Always on alert – families and experts talk about coping with food allergies among children

There is growing awareness of the seriousness of allergies, but when it comes to children, extra precautions need to be put in place. We talk to experts and parents about what it takes to ensure a safe environment - at school, home and in social situations - for everyone involved.

The Eita family, from left, Adam, 6, Mohamed, Jojo, 3, and Ghadeer. Adam has had food allergies since he was 9 months old and has outgrown a few but also developed new allergies. Pawan Singh / The NatShow more

The number of children with food allergies is increasing worldwide, making life for some families very difficult.

Research from this region is limited, but a 2013 study from the United States Centers for Disease Control and Prevention reported a 50 per cent increase in food allergies among children between 1997 and 2011.

It’s something the European Academy of Allergy and Clinical Immunology is taking very seriously, calling the situation a “public health problem of pandemic proportions”.

Dr Ahed Bisharat, consultant paediatrician at Healthpoint in Abu Dhabi, says one contributor to the increase is pollution. The more pollutants that enter the body, the more sensitive the immune system becomes, increasing the chance of allergy, he says.

The most common allergies he sees are to eggs, wheat, shellfish and peanuts, and the best way to treat these allergies, Bisharat says, is to avoid the allergen altogether. But for many families this is not always possible, especially when school-age children are involved, and precautions need to be taken in case there is exposure to the allergen.

There are medications to relieve the symptoms, but if the child is severely allergic, they must have an epinephrine auto-injector (known as an EpiPen). “It is very important that it is available at home, in the car, in the school or in the workplace. This will prevent him from having a severe anaphylactic shock, which can threaten his life,” says Bisharat.

And if a child has an allergy, the parents should make sure everyone at the child’s school is informed and aware, he says. “Children could carry a marker or document that shows they are allergic. When the attack happens, the surrounding people can know that this patient has an allergy and to react immediately.”

Allergies are not inherited, but a child can inherit a predisposition to becoming allergic. According to the EAACI, a child whose parents have no allergies has a 15 per cent chance of developing one. This increases to 60 per cent if the mother is allergic, and 80 per cent if both parents are.

Adam Eita’s first allergy was diagnosed at 9 months, after he had a severe reaction to tahini, a paste made from sesame seeds.

“We were at home and I gave him a drop of tahini,” says his mother Ghadeer Jaamour Eita. “His face swelled in a second. I was lucky that his paediatrician answered his mobile at the first ring and asked me to rush to the nearest hospital.”

Tests revealed Adam, now 6, was allergic to all tree nuts, sesame, chickpeas and soy. By 3, he outgrew the soy allergy, but became allergic to peanuts. Last summer he developed an allergy to cucumber.

He has annual skin tests to assess his reactions, and also does food tests under strict control in his doctor’s office.

His family feels lucky when it comes to his education. His school, they say, is very understanding and allows them to do presentations to pupils, teachers and other parents. It is a nut-free school and has two nurses. His family also sends notes to parents explaining Adam’s allergy and asking them not to bring certain foods.

The teacher always checks the lunch boxes and if there is something like hummus, which is his strongest allergy, she takes it out of the class and tells the parents that she couldn’t give it to the kid because of the allergy,” says Eita.

Adam wears a Mediband, a bright orange rubber bracelet that lists the foods he’s allergic to and says “Use EpiPen”.

“I show my bracelet to people and explain to people about my allergy,” says Adam, adding that he relies on his friends and little brother Jojo, 3, to help him eat the right foods.

His parents try not to let his allergy hinder him too much. “Adam is very aware of his allergies. It’s important to educate your child from a young age so he or she knows not to take food from anyone, to ask before eating, and to explain to their friends, and be confident,” says Eita.

Many schools and nurseries in the UAE do not allow nuts, and the training of medical staff in schools is governed by health authorities.

The Dubai Health Authority requires every school to maintain a policy on food allergy management and staff in school clinics must be trained in handling allergic reactions.

Branches of the Blossom Children’s Nursery are nut-free and cook all food on-site to “minimise the risk of allergens brought into the nursery environment”, says Chantal Ariens, the centre’s director. “Because we cook fresh food on-site, we have control over our produce, ingredient heritage and cooking methods. This helps decrease the risk of an allergic reaction.”

Each centre has a full-time nurse and more than 80 per cent of the staff are trained in paediatric first aid.

Every parent is given a handbook that tells them not to send their children with any nut products into the nursery. There are also laminated sheets on the doors and coffee mornings where food allergies are discussed. Ariens says it is of “utmost importance” that parents make their child’s school or nursery aware of any food allergies.

Despite most facilities having strict rules, Nina Pilawa feels more comfortable home-schooling her son Tim, 8, who is severely allergic to egg and dairy. His allergy was diagnosed at 5 months, after he reacted to a baby porridge that contained cow’s milk powder. It is so strong he reacts to the touch of dairy.

The family is very careful with the foods they eat and what comes into their home. Tim’s younger brother Tom, 6, has to change his school clothes at the front door to avoid bringing dairy traces into the house, and follows the same dietary restrictions.

His family feels Tim’s best chance of growing out of his allergy is by having as little exposure as possible, so keeping him out of mainstream school is the ideal option.

He is enrolled in a home-schooling programme officially approved by the Knowledge and Human Development Authority in Dubai.

“He has every right to an education, it’s just he cannot be in a room where all the kids have had cheese sandwiches and crisps,” says Pilawa.

Even when rules are in place, they are not always adhered to. “It’s not that people don’t care, they are just not aware. They don’t think about it because they don’t have to think about it.”

The family’s social life is also limited. They can’t go out for meals or attend birthday parties or communal soft-play areas. Friends invited over must make sure they are free of dairy traces before visiting, and everyone has to wash their hands when they arrive.

Pilawa says she can find replacements for most dairy products when cooking, but food labels are problematic. Some imported foods don’t have ingredients listed in English, and the Arabic sticker often covers the original list.

Eita, Adam’s mother, who is an Arabic speaker, says she doesn’t trust the translated ingredients labels.

“I buy a lot of imported snacks from the US and UK but find that the majority of the time the import labels are put over the ingredients, so I need to try to rip it off or look at lots of packets to find one where it is not covered up.

“The scariest thing is wrong translation or not translating the allergy part into Arabic. It’s sad to say we can’t trust the Arabic translation, and if I can’t see what’s written on the package itself, we don’t buy it.”