Happy New Year! Before we jump into 2011 on Food Allergy Living, we wanted to recap our top ten blog posts of 2010. We tackled topics from food allergy recipes to tube feeding and everything in between and had some excellent guest bloggers share their stories. Based on reader traffic, here were our most popular posts:

1) Baby Rashes (when is it a milk allergy?)

In this post, Christine talks about how to tell if your child has a typical rash or if it is a sign of an allergic reaction to cow’s milk.

2) Dysphagia, GERD and Silent Aspiration

Mallory tackled the topic of GERD, or gastroesophageal reflux disease, and two other conditions commonly associated with it: dysphagia and silent aspiration.

3) Accidental Injections of Epinephrine from an EpiPen

If you or your child uses an EpiPen, this blog is a must-read in case you ever have an accidental injection.

4) Fun Summer Camps for Kids with Food Allergies

Children with food allergies don’t have to miss out on summer camp fun with these allergy-friendly options.

5) How Can Duocal Help My Child Gain Weight?

If your child is underweight or has been diagnosed with failure to thrive, the supplement Duocal can help provide extra calories in their diet.

6) Baby Formula and Food Thickeners: What are the Options?

Thickeners can help treat reflux, but children with food allergies often react to the rice cereals or oatmeals that are commonly recommended. Christine offers some other options that are allergy-friendly.

7) Guest Blog: Living with Eosinophilic Esophagitis - Norman’s Story

Kendra Tiedemann shared her son Norman’s journey with eosinophilic esophagitis.

8) Understanding How Infant Taste Buds Work

If you’ve ever wondered if your baby can taste her food, then be sure to read this post from Mallory.

9) Failure to Thrive: My Child is Underweight, What Should I Do?

In this post, Nita helped to clear up some common confusions about what a failure to thrive diagnosis means and how it is treated.

10) Guest Blog: Food Protein-Induced Entercolitis Syndrome – Roland’s Story

Lorelei Alvarez, one of the founders of the Reflux Rebels group, shared her son Roland’s journey with FPIES in this guest blog.

Which blog posts were your favorite over the last year? Are there any topics you’d like to see us cover in 2011?

- Sarah

For a parent who is not familiar with food allergies, having a food allergic child over to play may seem intimidating. This blog is intended for parents whose children do not have food allergies who would like to know more about food allergies in order to safely host a food-allergic playmate.

Meals and Snacks

Obviously meals and snacks are the most critical times to be vigilant when you are caring for a child with food allergies. Follow these steps to keep your guest safe.

• Prior to the play date, arrange for the child’s parents to pack enough safe foods for the time they will spend at your house. Let them know if you plan to have a certain food so that they can provide an allergy-free alternative for their child and nobody feels left out. The most important thing is to only give the child the food that their parents provided. Food allergens are often hidden ingredients and it takes a lot of time and practice to master the art of reading food labels and detecting potential allergens. Never assume a food is safe.
• Make sure to clean the surface of the kitchen or table to remove any food protein residue from earlier meals. Soaps and commercial cleansing agents work well on counter tops, but dishwashing liquid is not enough.
• Be sure to wash your hands before and between handling foods. It’s important to remind the kids to wash their hands before eating as well. Use soap and water; hand-sanitizers will not get rid of food protein residues.
• When preparing food for the kiddos, be careful to avoid cross contact, where the proteins from one food mix in with another food. Even a tiny amount is enough to cause an allergic reaction in some people. To avoid it, use separate utensils when preparing food for the kids (or yourself).
• For the younger children, be sure to monitor the kiddos during meal or snack time and explain that it’s not safe for them to share or trade foods.

Airborne Allergens

Most children’s allergic reactions occur from actually eating the food that they are allergic to so as long as you keep the kid’s foods separate, you don’t need to worry about what your family eats around them. However, some kids have airborne allergens where they can have an allergic reaction by just being near the allergen. For example, you’ve probably heard of the “peanut-free” schools or lunch tables which are intended to protect children with peanut allergies who can react by just being around other kids eating foods with peanuts. You’ll need to use extra caution with these kiddos and be sure to not have any foods containing that allergen while the child is around.

