Coping with food allergies -
I poked around the EoE board on KFA and found answers to every question I had. I also shared concerns, and plenty of parents stepped up to help me, even sending me private messages of support.
There were many times that I wanted to quit. I plan to run the full marathon in and hope to raise twice as much as I did this year! Want to get more involved? Host, organize or participate in a KFA fundraiser or special event!
Not registered yet? Create an Account. About KFA. Coping With the Emotional Aspects of Food Allergies. By Amber Campbell I was so fortunate to discover Kids with Food Allergies in , when I was looking for support and guidance in caring for my newborn son, Henry. Print This Page.
Food Allergy Resources. Log In. Email Or Username. In one study, all participants reported searching for information on food allergies online [ 36 ].
Of course, some websites are better than others, and the internet is rife with misinformation. As a starting point, families can peruse the websites listed in Table 1 , which includes vetted material from national allergy organizations. Also, schools have a role in managing food allergies.
Given that, in any classroom, two or more children are likely to have food allergies, most schools are already accommodating. Of course, physicians are integral in helping families cope. A careful review of the basic tenets of food allergy treatment, including epinephrine auto-injector use and vigilant avoidance, is an important first step.
In support of this, one study of children with nut allergies found that both mothers and children had lower levels of anxiety when the child was prescribed an epinephrine auto-injector [ 38 ]. However, children who had an epinephrine auto-injector did not carry it all the time, or strictly avoid nut-containing products, suggesting that some children and families, despite physician-initiated education, are still not adherent to the treatment plan.
The time a physician is allotted at the initial food allergy consultation to assess mental health-related issues is limited.
A study evaluated the efficacy of a workshop that asked allergists, using a standard questionnaire, to identify anxiety in food-allergic patients. However, the workshop did not increase the rate of case identification [ 39 ]. Furthermore, the allergists reported that they did not have time to implement the screening questions into their practice.
Though there may be some resistance, it is still important for allergists to think about the mental well-being of their patients. Indeed, the stress from having a food allergy may be more burdensome than the food allergy itself. For a list of screening questions to ask patients during an office visit, and to determine what further actions need to be taken, see Table 2 and Fig.
Importantly, if a parent or child feels that it is warranted, a separate appointment, solely devoted to discussing the psychological aspects of food allergies, should be considered.
To help physicians screen for mental health-related disorders, various surveys have been described in the literature [ 22 , 40 , 41 ]. These surveys are used both for academic studies and in the clinical setting. The most commonly implemented tool is the Food Allergy Quality of Life Questionnaire FAQLQ , which is available in many different languages, and evaluates QoL in children, teens, and adults [ 21 ].
The Pediatric Food Allergy Quality of Life Questionnaire PFA-QL , which was validated in the UK in , was developed to measure food allergy QoL specifically in children [ 41 ]. The Scale of Psychosocial Factors in Food Allergy SPS-FA , by contrast, is Chilean in origin, and, compared to the PLA-QL and FAQLQ, focuses more on the caregiver—child relationship [ 40 ].
More recently, the SPS-FA was validated in the UK as well [ 42 ]. See Table 3 for pertinent questions, some of which are drawn from these surveys that a doctor, a food-allergic child, and his caregivers can consider together. Oral food challenges, a staple allergy procedure, may also be helpful in alleviating anxiety.
In a study of over families who underwent oral food challenges, mothers reported increased anxiety on the day of the challenge, although children did not, suggesting differences in perceived risks [ 43 ]. Yet 3—6 months after the food challenge was performed, both mothers and their children reported improved food-related QoL, including decreased fear of accidental exposures and confidence in treating allergic reactions.
This occurred even if children had an allergic reaction during the oral challenge, since parents were able to witness how reactions can be safely treated with medications.
Similarly, Herbert et al. studied mothers who had anxiety regarding oral food challenge referrals [ 44 ]. Of note, even mothers whose children did not pass the food challenge reported no increase in their level of anxiety.
