Summer camp is an invaluable childhood experience full of fun, learning and personal growth. However, for parents with children who have severe food allergies, sending your child away to camp can be very scary. How can you be sure there are safe food options? And what if there is an allergic reaction? Will the camp know what to do? These fears are legitimate but it doesn’t mean your child has to miss out on all the fun. Hopefully, this entry will offer some guidance on how to ensure a safe and enjoyable camp experience for your child with food allergies.

Childhood food allergy is an increasing phenomenon and awareness is starting to catch up. A few camps cater specifically to children with food allergies.

• One option is Camp Emerson (“the Food Allergy Specialist”), in the Berkshire Mountains of Western Massachusetts. On the Web site, Camp Director Sue Lein writes, “The Food Allergy Camp Team meets individually with your family to respond to your child’s needs. Our goal is to ensure that your child is able to eat safely and enjoyably at Camp Emerson. We want your child to feel like ‘everyone else’ in the dining hall.”

• Another such camp is The Center for Courageous Kids. This camp, located in Scottsville, Kentucky, has different themes throughout the summer and fall, each catering to a specific childhood medical condition. This year, there is a retreat weekend dedicated to children with severe food allergies scheduled for September 17-19.  A unique feature of this program is that the whole family attends.

• The YWCA Outdoor Education Center in Edmonton, Alberta (Canada) offers a program for kids with food allergies during session 4 of camp (July 26-30). On the Web site, the camp writes, “In partnership with Alberta Allergy Information Association, we are pleased to host a camp for children with severe food allergies. This camp, to be held during Session 4, will enable children with severe and life threatening food allergies to enjoy camp life in a safe environment.”

Next summer there will be many more options for campers with food allergies! Camp T.A.G.: A Safe Place for Food-Allergic Children and Their Siblings will open in various locations for the summer of 2011. The 11 cities chosen for the summer 2011 launch are: Joliet, Ill., Oak Brook, Ill., Minneapolis, Minn.., Houston, Texas, San Francisco, Calif., Raleigh, N.C., Philadelphia, Pa., Fairfax, Va., Silver Spring, Md., Long Island, N.Y., and North New Jersey/New York City.

Not everyone can attend a special food allergy camp so another option is to work with local camps to accommodate your child’s food allergies. The Food Allergy and Anaphylaxis Network has created “Guidelines for Managing Food Allergies at Camp” to help you through the process. The guidelines are divided into responsibilities of the parents, the camp and the campers and lists proper preparations and procedures to protect children with food allergies during camp.

Be sure to sign up soon! Camp application deadlines are fast approaching and you want to provide ample time for any special accommodations. Know of any other food-allergy friendly camps? Make sure to post them here!

Happy trails!

-Mallory

I often get asked whether our Neocate^® formulas have all the vitamins and minerals a child would need to thrive for all stages throughout their lives. The answer is yes; but I thought I should explain further what the term “nutritionally complete” really means.

If a formula is considered nutritionally complete it can be used as a sole source of nutrition because it will provide all of the important carbohydrates, protein, fat, vitamins and minerals a child needs to grow and thrive.  For a nutritional product to be nutritionally complete and say so on its product label, it should be age-appropriate and provide all the nutrients a child would need for that specific age.  For example, infant formulas are designed specifically to meet the needs of infants.  As the infant grows into a toddler and older child, their nutritional needs differ and age-specific nutritionally complete products are needed to ensure they are meeting all their nutrient needs.

Having complete nutrition is important for children who are on very restrictive diets because of conditions such as food allergies, eosinophilic esophagitis (EoE) and short bowel syndrome (SBS). When children cannot eat a wide variety of foods, it is common for them to have nutrient deficiencies as a consequence. One study¹ found that in children with food allergies, many were not receiving enough vitamin D, calcium, iron, vitamin E and zinc. This is a serious problem because inadequate nutrition in children could have long-lasting implications such as poor growth, delayed development, and failure to thrive.

One way to avoid nutrient deficiencies is by having a registered dietitian involved in your child’s care – they can assess your child’s nutritional status and give recommendations on what options may work for you and your family. Your chosen nutritionist can also help you to properly read food labels and really understand what is being put into your child’s food.  Just as important, finding a nutritional formula that has adequate (and even higher) amounts of important nutrients (such as calcium, iron, vitamin D, phosphorus and zinc) can help you ensure your little one is receiving proper age-specific nutrition to grow and thrive.

As I mentioned, all of the nutrition formulas in the Neocate family are nutritionally complete. If you are also using Neocate Nutra (a semi-solid amino-acid based medical food) don’t forget that it is meant to supplement formula and not replace it. Nutra contains lots of important nutrients like protein, fat, calcium, and vitamin D but just not enough to be the only source of nutrition.

