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Asthma & Food Allergies

Our 4 year old son has asthma. He is also highly allergic to dairy, which in turn, trigges his asthma. We are constantly reading food labels, carrying our own food & snacks, packing his lunch for school, providing his school snacks, etc., just so he doesn't accidentally ingest any dairy. 

Keeping him away from dairy at school has proven to be a struggle this year (and he's only in Pre-K). Although I pack his lunch, and provide his snacks, he has eaten dairy once (he had it at his activitiy table – he mistook a green skittle for a green M&M) and the teacher tried to give him a Hershey kiss, but he stepped backwards and said "I can't have that". It aggravates me that his food allergy isn't taken more seriously; it seems to be met with a lackadaisical attitude because he doesn't launch into anaphylaxis after eating it. Does anyone else have similar troubles with food allergies in school? 

What happens when he accidentally ingests dairy? He gets the typical runny nose, cough, red cheeks, and he'll usually get an ear infection. Last time this happened, he had all of the above, but after being on antibiotics for 9 days for his ear infection, he spiked a high fever. We were already doing breathing treatments because of his cough, but it turned out that he had also developed pneumonia (despite him being on antibiotics). All from a small amount of dairy.  

My husband and I sometimes feel like we're constantly fighting to keep him healthy. I know we're not alone in our battle, I know that there are others that have it worse than we do. There are parents who have lost their children, who would give anything to be sitting up at night with their child, doing breathing treatments, for nights on end.

As I sit here on the couch with our 4 year old for night 2 of round the clock breathing treatments, I know things could be a lot worse. But I do feel like we're fighting a constant battle with his asthma and food allergies. I've made it known to his school that dairy poses a huge issue for him. They know of his asthma. Without being a jerk (because I work at his school as well), I don't know how I can convince them that this is a big deal, that's not to be taken lightly. 

Suggestions? 

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  • Jen

    That does sound frustrating.  Our Kids With Food Allergies website has a handout called  that might be a good handout for the teachers.  Also, does your son have an  at school that details when to use epinephrine, etc?

  • Shea

    My son has food allergies to nuts, soy, chicken, turkey, cantaloupe, honeydew, and cat and dog dander, all severe. He is 5. 

    Getting caretakers on board is huge, and also supervising them. Some of them, I am comfortable with knowing what to feed him, and what to watch for, and what to check him and how to handle a reaction. I dont leave him alone with people who dont.

    And I have trained him too…. "my mom has to check the ingredients, I have allergies", practice it at home, practice it with relatives. The reactions can often be mild, with itchy armpits and itchy, red ears, but they can also  be hives and difficulty breathing.

    His father and I are not together, and he used to do timeshares where they would go out to eat, but his father had difficulty showing the restaurant staff his allergy card and asking for allergy menus, and even would leave his allergy bag in the hot car (epipens and plastic benadryl bottle should not be left in the car. I had papers for him to sign and went over his allergy action plan every 6 months after each doctors appointment. Luckily now he usually does his timeshares at our house, and I pack lunches if we meet at parks, etc, and have him and my son trained in having the allergy bag with. 

    I am able to stay at home with my son, and I was going to homeschool him and participate/take classes at a local homeschool co-op (that is what I did for preschool), but I found a free state program called Florida Virtual School and we do that this year for Kindergarten–I am his learning coach and he has a certified teacher as well, and we both really like the curriculum (lots of hands on stuff, as well as videos and computer activities, live lessons with others), and we meet up with some of his classmates who are nearby regularly too. It has been awesome. 

    Once he is ready and able to verbalize his allergies, and carry/administer his medicines, I will feel a lot more comfortable with other caretakers. But, I just was not comfortable with what the local schools do (they have different volunteers monitor large amounts of kids, and the kids arent supposed to share food–but theyre young!–teachers dont each lunch with them, the medications are locked up in the nurses office). I was just like, no… neither of us are ready for that. Peer pressures and shyness, along with the issues of supervision I mentioned– this is my son's life and health and safety! 

