It began with an angry red rash that spread quickly across her cheeks. Next dark, swollen lips. And then sudden, extreme agitation. But her screams were hoarse because her throat was contracting.
It was a situation we all fear as parents – anaphylaxis, a severe allergic reaction – and I watched it happen to our younger daughter, at just 20 months. As frightening as it was to see my child become unwell so quickly, I had always known it was possible. With a family history of allergic disease, including food allergies, eczema, asthma and hayfever, our daughters were at a higher risk of developing allergies than other children.
Later, an allergist confirmed our daughter was allergic to nuts – peanuts and tree nuts – like her dad, and the reaction had come from exposure in a normally harmless food to small amounts of nuts on a shared manufacturing line. The specialist gave us an action plan, which requires that we carry an EpiPen at all times, and suggested some risk minimisation strategies. Although we were cautious, the next reaction, a milder one, from cross-contamination in a cafe via food or the crayons she was using, followed only months later. This time I acted swiftly and confidently as I followed the advice of the action plan.
Our daughter is far from alone in her condition. The fact is, allergic disease is on the rise, in Australia and throughout Western countries. According to the Australasian Society of Clinical Immunology and Allergy (ASCIA) – the peak body for immune and allergic diseases in Australia and New Zealand – food-induced anaphylaxis has doubled in the last decade. Ten per cent of infants now have a proven food allergy, one of the highest incidences internationally (Allergy in Australia 2014, ASCIA). Cow’s milk, egg, peanut, tree nuts, wheat, soy, sesame, fish and shellfish are among the top nine foods causing immediate food allergy. Peanut allergy now affects 3 per cent of infants (ASCIA website).
Scientists are working hard to establish why allergic disease is increasing and, significantly, what we can do to treat sufferers as well as prevent it from developing in infants and children. A number of factors in both a mother’s diet and infant feeding have been identified, which may reduce the risk of allergies. Evidence is mounting for the early introduction of peanuts and other common allergenic foods.
This is, of course, important, interesting research; however, the main focus for families already dealing with food allergies has to be how we can minimise risk to our children. And critical to doing so is increasing awareness throughout the community about the impact and management of allergies. First and foremost we need to dispel the myth that allergies are undesirable but not serious. Let me state this clearly: intolerance can cause a sore tummy; anaphylaxis can cause sudden death. Although deaths from anaphylaxis in Australia are rare, moderate and severe allergic reactions – projectile vomiting, swollen eyes, mouth, ears, large welts covering the body, and the airways closing – are all too common.
Why all the fuss about peanuts? These nuts tend to trigger more severe reactions, and the triggers can come directly, that is, from ingesting a food containing peanuts, or indirectly, through exposure to peanut residue via touch or even by inhaling airborne particles (for example, from the breath of a child who has just consumed a peanut butter sandwich). So when families are asked to refrain from sending nut products to school, it isn’t a case of being uptight; it’s about minimising very real risks to children.
Fortunately, many children are now sensitive to the dangers of certain foods for their allergic friends. My older daughter, who is only three years old, regularly checks whether a food is safe for her younger sister to eat. I feel immensely proud that she shows this empathy and understands we have to make decisions as a family to protect her sister, sometimes to her own detriment.
Sadly, sometimes parents lack empathy when it comes to allergies. Regularly in discussions about allergies, you will find parents lamenting that their children can no longer enjoy a good ol’ peanut butter sambo in the school playground – as if it were a rite of passage of childhood. Worse, they continue to send nut products to school. The far greater shame is that there is a significant number among this generation of children who must deal with serious allergies for which there is no current cure and for whom another child’s peanut butter sambo could threaten their lives.
I speak to Heather Thomson, my sister and an Inner West Mum whose eight-year-old daughter has a severe peanut allergy. Heather says it was not until she witnessed her daughter experiencing full anaphylaxis that it truly sank in that the issue of food allergies was not a ‘beat-up’ by paranoid parents and educators.
While parents must take responsibility for their child’s allergies, and can indeed teach their whole family about being allergy safe, we all have a role to play in protecting children. Families of allergic children depend on others being allergy aware. Heather puts this point well: ‘It cannot be a young child’s responsibility. Allergies are not an opportunity to “teach children about the real world”, not when their lives are at risk.’