Instead, they found it helpful to see what types of reactions could potentially occur while in a controlled setting. Proximity food challenges, though not commonly performed, can be a useful intervention for families concerned that airborne or contact exposures will cause anaphylactic reactions.
In reality, studies have proven that such exposure-induced reactions are exceedingly rare [ 45 ]. Nevertheless, the fear of casual contact still pervades. A step-wise proximity challenge, when successfully performed, helps assuage some of this fear.
For instance, a proximity challenge for a peanut allergic child involves bringing an open jar of peanut butter increasingly closer to the child, until it is about 12 in. After 10 minutes pass, a lack of allergic symptoms rules out the possibility of anaphylaxis due to airborne exposure.
Next, the physician will dab a small amount of peanut butter on the intact skin of the volar surface of the arm, and observe for 5 more minutes.
With no contact exposure reactions, the arm can be cleaned off with water and soap. They reported that no patients had a systemic reaction, and only 1 had urticaria at the application site.
A large contributor to the distress associated with food allergies is the fact that no definitive treatment currently exists. Yet some exciting possibilities are on the horizon, including food oral immunotherapy OIT. The concept behind food OIT, which has been extensively studied for the past decade and is currently available in limited settings, is similar to that of immunotherapy for environmental allergies.
A patient ingests a minute quantity of a food that he is allergic to, and this amount is gradually increased, over many months, until he can consume a quantity that is large enough to prevent anaphylaxis from an accidental ingestion. Adverse reactions include gastrointestinal intolerance, allergic reactions during updosing, and eosinophilic esophagitis.
Peanut OIT is currently in phase 3 clinical trials, with the possibility that an FDA-approved product will exist in Similar treatments for egg and milk allergies are also being explored.
Despite the risks associated with OIT, there is a noticeable improvement in QoL in caregivers whose children undergo the procedure.
Factor et al. studied the parents of children being desensitized to peanuts, and found a significant decrease in food-related anxiety and a reduction in dietary restrictions [ 47 ]. Even after undergoing OIT to multiple foods simultaneously, which is far riskier than single allergen OIT, caregivers still reported an improvement in QoL, including decreased dietary restrictions and increased social interaction with others [ 50 ].
In summary, this data suggests that in some instances, the risk of a reaction during OIT treatment is preferable to allergen avoidance alone.
Once children and families with psychosocial needs are identified, physicians can refer them to mental health providers or other resources in the community. However, few studies have evaluated the efficacy of psychosocial interventions specifically for children with food allergies. Knibb et al.
followed a cohort of 11 and year-olds with severe food allergies attending a week-long camp [ 51 ]. This camp provided a supportive therapeutic environment in a setting that was allergen free, and consisted of outdoor activities, confidence building, and workshops about managing food allergies.
Follow-up questionnaires 3 and 6 months later demonstrated that participants had a reduction in anxiety and obsessive behaviors, gained confidence in talking to others about their food allergies, and developed an increased sense of agency in managing their own health.
Though the study had a small sample size, the lasting effects of positive experiences at camp reinforce the importance of providing support and education to children regarding their food allergies.
Food allergy support groups are another resource that can aid in reducing anxiety. Sharma et al. studied the impact of having an allergist speak at a food allergy support group [ 52 ]. Support groups are a useful forum for families not only to learn about food allergies, but also to commiserate and receive encouragement from other families facing similar challenges.
Because psychosocial interventions may be beneficial, the level of caregiver stress is also important to assess. Annunziato et al. Barriers to receiving mental health care included cost, lack of time, and lack of providers with specific expertise.
Despite the barriers, common therapies like Cognitive Behavioral Therapy CBT can be effective. Over the course of therapy, patients learn techniques to modify their thoughts and behaviors to improve their mood and anxiety. Knibb published a case series evaluating CBT as an intervention for mothers of children with food allergies [ 54 ].
She found that the mothers who received CBT for 12 weeks had reduced anxiety and depression with simultaneous improvement in overall mental health and QoL.
Although the literature on food allergies and psychiatric co-morbidities has blossomed in recent years, we have only just begun to tease out the intricacies of this relationship.