    I do recommend having friends and even caretakers watch Daniel Tigers Neighborhood episode on food allergies: 

    I hope you find solutions that work for you and yours that you are comfortable with!

  • CAPuttPutt

    @Shea Yes, FLVS is an awesome program! I have a couple of friends who teach at Florida Virtual & they have nothing but amazing things to say about it. The thought of enrolling our youngest son in FLVS has crossed our minds, since he's sick a lot. This school year alone he's already missed 7 days due to asthma & food allergy issues. But he loves school! And right now, he's way ahead of where he should be. Not once this year has he woken up and said "I don't want to go to school". He's always happy to go & I hope it always stays that way. 

    Our son is great about asking "does that have milk in it?" and vocalizing that he can't have dairy. But at the end of the day, he's 4. Having M&M's at his activity table was a hazard waiting to happen in my opinion, even if an adult was there with the kids.

    I volunteer to make the cupcakes for his classroom activities, when they ask for moon pies for a center activity I make brownies instead so our son can still participate. When they decorated sugar cookies, I took in an alternative item for our son. This is a weekly thing (having center activities that involve food). I furnish his snacks, treats, lunch, everything. And I always keep his rescue medicine with me versus the clinic. 

    @Jen When I filled out his paperwork for the school year, I listed his food allergies and asthma issues, and filled out a "what to do in case" type form, but that was it. And honestly, with me working at the school, I'd prefer the teacher call me versus the clinic if something happened. I appreciate the link for the food allergy handout. I'll print it and make it available to his 2 teachers! 

    I'm also going to ask why there isn't a food allergy alert tag on his classroom door. All other classrooms who have children with food allergies have a badge on the outside of their door alerting parents to ask the teachers before bringing in & handing out foods. I don't know if Pre-K isn't governed by the same rules, but they're on the same campus so I'd think they would be. 

    Thank you both for the replies! �� 

  • K8sMom2002

    @CAPuttPutt, if you haven't already, could you work on getting a 504 plan in place for your son? Kids With Food Allergies has an

    My DD has food allergies and asthma, and we have a 504 plan in place for her. It's a legal agreement between the school and us that lets who know who is responsible for what — teacher is responsible for letting us know about food-centered activities or lessons 48 hours in advance, for instance.

    DD is 16, so we don't have to ask for an allergy free class or food-free activities, but you might think about asking for something like that or a letter out to the parents stating that there are food allergies. 

    Our rule when DD was younger was "only food from home," and "No label? No, thank you." 

    Hugs on the problems you've been having!

  • K8sMom2002

    CAPuttPutt, were you ever able to ask about why he didn't have an allergy tag on his classroom door? I think that would be a great idea! Could you make one and ask the teacher to put it there?

  • CAPuttPutt

    @K8sMom2002 The director of food services in the district has been out of town at a training. She's back this week and catching up on email; I've emailed her (plus she's a personal friend of ours). As soon as I hear back I'll let you know.

    Our son sports a pin on his lunch bag that says "no dairy for me…I have food allergies". Doesn't alert the other parents coming into the room, but it helps some (I hope). 

  • K8sMom2002

    Great idea on the pin on the lunch bag! Does he wear a medical ID bracelet? 

    I'm hoping that you will soon get an email from the director of food services with lots of good ideas!

  • CAPuttPutt

    @K8sMom2002 The school nurse and I spoke today. Apparently the notices on the classroom doors are for children who have "life threatening allergies requiring the use of an epi pen". And I can understand this as an "extra precaution" as the nurse said. We're a step or so removed from his allergy being life threatening (dairy will trigger his asthma which can lead to his attacks). 

    We have a doctors appointment next Friday and one of the things we will be discussing is us being prescribed a stronger rescue medicine, one that we'd have to call the doctor and have them on the phone as we're administering it. 

