Handling Thanksgiving With Food Allergies

November 13, 2009 · Posted in Food Allergy Holidays

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This article was written by Dr. Delia Chiaramonte. She shares great tips and insights about preparing for Thanksgiving and how you can help keep your children with food allergies safe through the entire holiday.

Thanksgiving is challenging for food allergic families. The focus on eating and the influx of relatives and guests unfamiliar with the risk of anaphylaxis can create significant anxiety and stress. Some allergic families even consider skipping holiday gatherings just to avoid the whole mess. But with a little careful planning there is no need to miss the fun. Here are the most common problems and solutions.

Unfamiliar Foods
People with food allergies tend to stick with foods that are familiar. Thanksgiving brings mystery casseroles and vegetable dishes with nutty garnishes – it can be overwhelming and frightening to try to find safe foods at a Thanksgiving table. It is important to clarify for the allergic person which foods are safe for him or her to eat. Even if the foods have been prepared safely, children who are used to avoiding unfamiliar foods may be unwilling to change their eating patterns simply because it is Thanksgiving.

The solution
Provide at least one starch or protein and one vegetable that are prepared simply and are familiar to your child. If you are having Thanksgiving at the home of a friend or relative, bring a small container of back up food such as noodles and broccoli. Never force kids with food allergies to taste a dish that makes them uncomfortable. To stay safe into adulthood they will need to trust their instincts about which foods to avoid – support their caution, don’t squelch it. If Thanksgiving dinner is at your house you must decide if you will allow foods that contain allergens. Some families choose to make all the food themselves, while others allow guests to bring dishes that the allergic person will not eat. Let guests know that your child will most likely stick to the foods that you have cooked so they don’t encourage your child to eat something that you aren’t sure is safe. If you have allergy-aware guests who will bring safe food, be sure that your child knows which dishes are safe and which are off limits. Teach the child to say ‘no’ to a guest who offers him or her a dish that hasn’t been pre-approved.

Unfamiliar Chefs
You understand the risks of cross contamination, but your Aunt Ella may not. If her spoon spent time in milky mashed potatoes before mixing your supposedly dairy free casserole, there could be trouble. Many people do not understand that only minute amounts of an allergen are needed to cause a severe allergic reaction. They may assume that because they didn’t add nuts to the brownies, they can be deemed “nut free.” But can you assume that they read the bag of chocolate chips to be sure that they weren’t processed in a plant with peanuts? Probably not.

The solution
Your fellow chefs may assure you that their creation is safe for your kids with food allergies, but never take their proclamation at face value. A detailed conversation about cross contamination is a must. You must discuss mixing spoons, cooking pans and counter tops. Was the bread rolled out on a marble counter top after a breakfast of sesame bagels? It may not be safe for a person with sesame allergies. Was the butter in the recipe a brand new stick or did it have an old, potentially peanut butter contaminated, end? Because there are so many potential areas of cross contamination in a non-allergy aware kitchen it is safest to avoid any food that wasn’t discussed prior to its preparation. If your kind relative is willing to discuss labels with you, use only clean utensils and clean the counters prior to cooking, it can be perfectly safe to eat their food. But if you couldn’t discuss the food prior to preparation, it is simply safest to skip it.

Cross Contamination at the Table
Cross contamination can happen in the kitchen, but it can also happen at the table. Keeping your allergic child safe during a chaotic, potluck Thanksgiving dinner requires planning and education of your guests.

The solution
Ask your guests to avoid bringing foods that are likely to contaminate the environment. No almonds on the green beans for nut allergic households or shredded cheese falling off a casserole when milk allergy is the concern. If people do bring foods that concern you, place them on a separate part of the table so that they do not contaminate the foods that have been deemed safe. Be sure that each dish has its own serving spoon. You might consider having the allergic person be one of the first to eat just in case the serving spoons travel from dish to dish.

Skeptical Relatives
“This wasn’t a problem when you were little” is a familiar refrain to many allergic families. Grandparents, cousins, aunts and uncles may secretly, or not so secretly, believe that you are being overprotective and neurotic by worrying about serving spoons and stray nuts on the table.

The solution
Don’t let this get to you. Prepare a sentence or two to educate them, ignore the raised eyebrows and thank them for their help. A statement such as “food allergy is a lot more common now and the allergist says we need to be really vigilant. Thanks for helping to keep Emma safe” is a good start. Educating important relatives, such as grandparents, is an ongoing process so don’t be too heavy handed about it in the beginning. Provide them with written information about food allergy and continually reinforce the importance of allergen avoidance. Over time they will probably come around.

Holidays are stressful for everyone, but food allergic families cope with an added dimension. The emphasis on food can be unnerving but, with careful planning and good communication, there is no need to miss out on any of the fun.