Are there any vitamins and/or minerals you are worried your little one may not be getting enough of due to a restricted diet? Let us hear about it!

Christine

1. Salman et al, Dietary intakes of children with food allergies: comparison of the food guide pyramid and the recommended dietary allowances, J Allergy Clin Immunol 2002.

Back in our vitamin series we often referenced the ingredient list on formula & food labels and helped identify some of those long words as vitamins.  This sparked us to think about ingredients in general and the importance of understanding ingredients when dealing with food allergies.

There is so much more to ingredients then what’s listed on the label.  So, of course, we decided to blog about it!  Understanding fats, carbohydrates and proteins will be the topic of our next series.   Within the next few months we hope to cover some common inquiries such as types of fat, healthy vs. unhealthy fats, types of carbohydrate including corn, identify sugars, and hidden allergens such as dairy, and explain the building blocks of protein.

A few things to keep in mind while reading those labels and looking at ingredient lists: 

• The FDA requires all manufacturers to list all ingredients in the food on the label.
• Based on the Food Allergen Labeling and Consumer Protection Act of 2004, manufacturers are required to list the top eight foods which account for the most food allergies in commonly used terms.  This does not include allergens accidently introduced during manufacturing or packaging through cross-contamination. 
• Ingredients are listed in order of predominance.  The ingredient used in the greatest amount is listed first, followed by those in smaller amounts listed next, in descending order.
• There are several different types of ingredients such as:
  • Preservatives (ascorbic acid, citric acid) to prevent food from spoiling
  • Emulsifiers (soy lecithin, mono-and diglycderides) which allow smooth mixing and prevent separation
  • Sweeteners (saccharin, aspartame, acesulfame potassium) to add sweetness with or without the extra calories
  • Color Additives (citrus red no. 2, beta-carotene) which offsets color loss due to exposure to light, air, temperature extremes or moisture

Don’t forget to check back with us next week as we kick-off our ingredient series with the topic of fats.  Do you have any questions on what’s listed in the ingredients on food labels?

- Sarah

Our post today is a special guest blog entry from Nicole Smith. Her blog is Allergicchild.com and she is also the author of the books Allie the Allergic Elephant: A Children’s Story of Peanut Allergies, Cody the Allergic Cow: A Children’s Story of Milk Allergies  and Chad the Allergic Chipmunk: A Children’s Story of Nut Allergies. Nicole has also served as Treasurer for the non-profit organization, Kids With Food Allergies, Inc. and is currently serving on the Food Allergy Initiative (FAI) Advocacy Steering Committee. We would like to thank her for guest blogging for us.

Living with food allergies and eczema has become quite normal for our family. Our son, Morgan, is now almost 14 years old and has lived with food allergies his entire life. He is anaphylactic to peanuts, tree nuts, sesame, fish and shellfish. He is severely allergic to dogs, cats and other furry animals. His eczema is our ongoing battle. He is allergic to grasses, weeds and trees. He currently is receiving allergy shots in the hopes that his seasonal allergies will be minimized, and maybe he will be able to pet a dog in the near future!

From his first few months, Morgan had severe, weeping eczema across his body. It was everywhere – behind his knees, on his hands and feet, and even behind his earlobes. His skin was constantly infected, and I coated him with lotions and over the counter steroid creams to not much avail.

Morgan as a baby

Morgan’s eczema was helped by using Eucerin® lotion in the paste form, and by sparingly using Elocon® lotion (a steroid) when he was an infant. The Eucerin® is almost the consistency of lard.  Wal-Mart sells a generic brand of this that costs about 1/2 the amount of Eucerin®, and we’ve found it to be equally as good.  We slathered it on him every night.  When he was a baby, we applied it every time we changed his diaper.  The Elocon® lotion is a steroid cream, so we tried to use it only when his eczema got very severe. 

The eczema moved around his body as he grew older, but it has never entirely disappeared.  For a while, he had one finger that regularly sported an eczema spot if he ate any food with food dyes!

The use of heat in the winter time dries out his skin, as does swimming in chlorinated water in the summertime.  So, there isn’t a season where he gets a break.  If we forget to use the Eucerin® paste, his eczema will crack and fissures will form.  He has been put on antibiotics, which ended up curing the fissures.  However, we try to not allow the eczema to get this out of control.  The Elocon® lotion will sting if put on eczema with fissures.  He would cry in pain which hurt me almost as much as him – and made me more aware of staying ahead of his skin problems.