Arts and Crafts

It’s important to note that food allergens can be triggered by non-food items too. For example, Play-Doh and most stickers are not safe for a child with a wheat allergy. For more information on allergens hidden in non-food items, refer to Christine’s blog post, from earlier this year.

Emergency Plan

No matter how careful you are, it’s still important to know the signs and symptoms of an allergic reaction just in case exposure occurs. Symptoms typically appear within minutes to two hours after a child is exposed. If you suspect an allergic reaction has occurred, call the child’s parents immediately. If the child is having a serious allergic reaction and having trouble breathing, call 911 first, then call the parents.

Some allergic children experience anaphylaxis, a severe allergic reaction that progresses rapidly and can lead to death. These kids are usually prescribed an automatic epinephrine injector (aka an “Epi-Pen”), which must be kept with them at all times. It’s up to the child’s parents to notify you if their child carries one and explain to you how to use it just in case of an emergency. FAAN provides some online videos that demonstrate how to properly use an epinephrine auto-injector, which may help you feel more comfortable using one yourself.

As many of you may know, food allergy symptoms can appear in a variety of ways. One of the most concerning symptoms of a food allergy is when a person goes into anaphylactic shock. In fact, food allergies are believed to be the leading cause of anaphylaxis outside the hospital setting. The CDC reported that food allergies result in over 300,000 ambulatory-care visits a year among children.¹ Because this is the most life threatening response to food allergens, we wanted to review what the signs of anaphylaxis look like.

Anaphylaxis – What to Watch For

The signs of anaphylaxis may occur within seconds of exposure, or be delayed 15 to 30 minutes or even an hour or more after exposure (which is most typical of reactions to aspirin and similar drugs). Early symptoms are often related to the skin and include:

• Difficulty breathing; wheezing
• Changes in consciousness (including confusion, light-headedness, or stupor)
• Rapid swelling throughout the body
• Hives
• Blue skin
• Severe abdominal pain, nausea, or diarrhea
• Flushing (warmth and redness of the skin)
• Itching (often in the groin or armpits)

Throat and tongue swelling, difficulty swallowing, and difficulty breathing frequently follow the above symptoms. Vomiting, diarrhea, and stomach cramps may also develop.

If you know a child or adult with food allergies and suspect they are having an anaphylactic reaction, the most important consideration is time. Calling 911 or driving the person to the emergency room are the first things that should be done. Also, it is important to have an Epi Pen on hand for those times.

How You Can Protect Yourself or Others

• Follow-up with your doctor or allergist if you or your little one had a severe reaction.
• If you’ve been prescribed self-injectable epinephrine (i.e., EpiPen® or Twinject®), carry it at all times. (Here’s a great recent post on EpiPen usage)
• Educate others about your allergy. Teach them what you need to avoid, the symptoms of an allergic reaction, and how they can help during an allergic emergency. (Check out this post I did on being a PAL to a person with food allergies.)
• Teach yourself and others how to use an epinephrine auto-injector. Practice until it becomes second nature.
• Wear medical identification jewelry noting your allergy.

Have you or your little ones ever had an anaphylactic reaction? If so, what have you done to help minimize the risk of such a reaction?

- Christine

We’ve talked about EpiPens before on Food Allergy Living, including how to travel with them and what to do in case of an accidental injection of epinephrine. With the new school year upon us, many parents of children with food allergies are faced with the dilemma of where to store their child’s EpiPen at school. Should they carry it with them at all times? Should it be stored in the nurse’s office? What happens on the playground or on a field trip?

Carrying an EpiPen at School

If your child is old enough, some schools will allow them to carry the EpiPen with them at school or on a field trip and self-administer in the case of a reaction. While many states have passed legislation to allow this, New York, Pennsylvania, Rhode Island and Wisconsin have not. To find out specific details about what the legislation mandates in your state, you can visit the Allergy & Asthma Network website which provides links to each state’s current law regarding anaphylaxis medications.

EpiPens in the Classroom as well as the Nurse’s Office

If your child is not old enough to carry their own EpiPen, or their school will not allow it, you will want to determine whether or not one can be stored in their classroom (in addition to the nurse’s office). If they are in multiple classrooms each day, you may want to store one EpiPen in each room to be safe. You will also want to make sure that all of your children’s teachers are properly trained in how to administer the EpiPen.

