The teen years are sometimes referred to as "the danger years" for food allergies. Teenagers are more likely to have fatal allergic reactions than young children. Teens face unique challenges of peer pressure and learning to manage their allergy on their own. Parenting teenagers with food allergies also carries with it unique challenges.
Dr. Robert A. Wood, Chief of Pediatric Allergy and Immunology at the Johns Hopkins University School of Medicine, answers questions parents may have about teenagers and food allergies
Q. Can teenagers develop new food allergies? Can they outgrow allergies they've had since childhood?
Dr. Wood: Yes to both questions. People can develop a food allergy later in life. It's not uncommon to see someone who has never had a severe reaction to shellfish, for example, experience a severe reaction to seafood. And yes, people can outgrow a food allergy, if their immune systems become less sensitive to the allergen. Special care must be taken, however, in "testing" whether someone has outgrown a food allergy. Consult your allergist to discuss the risks and supervise any such "test" very closely.
Q. Why are teens at higher risk for serious or fatal reactions than younger kids? What can we do as parents to reduce that risk?
Dr. Wood: Some teens, not all. Teenagers may let down their guard for any of several reasons: frustration, resentment, complacency, increased risk taking, and greater freedom in general may all contribute. In addition, it is common for allergies to peanuts and tree nuts to become more severe over time and even peak in the teen years. We can't completely eliminate the risk, but we may often mitigate it by gradually giving the teen a larger role in managing his or her food allergy.
Q. How can we help our teens protect themselves from food allergy bullying?
Dr. Wood: As we say in Food Allergies For Dummies, having a food allergy can be like walking around with a "Kick Me!" sign on your back. Teasing and threats have no place inside or outside schools. Old school strategies for dealing with bullies may work: Ignore them, tell them how you feel, ask them to stop, and tell an adult. Having a PAL can also help make a child or teen with food allergy feel less isolated and alienated. PAL stands for Protect A Life from food allergy, a great program sponsored by the Food Allergy and Anaphylaxis Network (FAAN).
Q. Is it true that you can have an allergic reaction from kissing someone who has eaten a peanut? What advice do you give to teenagers about dating and kissing?
Dr. Wood: Unfortunately, this is true. The best defense is education and open communication. I recommend holding off on kissing until you can be honest with your date about your food allergy and confident that your date will respect your food restrictions and perhaps even cut the allergen out of their diets.
Q. When and how should teenagers start to manage their allergies on their own?
Dr. Wood: How you and your teen deal with this transition is up to you and your teen and perhaps your family doctor and allergist. Following are a few suggestions that may help:
- Take it slow. Food allergy management has many facets, including medication management, dining in, dining out, desserts, snacks, riding the school bus, doctor visits. You don't need to pass along all responsibilities at once. A slow, gradual transition is often best.
- Start with doctor visits. Encourage your teen to play a more active role during doctor visits - asking questions about medications, treatment options, and how to deal with certain situations.
- Let your teen order the next time you dine out. Most teenagers are perfectly capable of communicating with the server and cook, asking questions about ingredients and food preparation. As with anything, teach the skills and then step back as your teen puts them into action.
- Practice using an epinephrine auto-injector. If your teen may need an epinephrine injection, have them practice using an expired auto-injector or an Epipen trainer on an orange or grapefruit. NOTE: Children and adults should NEVER inject themselves when practicing how to administer epinephrine.
- Hand over control of the medications. Responsible medication management is key to your teen's safety. Your teen should be responsible for carrying any required medications at all times. Your responsibility is to nag them until they do.
- Learn from past mistakes. Reactions occur no matter how careful you and your teen are. Foster an environment of open communication (without threat of punishment), so you can use mistakes as opportunities to learn how to more effectively prevent and respond to future reactions.
Q. Teenagers with food allergies report feelings of isolation and sadness over being different from their peers. How can parents help them cope with their feelings and reduce their sense of being the only one in the lunchroom who "can't eat anything"?
Dr. Wood: Empathy and a sympathetic ear are key. Having a food allergy is no fun, and it's perfectly natural for teenagers to feel some resentment over it. Though I cannot recommend a one-size-fits-all solution, I often suggest that parents team up with their teens to discuss issues and disagreements and problem-solve together.
Q. What advice would you give teenagers heading off to college? What should they look for in a living situation?
Dr. Wood: Where you live is less important than whom you live with. Colleges often have methods for pairing up roommates who are more or less compatible. Being honest about your food allergy can help you get matched with an appropriate roommate. Often, educating the roommate about your food allergy is the best approach. And if a roommate does not respect your food restrictions, you may need to switch roommates.
About Dr. Wood
Dr. Robert A. Wood is Professor of Pediatrics and International Health and Chief of Pediatric Allergy and Immunology at the Johns Hopkins University School of Medicine in Baltimore, Maryland and author of the recently published Food Allergies For Dummies (John Wiley & Sons).
Wood, Robert A. and Joe Kraynak. Food Allergies for Dummies. John Wiley & Sons, 2007.