Reducing anxiety in a child with food allergy

My son Alex is very atopic. He suffers from eczema, asthma, allergic rhinitis (hayfever) and food allergies.

Alex was diagnosed with an allergy to egg and peanut at 16 months of age. He had his first anaphylactic reaction at age two when he was given a peanut butter sandwich by accident. He had one mouthful which he spat out. Alex’s tongue swelled up so much it was protruding from his mouth, his whole body flushed bright red and he began coughing and wheezing. His reaction was biphasic (occurring in two stages) with his symptoms improving over a couple of hours, but then breathing difficulties reoccurring two hours later.

This gave us all a fright and we decided to remove all egg and peanut products from our house. He was prescribed an EpiPen®. The next few months were focused on managing his eczema and trying to get his asthma and allergic rhinitis under control.

Alex was learning about his allergies. He learnt not to take food from anyone apart from immediate family and would tell anyone who looked sideways at him that he was allergic to eggs and peanut.

When Alex was about three we began to notice he was relaxed at home but became anxious when out. He became hypervigilant when food was around or people were eating. He was reluctant to leave our sides. It was apparent he was anxious seeing foods he was allergic to and had begun to view the world outside our home as being very frightening.

We decided we would need to implement some strategies to help him become more familiar with eggs and peanuts and to demonstrate to him that he could safely sit next to someone eating foods containing his allergens, and that even having the foods in our house did not pose a risk to him.

1. Slowly we began to bring the foods into the house.
2. We demonstrated that we, his parents, could sit next to him and eat a cake containing egg while he and his little sister ate an egg-free cake which Mum had cooked especially for them.
3. We spoke about storing the foods which contained his allergens in a sealed container away from his foods and his small sister’s prying fingers.
4. We showed Alex what the foods looked like in all forms—i.e. eggs in a shell, fried eggs, scrambled eggs, peanuts with and without shells, peanut butter, etc. We also explained egg could be used as a glaze to make foods like pastries shiny, and as an ingredient in baked goods.
5. As he became older we even ate peanut butter on toast while sitting beside him. He watched as we removed the peanut butter from our secure hidey-hole, used separate knives for the butter and peanut butter, then washed the knives and plates well afterwards. (We always kept the peanut butter away from all the other foods as we didn’t want any guest to use it and risk contaminating the butter, etc.)

Over the next few months we saw a change in Alex. He became less anxious when leaving the house and more confident/assertive with managing his allergies. Alex’s preschool staff observed him socialising more and joining in activities which he hadn’t been doing.

Alex is now an adult. He grew out of his egg allergy at age 13, but retains his peanut allergy, allergic rhinitis and eczema. Alex has travelled and lived overseas.

Alex has had two allergic reactions in the past 17 years, and administered his EpiPen® during the last reaction a year or so ago.

Recently, he assisted his work colleague who was having an anaphylactic reaction. She had left her EpiPen® at home so Alex stepped in and administered his own EpiPen®, potentially saving her life.

We recently asked Alex which illness he would like to lose. To our surprise, he nominated his eczema, not his peanut allergy as we’d expected.