Alice Anderson, who lives in Depew, N.Y., has been managing her daughter's peanut allergy for more than 10 years. "Claire is 13 now and has been allergic to peanuts since she was 2," says Anderson, who runs a parenting website called Mommy to Mom.
There have been ups and downs and you have to live carefully, she says, but it's manageable. "The best way to manage living life with a food allergy is by staying diligent, doing your research, speaking up for yourself, and educating others," Anderson says.
David Stukus, MD, a spokesperson for the American College of Allergy, Asthma and Immunology, agrees. "It takes practice and time," he says. "But with education and guidance from a board-certified allergist, these are skills that all families can learn."
Teach Your Child at an Early Age
Anderson and her husband, Rob, started teaching Claire about her allergy when she was a toddler. They used simple language she could understand. "We told her foods with peanuts in them or foods that could have touched other foods could make her sick," Anderson says.
They had a strict rule about not eating homemade treats from anyone. "The rule was that she always had to check with us first, before eating anything," Anderson says.
They also helped Claire understand by reading her books about peanut allergies as part of her bedtime story routine. They used a practice injector to help her become comfortable with it.
"There was a lot of repetition, just reiterating the same messages," Anderson says. "We explained how it would feel if she was having a reaction and made sure she knew to tell us right away if she ever felt those symptoms."
Pay Attention to Age Differences
When managing your child's food allergy, different ages bring different challenges.
Infants and toddlers are naturally curious and explore their environment with their hands and mouths, so they need constant supervision, Stukus says. Teens are more likely to take risks and face peer pressure that may lead to less caution around peanuts.
No matter your child's age, try to model positive behavior. "If parents are highly anxious, their child may learn to be more scared and less in control of their allergies," Stukus says.
"On the other hand, parents who continually demonstrate checklists before leaving home, have consistent communication with food handlers and caregivers, and involve their children in reading labels can help their children develop confidence."
Check Foods Carefully
Anderson says watching out for foods that may contain peanuts is a constant necessity. "We always read labels when grocery shopping," she says.
But reading labels isn't always simple.
Even if you don't see the words "contains peanuts," a product may have been manufactured on the same equipment as other nut products, so there may be cross-contamination. Or sometimes a food you buy regularly changes its ingredients.
"I call companies to find out their manufacturing processes and whether or not they voluntarily label for 'may contain,'" Anderson says.
Plan Ahead When Eating Out
It may be easy to stay peanut-free at home, but being out of the house can be a challenge. "Unless you have a package label to read, you have no idea what's in that food or what allergens it may have come into contact with," she says.
Before eating at a restaurant, Anderson looks online or calls ahead to speak to a manager to see if they can accommodate Claire's food allergy.
Now that she's 13, Claire knows which foods to avoid when she's out. But when she was younger, the family set a strict rule about not eating unlabeled or homemade foods outside their home.
Prepare for Emergencies
In case of emergency, Claire carries two epinephrine injectors and Benadryl in her bag at all times.
At home, there's always an adult available to help if something goes wrong. At school, they have a plan in place where if Claire has symptoms, the staff will give her epinephrine and dial 911.
"Claire also has a cell phone to call 911 if she ever has a reaction and needs to administer her medicine herself," Anderson says.
If you have a child with a peanut allergy, these tips may help:
Learn the facts. Find information on websites that specialize in food allergies. Always use reputable websites. Stukus says there's a lot of misinformation and overblown stories online that can make you feel anxious and unsafe.
Educate your child. Talk to your child about their allergy no matter how young they are. "We were surprised how much our daughter soaked in when she was 2," Anderson says. "By preschool, she was advocating for herself."
Inform others. "Be willing to teach others how they can help keep your child safe," Anderson says. "In my experience, most people don't understand food allergies but are more than willing to help."
Talk to school officials. Check about a 504 plan that will keep everyone on the same page about what to do in an emergency, Anderson says.
Be ready for an emergency. Never leave home without your epinephrine, Anderson says. Teach your child to take it with them no matter where they go.
Consider oral immunotherapy. The FDA has approved a drug called Palforzia -- a type of oral immunotherapy -- to treat peanut allergy. The generic name of this medication is "peanut (Arachis hypogaea) allergen powder-dnfp." It doesn't cure peanut allergies, but it can reduce the severity of allergic reactions, including a life-threatening symptom called anaphylaxis.
Get support. Connect with family and friends who support you and your child's needs. Join a community of parents dealing with food allergies to learn about local resources, allergen-free recipes, or practical tips for daily life. Anderson joined a local Facebook group where she's attended events with other allergy families. "It helps to know you're not alone," she says.
It's common to worry about what may happen to your child. "Parents of children with food allergies naturally have hundreds of 'what-if' scenarios running through their minds," Stukus says.
If you understand the risks and how to avoid them, you can manage anxiety and lead a normal life. "Many families whose children have severe peanut allergies find ways to travel, participate in social encounters, and safely dine at restaurants," Stukus says.