It's three o'clock in the afternoon and your little one has just been delivered home from school safe
and sound. He barely makes it out of the big yellow bus before he breaks into a run at the sight of
you. You outstretch your arms, but he thrusts a card into your hands instead, hardly able to contain
his excitement. Peering down at the childish scrawl, your heart sinks. Another birthday invitation.
“Momma, can I go?”
How do you respond? There isn't one right answer. Depending on your child's age and allergy
severity, he may not be able to go to the party. Or, he may be able to go as long as you attend to
make sure he isn't served birthday cake or reaches for some off a friend's plate.
Restrictions in foods and social activities can lead children to experience feelings of sadness, anger,
frustration and self consciousness — particularly when they feel safety precautions make them stand
out from their peers, explained Jennifer LeBovidge, Ph.D., a psychologist at Children's Hospital
Boston. These emotions are normal for children with and without food allergies, and children can
develop skills for managing them.
Michael Miller, M.Ed.S., LCSW, put it a another way. “Children and their families are
dealing with a loss — whether it's a loss of body integrity, for instance, or not being able to
eat foods that others are enjoying,” he said.
“They go through all the different stages of grief even though they might not be aware of
it. Children can get angry, can get sad — they can't believe it's happening to them. Children
need to be helped to recognize these different feelings, helped to understand that these
feelings are normal and taught to express them in ways that are appropriate. In time,
these feelings can weaken and children can learn to accept and live with their allergies,
like avoiding what they need to avoid,” said Miller, the director of psychological services in
The Pediatric Outpatient Clinic at National Jewish Health,
Five Stages of Grief
Finding out your child has food
allergies can be emotionally
devastating to both you and your
child. It's common for your child
(and yourself) to go through the
stages of grief before accepting the
1. Denial: “I feel fine. I can
2. Anger: “Why me? My sister
doesn't have it!”
3. Bargaining: “I will give my life
savings if only
4. Depression: “What's the point?
I'd just as soon die.”
5. Acceptance: “It's going to be
OK. There are other things I
As a parent, you know all too well that birthday parties
simply scratch the surface of socially-ostracizing events.
Your food-allergic child may have to sit at an allergen-free
table at lunch. Sleepovers or parties could be banned if
there is concern about whether the supervising adult can be
trusted to follow safety precautions and take action in an
emergency. Children might even pose a risk to themselves,
particularly as they move towards adolescence.
“They can feel embarrassed asking questions about
ingredients or asking others to wash their hands before
eating if they feel their allergy makes them stick out or is
a ‘big deal’,” said LeBovidge. “Some adolescents may feel
uncomfortable with dating situations that require them
to talk to romantic partners about issues such as safety
practices around kissing.”
Although some children with food allergies experience
teasing about their allergy, or even bullying, it is important
to remember that most children with food allergies have
supportive friends and can participate in most social
activities with some advanced planning, she stressed.
HOW TO CONTROL EMOTIONS
Younger children who may not yet know how to express
their feelings appropriately might take their feelings out on
parents or siblings, which is often anger. Miller suggested
that parents dedicate a “feelings corner” in their home for
this very reason.
“A feelings corner is a specific area that is precisely for
your child to go to when he's upset. ‘Here's another birthday
party I can't have birthday cake at!’ he might yell, to which you as the parent would reply
empathetically, ‘You look really upset, and I don't blame you for being upset. Why don't
you go to the ‘feelings’ corner, and punch that pillow (or do jumping jacks, or rip paper, or
journal, or draw)?’” explained Miller.
Depending on your child, their
temperament and the way they handle
certain strong emotions, this corner of
your home can serve as a spot where
children can learn to put words to
feelings and then actively get them out.
“They're not hitting anyone, throwing
things across the room or breaking
windows. Rather, they're retreating to a
place where it is appropriate, acceptable
and actually encouraged to blow off
steam or to cry,” said Miller. “Try to
encourage your child to bring it upon
himself to say, ‘I'm so upset I'm going
to the feelings corner.’ Once they do, the
parent can just put another check on the
calendar as a reward for handling the
situation so well. Depending on the age,
these checks can earn rewards.”