Planning for EpiPen Use When Outside the Classroom

One thing that can help you address where your child’s EpiPen or other medications are stored at school is a 504 plan. A 504 plan refers to Section 504 of the Americans with Disabilities Act, which ensures that children with special needs get a level playing field from government services like public school. Depending on the details of your child’s food allergy, he or she may qualify for a 504 plan for the school to follow. The plan will outline not only where their EpiPen is stored, but also where they will eat, what allergens are permitted on school grounds, and how teachers and other personnel are trained to react in the event of an anaphylactic reaction.

Planning ahead is key to ensuring that your child will be safe at school in the event of an allergic reaction. What plans do you have in place for your children?

- Sarah

Self-administrated shots of epinephrine (often referred to by their brand names: EpiPen and Twinject) are life-saving devices which can halt an allergic reaction and give a patient time to get to a hospital. For children and adults who experience anaphylaxis, an epinephrine shot is a matter of life or death. But it’s important for patients and caregivers to know how to properly work an automatic epinephrine shot. An incorrect or accidental administration can have dangerous consequences.

Accidental Epipen Injections & the Consequences:

In order for epinephrine to work properly, it must be injected into the thigh muscle. The greatest risk of an accidental or an incorrect injection is that injecting the epinephrine elsewhere can delay or impair the effectiveness during a time-critical emergency.

Aside from this, there are also risks of an accidental injection in and of itself. An accidental intravenous injection (which is very rare and would be fairly difficult to do on accident), is especially dangerous and can lead to hypertension and/or heart problems[1]. Most accidental injections (an estimated 94%) occur when a patient or someone trying to help them accidentally jabs their finger or thumb[2]. An accidental injection to the hands or feet can impair blood flow to these areas and can potentially cause tissue death. This however, is the worst-case scenario.

Symptoms of an accidental injection are not usually so severe and may include temporary numbness or tingling, pain and swelling at the injection site, elevated heart rate and/or heart palpations. Regardless, you should always seek medical attention in the event of an accidental injection; it’s better safe than sorry!

Know How To Use the Epipen:

It never hurts to refresh your memory on how to use your child’s epinephrine shot. You may even want to print out the instructions and keep them in a handy place (for example, fold it up and keep it with the epinephrine shot). Both EpiPen and Twinject have several resources to teach patients about the proper use of epinephrine shots.

• EpiPen
  • Downloadable instructions
  • Demonstration video

• Twinject
  • Downloadable instructions
  • Demonstration video

For best results, ask your child’s health care provider to demonstrate how to properly use an epinephrine shot[3]. Research shows that parents who receive hands-on training are better able to properly demonstrate how to use their child’s epinephrine shot[4]. Remind them to be careful! An ironic side note: An estimated 10% of accidental epinephrine injections occur in health care providers when demonstrating to their patients how to use it!

How many of you carry Twinject or EpiPens for your children? Have you ever had to deal with an accidental epinephrine injection?

-Mallory

[1] Epinephrine. Drug Facts and Comparisons. Efacts [online]. 2008. Available from Wolters Kluwer Health, Inc.
[2] Accidental EpiPen injections becoming more common. Annals of Allergy, Asthma and Immunology, April 2009.
[3] Pediatr Pharm.2008;14(5)©2008Children's Medical Center, University of Virginia.
" [4] Arkwright PD, Farragher AJ. Factors determining the ability of parents to effectively administer intramuscular adrenaline to food allergic children. Pediatr Allergy Immunol 2006;17:227-9.

As the weather warms up and school lets out, many of you are likely planning a summer vacation with your family. When you have a child with food allergies, traveling can be stressful because you are out of your comfort zone. By planning ahead, you can ensure that the trip goes smoothly and that your child gets to experience all of the fun. It will also take away a lot of your anxiety so that you can relax and enjoy your vacation time too! Here are some tips for planning your next vacation.

Automatic Epinephrine Injectors (EpiPens)

If your child has an automatic epinephrine injector (or EpiPen), make sure it isn’t expired and consider packing an extra just in case. Have it handy at all times and get an insulated carrying case to prevent it from getting too hot or cold.