One issue is that most data in the reviewed studies only captured a snapshot in time. More longitudinal research is needed on how a patient with food allergies copes over a lifetime, from the initial diagnosis in childhood to how he manages as an adult.
Further, there is a dearth of information on prevalence rates of depression, anxiety, and PTSD in both patients with food allergies—particularly young children—and their caregivers.
It is likely that the mental health issues associated with food allergies are underreported. Moreover, there is a deficiency in data looking at how ethnic minorities cope with food allergies. Immigrant communities have been similarly neglected. For example, East and Southeast Asians residing in Canada often face skepticism and disbelief when they disclose their food allergies to relatives in Asia, where food allergies are less common [ 56 ].
This, in turn, leads to social exclusion. How these patients navigate between different cultures is an area ripe for exploration. In the clinical arena, physicians should become more cognizant of the relationship between food allergies and mental health.
We should make sustained efforts to enlighten primary care physicians, especially pediatricians and family physicians, as well as allergists, for whom mental health aspects of food allergies should become a formalized part of the training curriculum.
With the endorsement of the American Board of Allergy and Immunology, we can educate trainees during fellowship. For allergists already in practice, we can incorporate this topic into the Continuous Assessment Program as part of the Maintenance of Certification.
Additionally, at regional and national allergy meetings, we can devote breakout sessions to food allergies and mental health. At the same time, with the increasing numbers of children and families with food allergies, psychiatrists, psychologists, and therapists can devote more effort to finding effective treatments to integrate into their practices.
Eventually, allergists and psychiatrists, who historically have had limited interactions, can devise standardized guidelines on the psychosocial impact of food allergies.
Ultimately, health care providers from different disciplines, working together, can help reduce the mental health burden of the food allergy epidemic.
In the process, patients and their families will greatly benefit. Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, Holl JL The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics e9—e Article PubMed Google Scholar.
Jackson KD, Howie LD, Akinbami LJ Trends in allergic conditions among children: United States, NCHS Data Brief —8. Google Scholar. Sicherer SH, Muñoz-Furlong A, Godbold JH, Sampson HA US prevalence of self-reported peanut, tree nut, and sesame allergy: year follow up.
J Allergy Clin Immunol — Article CAS PubMed Google Scholar. Walkner M, Warren C, Gupta RS Quality of life in food allergy patients and their families. Pediatr Clin N Am — Article Google Scholar.
Cummings AJ, Knibb RC, King RM, Lucas JS The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: a review.
Allergy — Bollinger ME, Dahlquist LM, Mudd K, Sonntag C, Dillinger L, McKenna K The impact of food allergy on the daily activities of children and their families. Ann Allergy Asthma Immunol — Branum AM, Lukacs SL Food allergy among US children: trends in prevalence and hospitalizations.
Clark S, Espinola J, Rudders SA, Banerji A, Camargo CA Jr Frequency of US emergency department visits for food-related acute allergic reactions.
Rutter L Remembering those we have lost to food allergies. Cohen BL, Noone S, Munoz-Furlong A, Sicherer SH Development of a questionnaire to measure quality of life in families with a child with food allergy. Petrovic-Dovat L, Fausnight T, White AM, Zeiger T, Bansal PS, Garg N, Annapareddy J, Iriana S, Slattery MJ, Meyer RE, Bixler EO Degree of anxiety of food allergic children in a tertiary care center.
Article PubMed PubMed Central Google Scholar. Lebovidge JS, Strauch H, Kalish LA, Schneider LC Assessment of psychological distress among children and adolescents with food allergy. Weiss D, Marsac ML Coping and posttraumatic stress symptoms in children with food allergies.
Greenhawt MJ, Singer AM, Baptist AP Food allergy and food allergy attitudes among college students. Bock SA, Muñoz-Furlong A, Sampson HA Further fatalities caused by anaphylactic reactions to food, Shanahan L, Zucker N, Copeland WE, Costello EJ, Angold A Are children and adolescents with food allergies at increased risk for psychopathology?