    No, we do not have a medical bracelet for him yet. I've been looking at several options, but he does need one. Is here one that you would recommend? 

  • K8sMom2002

    Caputputt, just a question … how soon does dairy trigger his asthma, and what does it look like when it happens?

    I was one who thought that anaphylaxis or severe food allergic reactions looked like what was on the movies or TV: swollen face, covered in hives, trouble breathing. That's not always how it looks, and past reactions are not a predictor of future reactions. For years before her big, life-threatening reaction to corn, DD had reactions that met my doctor's definition of anaphylaxis (two body systems involved). 

    Any severe reaction needs to be treated with epinephrine.

    Here's a great resource that helped me:

    Could you talk to your doctor about it when you have your appointment?

  • K8sMom2002

    Oops! I forgot to add in the info on the medical ID bracelets.

    Members here and on Kids With Food Allergies have used a variety of different companies …

    • (it's more than a bracelet — comes with a subscription service that actually has a number doctors can call to get a medical history that you upload)
    •  (stylish options, plud kd-friendly options as well)
    •  (stylish options, plus kid-friendly options as well)

    DD currently has a MedicAlert bracelet, and we've used Lauren's Hope in the past, and I've heard good things about Hope Paige as well.

  • CAPuttPutt

    @K8sMom2002 So his reactions have varied over the last year. After he eats dairy, it's relatively soon after that he starts with the upset stomach, red cheeks, runny nose & coughing (generally within the hour). The coughing fits can get bad, and we'll have to do an albuterol treatment. The bad complications come later; ear infections and even pneumonia, which is a whole different can or worms. 

    He has had out of the blue asthma attacks before, but only 3 so far, where he was croupy, wheezing and struggling to breathe, but so far they weren't associated with dairy. Doesn't mean his coughing from dairy ingested won't cause it in the future, but for now it hasn't. 

  • K8sMom2002
    CAPuttPutt posted:

    @K8sMom2002 So his reactions have varied over the last year. After he eats dairy, it's relatively soon after that he starts with the upset stomach, red cheeks, runny nose & coughing (generally within the hour). The coughing fits can get bad, and we'll have to do an albuterol treatment. The bad complications come later; ear infections and even pneumonia, which is a whole different can or worms. . 

    Not meaning to scare you, but our allergist's action plan says for us to use epinephrine with those symptoms. Yours may suggest a different plan, as each kiddo is different. Please talk to your allergist ASAP about an epinephrine auto-injector!

    You've described three body systems affected by dairy, and within an hour of eating dairy:

    Gastrointestinal: upset stomach

    Skin: red cheeks

    Respiratory: coughing

    Asthma is a risk factor for anaphylaxis. And the ONLY treatment for a severe allergic reaction is epinephrine. 

    Hugs …

  • Jen

    @CAPuttPutt I agree with Cynthia.  Those symptoms sound a lot like symptoms of an allergic reaction.  I recommend reading the anaphylaxis resource she linked and discussing it further with your doctor. 

    As for a medical bracelet, my oldest dd has a MedicAlert bracelet.

  • mrklove

    @CAPuttPutt 

    So when I was 4 year old I had the exact same combination. My allergy to dairy would trigger my asthma. I still have this combination today. What your describing to me is an allergic reaction that is triggering asthma symptoms. If your kiddos asthma symptoms worsen in severity generally the intervention is epinephrine. Conversely, if your kiddos reactions to dairy worsen in severity (which is very likely) it is absolutely possible that your kiddo could eventually have an anaphylactic reaction and once again the first and most vital intervention is epinephrine. This played out dozens of times for me throughout my childhood. I was even intubated and put in critical care because of it.

    The problem here is this. I worked 911/EMS for some time and if an allergic reaction call goes out the key indicator for us determining the level of intervention needed is respiratory symptoms. Hives, angioedema and swelling due to the reaction sure they can cause inflammation and bronchospasms but this can very fast turn into swelling of the upper airway in a minutes time. 