Air travel

Traveling by plane can be incredibly stressful for those with food allergies, especially those with peanut allergy and anaphylaxis. However, there are steps you can take to minimize the risk for an allergen exposure.

• Ask ahead if you can pre-board so that you can clean the area around your child’s seat.
• Bring a sheet or cover for the seat. You can buy washable or disposable covers from Plane Sheets.
• Call ahead to alert the airline of your child’s food allergies and find out about their policies. Some airlines are more allergy-friendly than others so do your research. For example, Continental does not hand out snacks that contain peanuts. Delta will create a “buffer zone” of 3 rows where they will not serve snacks containing peanut ingredients.
• Request a special meal that accommodates your child’s dietary restrictions if you are flying on an extended flight where a meal is served.
• Prepare for anything! Even when all precautions are taken, you can never completely eliminate the risk for allergen exposure. Have emergency plans and medication handy at all times.

Road trips

Road trips are generally less stressful because you have control over what comes into the car. However, it still requires a lot of planning to ensure you bring along enough safe foods for the trip. Check out Kids with Food Allergies for some great tips on how to plan effectively for your vacations & road trips.

Amusement Parks

In addition to being the happiest place on earth, Walt Disney World in Orlando, Florida is also perhaps the most accommodating place on earth. With ample notice, Dining Services can accommodate just about any dietary restriction. Disney Land, in Anaheim, California, also strives to accommodate dietary restrictions. Other parks, like Six Flags and Busch Gardens, will usually provide an exception to the rules about bringing food into the park when a person has a food allergy or intolerance.

More articles on travel with food allergies

• Camping with food allergies
• Trouble-free travel
• Allergy and asthma travel tips check-list
• Cruises with food allergies

Resources

• Chef cards
• International chef cards (translations for your food allergies)
• Food allergy t-shirts

Based on your experiences, what tips can you offer other parents about traveling with a child with food allergies?

- Mallory

EpiPens, for any child with allergies, can be a huge life saver. However, sending your little one to school with their EpiPen can be rather stressful for a parent. There are a thousand questions that might go through your mind, “Will they be safe even with the EpiPen?” or “Will someone know how to use the EpiPen?”.

EpiPen and Anaphylactic Shock Basics

For those of you who don’t know, anaphylaxis or anaphylactic shock can be a life-threatening allergic reaction to specific triggers, such as food proteins and medication. This results in hives or swelling of the throat or tongue, which can lead to constricted airways and/or a dramatic drop in blood pressure.

An injection from an EpiPen is imperative when anaphylactic shock occurs and can save a person’s life. An EpiPen is a premeasured dose of epinephrine, which is injected into someone’s body during a severe allergic reaction to avoid or treat the onset and symptoms of anaphylactic shock, which provides a window of time to seek further medical attention. ¹

EpiPens at Schools

If you are a parent of a child who is at risk for anaphylactic shock, you probably carry his or her EpiPen with you at all times, in case they are exposed to an allergen to which they are allergic. This is excellent for when you are with your child; however, your child could be exposed to many more allergens at school when you and your EpiPen aren’t there!

In fact, one study of children and adolescents found that 10 out of 13 fatal or near fatal anaphylactic reactions occurred outside the home. All the fatalities did not have an EpiPen and those who survived received an EpiPen shot before or within 5 minutes of developing severe symptoms.²

So, what does this mean? EpiPens can save lives! You need to ensure that the other adults who spend time with your child are trained and able to assist in any situation if you’re not around.

Don’t worry, this isn’t as difficult as it sounds! I suggest sitting down with your child’s teacher in the beginning of the school year to set up a 504 plan. This will ensure he or she receives proper care and attention when you aren’t there and that all adults that are around your child have the proper training to use an EpiPen if an emergency situation arises.

Also, there is good news for all you Massachusetts residents! Thanks to your persistent neighbors, starting March 2010, all newly hired school bus drivers in the state of Massachusetts will be required to have EpiPen training. Unfortunately, the law doesn’t mandate the existing school bus drivers to be trained; however, it’s a step in the right direction. Hopefully the other 49 states will follow suit. Good work Massachusetts!