J Psychosom Res — Ferro MA, Van Lieshout RJ, Ohayon J, Scott JG Emotional and behavioral problems in adolescents and young adults with food allergy.
Annuziato RA, Rubes M, Ambrose M et al Allocation of food allergy responsibilities and its correlates for children and adolescents. J Health Psychol — Lieberman JA, Weiss C, Furlong TJ, Sicherer M, Sicherer SH Bullying among pediatric patients with food allergy. Pediatr Allergy Immunol — Shemesh E, Annuziato RA, Ambrose MA et al Child and parental reports of bullying in a consecutive sample of children with food allergy.
Pediatrics e10—e Muraro A, Dubois AEJ, DunnGalvin A EAACI food allergy and anaphylaxis guidelines. Food allergy health-related quality of life measures.
Annunziato RA, Rubes M, Ambrose MA Longitudinal evaluation of food allergy-related bullying. J Allergy Clin Immunol Pract — Matti M Michigan student pleads guilty in peanut butter face-smearing case. Eltagouri M Three teens charged with knowingly exposing allergic classmate to pineapple.
She was hospitalized. Gluck W, Nalbandian Z, Gluck W Peter Rabbit [motion picture]. Sony Pictures, London. Venter C, Sommer I, Moonesinghe H, Grundy J, Glasbey G, Patil V, Dean T Health-related quality of life in children with perceived and diagnosed food hypersensitivity.
Birdi G, Cooke R, Knibb R Quality of life, stress, and mental health in parents of children with parentally diagnosed food allergy compared to medically diagnosed and health controls. J Allergy Cairo King RM, Knibb RC, Hourihane JO Impact of peanut allergy on quality of life, stress and anxiety in the family.
Gupta RS, Springston EE, Smith B, Kim JS, Pongracic JA, Wang X, Holl J Food allergy knowledge, attitudes, and beliefs of parents with food-allergic children in the United States. Rouf K, White L, Evans K A qualitative investigation into the maternal experience of having a young child with severe food allergy.
Clin Child Psychol Psychiatry — Gupta RS, Kim JS, Barnathan JA, Amsden LB, Tummala LS, Holl JL Food allergy knowledge, attitudes and beliefs: focus groups of parents, physicians and the general public.
BMC Pediatr Article CAS PubMed PubMed Central Google Scholar. Versluis A, Knulst AC, Kruizinga AG, Michelsen A, Houben GF, Baumert JL, van Os-Medendorp H Frequency, severity and causes of unexpected allergic reactions to food: a systematic literature review.
Clin Exp Allergy — Yamamoto-Hanada K, Futamura M, Takahashi O, Narita M, Kobayashi F, Ohya Y Caregivers of children with no food allergy--their experiences and perception of food allergy. Abdurrahman ZB, Kastner M, Wurman C, Harada L, Bantock L, Cruickshank H, Waserman S Experiencing a first food allergic reaction: a survey of parent and caregiver perspectives.
Allergy Asthma Clin Immunol Section and written management plans. Cummings AJ, Knibb RC, Erlewyn-Lajeunesse M, King RM, Roberts G, Lucas JSA Management of nut allergy influences quality of life and anxiety in children and their mothers.
Rubes M, Podolsky AH, Caso N, Ambrose MA, Sicherer SH, Shemesh E, Annunziato RA Utilizing physician screening questions for detecting anxiety among food-allergic pediatric patients.
Clin Pediatr Phil — Cortes A, Castillo A, Sciaraffia A Development of the scale of psychosocial factors in food allergy SPS-FA Pediatr Allergy Immunol — Knibb RC, Ibrahim NF, Petley R et al Validation of the paediatric food allergy quality of life questionnaire PFA-QL Pediatr Allergy Immunol — Knibb RC, Cortes A, Barnes C, Stalker C Validation of the English version of the scale for psychosocial factors in food allergy and the relationship with mental health, quality of life, and self-efficacy.