HOW PARENTS CAN HELP
When your food-allergic child feels left
out of a social situation, what should you
do to help?
Empathetic listening should take
place first and foremost — because it
does feel bad, and your child has to have
their feelings validated, listened to and
understood, said Miller.
. “Parents can also
involve children in problem-solving
how to handle social situations — for
example, attending a birthday party or
extracurricular event where food will
be served — to help them feel more in
control. Typically there are different
options for how to handle a situation and
having some say in the matter can help,”
suggested Dr. LeBovidge. An alternative
treat to bring might help them feel more
involved at the party.
Helping children rehearse and
role play language to use for common
situations that may arise (such as when
a friend asks them about their allergies
or when someone offers them food in a
social situation) may help them
Take steps to educate others (e.g., school personnel, relatives, other parents) about food allergies.
“While food allergy management is second nature to many families of children with food allergy, it is not
so for most people. Providing education, not only about what food allergies are, but providing concrete
examples of simple steps that people can take to include children with food allergies in social situations, can
be extremely valuable,” Dr. LeBovidge explained. The more information others are armed with, the more
supportive they can be.
. Explain to your child that he should always tell you if he is being teased or bullied because of his
food allergy. Let him know how important it is to tell you his feelings and that it is not tattling; it is standing
up for himself and being responsible for his health and well-being.
Behavioral health professionals can help with the tasks mentioned above. They also provide a safe space
for divulging feelings, planning for events, devising strategies for behavior management, grieving, etc. But
remember, children take their cues on how to handle challenging situations from their parents.
“So when parents project a calm, matter-of-fact approach to allergy management, focusing on safety routines
and model use of coping strategies themselves, children will benefit from the underlying message that food
allergy is manageable,” explained Dr. LeBovidge.
Positive attention and praise for children's use of coping strategies (whether it's going to the feelings corner,
problem-solving or taking an active role in allergy management) can also help build children's sense of self-efficacy
“It's also important that parents remember — and remind others — that children are not defined by their
food allergies,” said Dr. LeBovidge. “Helping children identify their strengths and pursue their interests will
increase their self-confidence overall.”
RESOURCES FOR PARENTS
DEPRESSION VS. ANXIETY
The following signs indicate depression:
The following signs indicate anxiety:
NOTE: Some anxiety about food allergies is normal
and can be very adaptive in promoting the vigilance
and caution necessary for food allergy management.
- Persistent sad or irritable mood
- Less interest in activities that were once enjoyed (younger children might complain of feeling "bored")
- Social withdrawal
- Trouble concentrating
- Physical complaints (e.g., headaches, stomachaches,
- Trouble sleeping or sleeping more than is typical
- Appetite or weight changes
- Non-compliance with the medical regimen
- Impairment of functioning (e.g. a teacher might express
worry about the child zoning out or not turning work in)
- Morbid thoughts
Signs that anxiety may be more chronic or impairing include:
Symptoms that are getting in the way of daily activities
or that are generalizing to more and more situations
also signal that children may need support from a
mental health professional to learn skills to manage their
anxiety and cope effectively with their food allergies.
- Frequent worried thoughts that are difficult to control
- Constant need for reassurance about what is safe
(which does not seem to help to reduce the anxiety
level for long)
- Physical symptoms of stress (e.g., accelerated heart
beat or palpitations, feeling of choking, trembling,
- Separation anxiety or school refusal
- Frequent trips to the nurse
- Trouble sleeping
- Fear of dying (because of a history of anaphylaxis)
The No Biggie Bunch Children's Book Series
Understanding Children and Chronic Illness booklet
Find a local food allergy support group
Read more about emotional and social issues in food-allergic children:
Beth Puliti is a professional writer for a national healthcare magazine.