to when he’s not with her. 
 
Then came the time we needed to introduce peanuts to him. Peanut butter is messy and something I really didn’t want in my home.  So, I decided to do this outside of the house.  This situation made me more nervous than the others.  So as we left the house that morning, I also grabbed our backup set of epinephrine auto-injectors. I placed my son into the shopping cart’s seat and fed him peanut butter candy as we walked though a store. (It was hard candy. Not messy. I also wiped off the shopping cart well afterwards. My children will not be the reason another food-allergy mom panics over left-over crumbs or food residue!) My reasoning for the location was that at least we were in a public place and there would be people there to assist with calling 911 if necessary. Looking back, do I think I was a little over the top? Possibly. But it gave me peace of mind at the time and the confidence to actually go through with feeding him peanuts.   
 
My son and I continued regular outings to restaurants, incorporating all of my daughter's allergens into his meals or snacks until he started preschool.  At this point we started buying individually wrapped/boxed allergen food items and send those to school with him.  We keep them on the top shelf of the pantry/refrigerator.  Everyone in the family is aware (including babysitters that come into the house). Even my son at three years old understands he can’t have those items in the house.  There has been the occasional treat or leftover snack that has come in my son’s school bag.  These are usually finished in the driveway. 
 
Eating allergens outside of the house meant that we needed to introduce rules and procedures to reduce food residue coming into the house (and to help my peace of mind).

• Hands are always washed as soon as we enter the house. 
• I keep wipes in the car to clean up any residue on my son’s face or hands when I pick him up from preschool or after a meal out.
• Extra clothes are always kept on hand.  Sometimes a shirt change is necessary.

 
Making the leap to introduce foods that you know could greatly harm one of your children to the other sibling is a tough situation that must be faced.
 
Are you unsure if you should introduce an allergen to a younger sibling?
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A recent study shows that siblings of kids with food allergies aren’t necessarily also allergic.  If you are restricting the diet of one of your children due to the concern that he/she may also be allergic, I recommend speaking with your allergist to decide if this is best for your child’s individual needs.  You can read Dr. Singer's (our Medical Advisor) thoughts on this topic here.   
 
If your allergist recommends that certain foods should be introduced to other family members, develop a plan.  Include friends and family to help with this.  The first introduction can be filled with anxiety.  Having extra hands around to help (or watch the child diagnosed with allergies) can lesson your anxiety.  Once you’re over the hurdle of the first introduction, a quick stop at a friend’s house could be the perfect opportunity to have a snack that is normally off limits at home.
 
A limited diet is necessary for those diagnosed with food allergies.  However, diets should not be restricted for someone without food allergies.  Proper nutritional balance and variety are important. Don’t allow fear override what is best for your child’s health.