Knibb RC, Ibrahim NF, Stiefel G, Petley R, Cummings AJ, King RM, Keeton D, Brown L, Erlewyn-Lajeunesse M, Roberts G, Lucas JSA The psychological impact of diagnostic food challenges to confirm the resolution of peanut or tree nut allergy.
Herbert LJ, Dahlquist LM, Bollinger ME Maternal intolerance of uncertainty, anxiety, and adherence with food challenge referrals. Simonte SJ, Ma S, Mofidi S, Sicherer SH Relevance of casual contact with peanut butter in children with peanut allergy.
Dinakar C, Shroba J, Portnoy JM The transforming power of proximity food challenges. Factor JM, Mendelson L, Lee J, Nouman G, Lester MR Effect of oral immunotherapy to peanut on food-specific quality of life.
Carraro S, Frigo AC, Perin M Impact of oral immunotherapy on quality of life in children with cow milk allergy: a pilot study. Int J Immunopathol Pharmacol — LeBovidge JS, Haskell S, Borras I et al Patient and Parent Perspectives on Quality of Life during Participation in a Study of Rapid Oral Desensitization with Omalizumab Therapy in Patients with Milk Allergy.
J Allergy Clin Immunol Supplement AB Otani IM, Begin P, Kearney C et al Multiple-allergen oral immunotherapy improves quality of life in caregivers of food-allergic pediatric subjects. Knibb RC, Hourihane JO The psychosocial impact of an activity holiday for young children with severe food allergy: a longitudinal study.
Sharma A, Prematta T, Fausnight T A pediatric food allergy support group can improve parents and physician communication: results of a parent survey. Knibb RC Effectiveness of cognitive behaviour therapy for mothers of children with food allergy: a case series.
Healthcare Basel — Lu SK, Elliott SJ, Clark AE Exploring perceptions and experiences of food allergy among new Canadians from Asia. J Allergy Download references. Department of Allergy and Immunology, Palo Alto Medical Foundation, E El Camino Real, Mountain View, CA, , USA. Department of Behavioral Health, Santa Clara Valley Health and Hospital System, Alexian Drive, Suite D, San Jose, CA, , USA.
You can also search for this author in PubMed Google Scholar. Correspondence to Charles Feng. This article does not contain any studies with human participants or animals performed by any of the authors. Reprints and permissions. Feng, C. Beyond Avoidance: the Psychosocial Impact of Food Allergies.
Clinic Rev Allerg Immunol 57 , 74—82 Download citation. Published : 01 September Issue Date : 15 August Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article.
Over the past few years, vood Coping with food allergies of Resupply logistics solutions allergies have dramatically increased. As wiith result, alldrgies lives of patients Coping with food allergies their caregivers have been dramatically altered. Allergiies most Coping with food allergies surrounding fpod allergies has focused on treatment, less consideration allergjes been given to the mental health ramifications of living with this condition, among them depression, anxiety, post-traumatic stress, being bullied, and an overall poorer quality of life. Parents of food-allergic children, especially mothers, report anxiety, depression, and a decreased quality of life. Indeed, mental health issues associated with food allergies are likely underrecognized. In this review, we describe not only the psychosocial impacts of food allergies but also survey treatments that can be used to address this burgeoning problem. The diagnosis of wihh food Copnig is life-changing, not just for the individual but for those who love Copimg live allergifs Coping with food allergies person. In addition to avoiding exposure to certain foods, Coping with food allergies condition requires flod these families DEXA scan for diagnosing osteoporosis Coping with food allergies explain, over and over again, the seriousness of the allergy at schools, restaurants, social gatherings, workplaces, daycare facilities and countless other places. It can all be exhausting, says Tamara Hubbard, a licensed clinical professional counselor whose son was diagnosed with a peanut allergy six years ago. Families receiving a new allergy diagnosis face steep learning curves that can cause them to worry and to overthink every detail of what their child or other loved one eats or might be exposed to. Food allergies affect an estimated 4 to 6 percent of children in the United States, according to the U. Centers for Disease Control and Prevention. Between andfood allergies increased 18 percent among American children and adolescents younger than
0 thoughts on “Coping with food allergies”