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Dr. Neumann’s KidsTravelDoc Ten Tips: Kids/travel/food allergies and sensitivities

Date May 15, 2013

No need to forgo family outings and vacations because your kid(s) are among the millions of children who have food allergies, celiac disease, lactose intolerance, irritable bowel syndrome or other food-related problems requiring special diets. While you can’t leave these problems at home, you can leave home with the knowhow to avoid most problems and be able to deal with the ones that may occur.

food-allergies1Most food-related health issues surface in childhood. And many show up when eating out. Meals away from home are more likely to expose kids to new and unusual foods and make it difficult for parents to check ingredients. Children known to be allergic/intolerant to one food often have issues with other foods.   Consider food allergy/intolerance as a possible cause of intestinal symptoms generally blamed on poor sanitation and other vagaries of travel.

Some children are erroneously labeled as having food-related issues. Rashes and diarrhea, for example, are generally blamed on the last food item eaten. But the symptoms may be due to foods eaten a day or two earlier, viral infections and other causes – many of them more common when eating away from home. (Many people labeled “allergic to penicillin” are not. They experience allergy-type symptoms caused by the illness for which penicillin was prescribed, not from the penicillin.)

food-allergies2Testing for food issues has improved in recent years. While such testing is not yet perfect, physicians are increasingly able to tell whether an allergy truly exists, the severity of symptoms that may occur from contact with the food item, whether new treatments are beneficial, and if the problems has been “outgrown.”  Some conditions are not life-long, as was previously believed.

Never assume that food handlers know the ingredients of items they serve. Waiters, flight attendants, and play date mothers, for example, may have little understanding of your child’s problem and limited knowledge of what is in the foods they serve, and yet want to reassure you that there is no problem. Ask them (politely) how they know that the food is safe. Chefs and restaurant managers are likely to be better informed. Carry cards that explain simply the items that your child must avoid. Cards are available for non-English speaking countries(see below.)

food-allergies3Serious food allergies require more questioning. Rarely, children are so sensitive to a food that “cross contamination” is problematic. If food preparers touch both the child’s offending food and safe food, for example, or if particles of the offending food reach the child’s food via air currents, the child can experience a reaction. Buffets may be troublesome. On airplanes, peanut dust in the cabin air may cause symptoms in peanut-allergic children. Some airlines will discontinue serving peanuts if notified several days prior to the flight.

Teach children to advocate for themselves. Most children can take responsibility by about seven year of age and do it quite well. They can remind adults to check labels when visiting friends.

Certain types of travel simplify logistics. Cruise ship companies, large amusement parks and self-contained resorts allow you to remain in one place for your vacation, have personnel you can contact beforehand regarding your special needs, have kitchen and dining room staff experienced in handling special dietary requests, and have readily available doctors/nurses in case medical issues arise. Remote destinations may not offer such personnel/facilities.

food-allergies4Do your own cooking. Bring food from home or buy it locally. This is especially helpful when you first learn that your child has food issues. Clean pots and microwave ovens and line toasters with foil before using them. At picnics, make sure that grills at fireplaces are clean. Serve the safe food to everyone to simplify logistics and, perhaps, to make afflicted children feel more comfortable.

Family parties can be hazardous for younger children. Many holiday treats contain peanuts, tree nuts, eggs, milk, wheat or shellfish, common offending foods.  It is difficult to inform each guest not to offer food to children. Even when you warn them, they forget, don’t understand the importance, or go against your will, sometimes with an older child’s encouragement. If you are otherwise busy, designate one responsible adult to take charge. For sleepovers, notify parents where you will be, and how to handle emergencies.

food-allergies5Check the web for information. Chances are that there is an association that deals with your child’s food issue, that they have a website, and that the website provides information regarding eating out and travel, including foreign travel. Some associations provide phrase books in foreign languages to help you translate menus. Also, check if there are restaurants at your destination that provide special diets. For example, check “celiac disease,” “New York City, downtown,” “restaurants.”

Be prepared. Arguably, the most important item in a modern “medical kit” is a telephone that is operable where you will be and the telephone numbers of all your kid’s health providers. Call them first if problems occur. Carry all your child’s important medications, make sure that they have not expired, know how to store them for travel and whether you need a physician’s letter for customs and airport security personnel.

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