    Some of my allergic reactions at that age presented with the common hives, swelling and wheezing symptoms but at a certain point not very long after age 4 they went from moderate/mild asthma symptoms to severe airway restrictions, in other words anaphylaxis. 

    I really would press your kids doc to prescribe an epipen because in the event that his allergic reactions go that route you and the school will need that to save precious open airway time and frankly his life prior to EMS arriving. 

    In my opinion the school has NO excuse to not take the allergy seriously. First, they are not experts – any of them. The only person in that school who likely knows anything about the seriousness is the RN. If the school only considered allergies with prescribed epipen to be taken seriously then get one ASAP. I find that policy to be ludicrous because of the nature of reactions. 

    I'm in my 30's and only a few years ago I had an allergic reaction close my airway up to the size of a small straw in under one minute, ONE MINUTE! If this ever happens the only intervention is epi and you can't wait for EMS, the nurse has to have it.

    Reading your initial post and seeing that you don't have epi in the toolkit scares me. Talk to the doc soon please!

  • CAPuttPutt

    @mrklove Thank you, very much for your post. It supports what I've been thinking and have been worried about for a while now…..his allergy to dairy getting more severe over time. Though he doesn't get exposed to it often these days, when he does his reaction seems to be getting worse, especially if it's more than just a little bit of dairy. 

    I also worry that him simply having asthma will one day lead to an attack that I can't manage with his albuterol alone. Granted he's only had a handful of attacks thus far, but it's still in the back of my mind. 

    I am going to speak with his PCP and pulmonologist about having an epipen on hand, just in case. I think with his history (ICU for RSV, pneumonia twice within a few months, coughing spells that last for hours, coughing until he pukes, etc) it is warranted at this point. I don't want to wait until it is too late. 

  • K8sMom2002

    Way to go, CAPuttPutt! 

    As mrklove says it SO well, anaphylaxis can happen very quickly, and you can't predict future reactions by past ones. You just never know when a kiddo with a past history of "mild" reactions will have that first really severe reaction that doesn't get better on its own.

    Also, epinephrine is the FIRST line treatment for anaphylaxis. 

    The way my doc has described anaphylaxis to our family is this: two body systems reacting to a substance within a specified time period (can be minutes to hours, but usually within 20 minutes.)

    And people tend to focus on respiratory symptoms, but at least  would call for epinephrine if a kiddo had all of these symptoms after eating:

    • occasional sneeze or cough; mild nasal congestion or runny nose +
    • tired; lightheaded; mildly dizzy; unexplained tachycardia; delayed capillary refill +
    • moderate to abdominal severe pain; or vomiting and/or diarrhea =3 total, in past 1 hour (or since epinephrine if it was given in past hour) +
    • rapid onset, e.g. = 1 hour post exposure (food, drugs, contrast); OR known allergies with possible exposure)

    That doesn't look AT ALL like the "TV" picture of a severe allergic reaction. 

    When epinephrine is delayed, people of all ages, but especially kids, have more of a risk of something called a biphasic reaction — a second reaction that can occur up to four hours after the first reaction. Here's a that talks more about biphasic reactions.

    The blog post quoted a doctor who did a study on biphasic reactions, and this is what he said:

    “The key message here for patients, parents, caregivers, teachers, and first-responder health professionals is: to prevent an anaphylactic reaction from worsening, administer epinephrine immediately after the onset of the early symptoms of an allergic reaction,” he said in a statement.

    Talking with your doctor can help you tailor your kiddo's treatment plan and help you know when to give epinephrine. I know reading information like I shared here helped me to talk with my doctor and really understand that we'd been VERY lucky multiple times that my daughter had experienced anaphylaxis. 

  • CAPuttPutt

    @Jen

    The doctor actually cancelled our appointment (something came up and she was out of the office), so we're having to wait until our next appointment to get one. But I am on a mission for one