Morgan’s eczema gets worse when certain foods are added to his diet.  We notice that processed foods with yellow and red dyes made his skin much worse, so we removed these from his diet entirely when he was young.  This helped the eczema to disappear, yet it would amazingly reappear for no apparent reason. When he was a baby he was severely allergic to eggs; when this allergy disappeared, we started feeding him foods containing eggs, only to find that his eczema flared up.

We live in Colorado Springs, which has hot, dry air in the summer.  However, combining the heat with sun lotions is a recipe for disaster.  We use titanium dioxide sun lotions since they seem to be kinder to his skin.  Certain fabrics such as nylon bother his skin, creating eczema-like blotches.  Long ago, I began using laundry soap that is free of all dyes and perfumes.  None of this cures his eczema, but it helps it to not become worse.

Morgan today

Now that he’s a teenager, he’s responsible for taking care of his skin. As with most teenage boys, hygiene is a difficult daily practice! For a while, the prescription medication Singulair® cured his eczema completely. Now it doesn’t work as well. Since he started allergy shots his eczema seems to be worse, yet he is also in the middle of puberty. Our allergist had told us that some patients experience worsening eczema with allergy shots, yet his environmental and pet allergies are much better. It’s a difficult trade off!

When he has a bad eczema breakout, we have begun wet wrapping his skin with CeraVe® moisturizing cream and Betamethasone steroid cream. (He also takes an antihistamine, such as Xyzal or Zyrtec once a day.) We apply the steroid first, then the moisturizing cream and then hot, wet gauze to wrap his skin sealing in the moisture. Adding socks or ace bandages over the top insures the gauze stays in place. Keeping the wet wraps in place overnight helps the worst eczema spots. Twice a day wet wrap treatments can do wonders for his skin!

We feel like detectives on most days, attempting to find the cause of the eczema. It might be food related, contact related (such as grass or clothing articles) or none of the above. We would love to find the magical cure to make his eczema disappear. In the meantime, we’ll keep searching for what works for today to ease the itch!

 Nicole can be reached at:

Allergicchild.com

425 W. Rockrimmon Blvd, Suite 202

Colorado Springs, CO 80919

nicole@allergicchild.com

http://www.linkedin.com/in/nicoleshieldssmith 

EpiPens, for any child with allergies, can be a huge life saver.  However, sending your little one to school with their EpiPen can be rather stressful for a parent. There are a thousand questions that might go through your mind, “Will they be safe even with the EpiPen?” or “Will someone know how to use the EpiPen?”.

EpiPen and Anaphylactic Shock Basics

For those of you who don’t know, anaphylaxis or anaphylactic shock can be a life-threatening allergic reaction to specific triggers, such as food proteins and medication. This results in hives or swelling of the throat or tongue, which can lead to constricted airways and/or a dramatic drop in blood pressure.

An injection from an EpiPen is imperative when anaphylactic shock occurs and can save a person’s life.  An EpiPen is a premeasured dose of epinephrine, which is injected into someone’s body during a severe allergic reaction to avoid or treat the onset and symptoms of anaphylactic shock, which provides a window of time to seek further medical attention. ¹

EpiPens at Schools

If you are a parent of a child who is at risk for anaphylactic shock, you probably carry his or her EpiPen with you at all times, in case they are exposed to an allergen to which they are allergic.  This is excellent for when you are with your child; however, your child could be exposed to many more allergens at school when you and your EpiPen aren’t there!

In fact, one study of children and adolescents found that 10 out of 13 fatal or near fatal anaphylactic reactions occurred outside the home.  All the fatalities did not have an EpiPen and those who survived received an EpiPen shot before or within 5 minutes of developing severe symptoms.²

So, what does this mean? EpiPens can save lives!  You need to ensure that the other adults who spend time with your child are trained and able to assist in any situation if you’re not around.

Don’t worry, this isn’t as difficult as it sounds!  I suggest sitting down with your child’s teacher in the beginning of the school year to set up a 504 plan. This will ensure he or she receives proper care and attention when you aren’t there and that all adults that are around your child have the proper training to use an EpiPen if an emergency situation arises.

Also, there is good news for all you Massachusetts residents!  Thanks to your persistent neighbors, starting March 2010, all newly hired school bus drivers in the state of Massachusetts will be required to have EpiPen training. Unfortunately, the law doesn’t mandate the existing school bus drivers to be trained; however, it’s a step in the right direction. Hopefully the other 49 states will follow suit.  Good work Massachusetts!

How have you been able to ensure that your child is safe and can receive the proper care if they go into anaphylactic shock? Did it involve a 504 plan or EpiPen training?

- Nita

References:

1. www.epipen.com/

2. Sampson H, Mendelson L, Rosen J. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med. 1992;327:380-384.