Kids’ Food Allergies Damper Dining Out

Study Shows Children With Peanut Allergies Often Don’t Get Lifesaving Medication

Medically Reviewed by Louise Chang, MD on March 17, 2008
From the WebMD Archives

March 17, 2008 (Philadelphia) -- Even though most parents alert restaurant staff if their children have food allergies, a sizable number of the kids still suffer allergic reactions when dining out, a new survey shows.

Adding insult to injury, a second study suggests that children who suffer peanut allergies often don't get lifesaving medication.

Both studies were presented here at the annual meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI).

Food Allergy Common Among Kids

Up to 8% of children have food allergies, which can be life-threatening. People with food allergies must strictly avoid their trigger foods, and that can put a damper on eating out, says Scott Sicherer, MD, a pediatric food-allergy specialist at the Mt. Sinai School of Medicine in New York City.

"Surveys have shown that dining out is the No. 1 thing that negatively impacts the quality of life of people with food allergies," he tells WebMD.

Sicherer and colleagues surveyed 294 families attending the 2007 Food Allergy & Anaphylaxis Network conferences in New York and Chicago. Parents were asked about their experiences when eating out or getting take-out food.

Most of the kids, whose median age was 5 years, were allergic to peanuts, tree nuts, eggs, and milk; 83% avoided more than one food.

Overall, about one-third of the kids experienced at least one allergic reaction when dining out, and one-third of these kids had had three or more adverse reactions, Sicherer says.

In 70% of cases, peanuts were to blame; tree nuts were the culprit in 64% of cases.

Many Parents Didn't Alert Restaurant

One of the most noteworthy findings, Sicherer says, was that 30% of parents said they didn't always alert restaurant staff of their children's food allergies.

"You should always identify yourself or your child as being allergic," he says.

Go into detail, he advises. "Telling someone you're allergic to peanuts is a lot different than explaining that even a trace amount of a food could make you or your child sick."

When there was communication between the family and the kitchen, it was typically verbal, he says. Only 14% of parents conveyed food-allergy information to the restaurant in writing.

"We call this a chef card," Sicherer says. Many experts recommend typing up small business-size cards featuring the person's name and food allergy and all offending ingredients, with a request that the kitchen leave them off any dish you order.

As for who they talked to, the survey showed that most parents (95%) informed the waiter or waitress about their child's allergies. Fifty-six percent told the manager, and 44% informed the chef or kitchen staff.

Wesley Burkes, MD, chairman of the committee that chose what studies to highlight at the AAAAI meeting and a child allergy specialist at Duke University, says that talking to the chef or cook is always a good idea.

"Talk to someone who really knows what is in the meal," he says.

"Say your kid is allergic to cheese. You need to spell out that eating a burger that has been prepared on the same grill as a cheeseburger could evoke a life-threatening reaction," Sicherer adds.

Other Findings

  • About one in five families said they never ate out or ordered fast food because of their kid's allergies.
  • Only 71% were aware that restaurant chains and corporate web sites often provide allergen information, and only 26% knew that 800 numbers offer allergy information.

The survey also showed that restaurants can improve their notification of allergenic ingredients, Sicherer says. Advisory statements such as "menu item may be cooked in the same oil as an item containing the allergen" don't help much, the parents reported.

Also, 48% of parents found allergen information "extremely inconsistent" from restaurant to restaurant.

Epinephrine Underused

For the second study, Nha Nguyen Luu, MD, and colleagues at McGill University Health Care in Montreal, Canada, surveyed 271 parents of kids with peanut allergy.

Overall, 127 of their children suffered 148 reactions over an average one-year period. Seventy-eight were considered moderate, and 19 were severe. Such attacks are usually rapid and overwhelming, and include symptoms such as nausea, vomiting, severe, high-pitched wheezing, breathing difficulty, hives, facial swelling, and loss of consciousness.

Results showed that even though an epinephrine shot can slow down or stop a life-threatening allergic reaction, it was used in only 22 of these 97 cases, Luu says.

"All these kids had diagnosed peanut allergies, so they should have had a device for self-injecting epinephrine (commonly known as EpiPen or Ana-Kit)," she tells WebMD.

"We don't know if they never got the prescription, they didn't fill the prescription, or in my best guess, were scared to inject their kids," Luu says.

Epinephrine shots do have side effects, chiefly palpitations and flushing, but kids generally tolerate them well, she says.

WebMD Health News


American Academy of Allergy, Asthma & Immunology Annual Meeting 2008, Philadelphia, March 14-18, 2008.
Scott Sicherer, MD, associate professor of pediatrics, Mt. Sinai School of Medicine, New York City.
Wesley Burkes, MD, chairman, program committee, AAAAI Annual Meeting 2008; professor of pediatrics, Duke University, Durham, N.C.
Nha Nguyen Luu, MD, McGill University Health Care, Montreal.

© 2008 WebMD, LLC. All rights reserved.