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How to Keep Your Food-Allergic Child From Feeling Left Out

September 2011



Social Security by Beth Puliti

How to keep your food-allergic child from feeling LEFT OUT...

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, Denver, Colo.

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 situation.

1. Denial: “I feel fine. I can eat this.”

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 can eat.”
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 keep your allergic child from being left out

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?

Listen. 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.

Problem solve. “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.

Role play. 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 feel prepared.

Educate. 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.

Instill trust. 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 and confidence.

“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.”

DEPRESSION VS. ANXIETY

The following signs indicate depression:

  • 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, muscle aches)
  • 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)
  • Peer-conflict
  • Guilt
  • Morbid thoughts

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.

Signs that anxiety may be more chronic or impairing include:
  • 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, or nausea)
  • Separation anxiety or school refusal
  • Frequent trips to the nurse
  • Trouble sleeping
  • Fear of dying (because of a history of anaphylaxis)
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.


RESOURCES FOR PARENTS
• 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:
http://www.kidswithfoodallergies.org/resourcetopic.php?topic=emotional_social



Beth Puliti is a professional writer for a national healthcare magazine.

This article was first published in the Spring 2010 issue of Support Net. It was updated September 2011.





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Page last updated 7/29/2012

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