How have you been able to ensure that your child is safe and can receive the proper care if they go into anaphylactic shock? Did it involve a 504 plan or EpiPen training?

- Nita

References:

1. www.epipen.com/
2. Sampson H, Mendelson L, Rosen J. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med. 1992;327:380-384.

While I’m always paying attention to stories about food allergies, I’ve noticed lately there have been even more articles than usual in the media, which is great. More stories helps to increase awareness and educate the public about how serious food allergies can be as well as some of the signs/symptoms people should look for if they suspect an allergy. Below are just a few of some of the articles and posts about food allergies from the past few weeks that have caught my attention.

How – and How Not – To Diagnose A Food Allergy

Have you been thinking about having your child tested for food allergies? Before heading to the allergist check out this entry from The Washington Post’s “Checkup” blog. It talks about the benefits of formal allergy testing and gives some helpful information about the different types of diagnostic tests from the Food Allergy Initiative.

A Family That Takes It’s Food Allergies Seriously

I always think it is amazing when kids are out in the community raising awareness about their food allergies. The Boston Globe reported last week on Spencer and Zoe Cohen. Between the two, they are allergic to nuts, fish, soy, mangoes, bananas, carrots, broccoli, and lettuce! The siblings traveled to the FAAN Kids Congress last month where they met with lawmakers to lobby for the FAAMA Act which could help fund more food allergy research.

A Next-Generation Epi-Pen is unveiled

Dey Pharma, the makers of Epi-Pen, released a new more user-friendly Epi-Pen. If your little one needs one, don’t forget to read our tips for Epi-Pen safety. Hopefully you will never need to use one, but it is always best to be prepared for an emergency situation!

Trained Dog Warns Child with Allergy to Peanuts

We blogged about a new furry trend in food allergy safety - food allergy dogs - a few weeks ago. Now USA Today is telling the story of the Rine family whose adorable Portuguese water dog Nicco helps their son Ethan avoid peanuts. Right now these dogs are expensive because of the high cost of their extensive training, but they are helping keep kids safe. Perhaps as they become more common, the cost will go down and they will be more affordable.

Have you read any interesting news or tips recently? If so, share them with us in the comments!

-Christine

The first day of school or daycare is an exciting time for young children, but introducing food allergic little ones into a new environment can be dangerous. It is important to educate and remind your children’s teachers and caregivers about food allergy precautions and safety before they begin their new adventure.

Here are some simple steps you can follow to make sure that the transition into a new environment is a safe one for your child:

1) Schedule a back-to-school check up with your pediatrician or allergist to make sure that your current treatment plan is still effective.

2) Document your child’s allergies and treatment plan in school or daycare paperwork.

3) Provide teachers and caregivers with brochures and information on your child’s allergy to prevent accidents.

4) Create a one page “Cheat Sheet” with information about your child’s allergies for substitutes or new employees.

5) Discuss what to do in case of an emergency. Ask your pediatrician about keeping an EpiPen on-site. Be sure to train the caregiver on when and how to use one.

6) Make sure that your child fully understands what can trigger their allergy.

7) Look at upcoming lunch or snack menus and identify safe options, also provide the school with a list of safe foods that your little one can enjoy at any time.

8) If no safe options are available, pack food from home and warn your child not to share with their classmates.

9) Offer to bring in allergy-safe treats for holidays and special events. This way you know that your child is safe, and he/she won’t feel excluded from the fun!

Other tips? Let us know what you are doing to prepare your child for the upcoming school year.

- Nita

The EpiPen. According to an article on MSNBC.com, doctors prescribed 1.9 million EpiPens in 2007, a 36 percent increase from 2003, when 1.4 million were prescribed. Since food allergies are on the rise, this comes as no surprise.

The pocket-sized, life-saving EpiPen has cultivated quite a following. It “auto injects a pre-measured dose of epinephrine to someone experiencing anaphylaxis, a severe whole-body allergic reaction.” Some parents have 10 or more EpiPens around the house at all times, as well as at school, in the car and on their allergy-prone little one.

Stylish EpiPen carriers and portable pouches have even emerged. There are carriers covered in cartoon characters for the younger kids and discreet leg straps for the older kids that might be a bit self-conscience.

For many years, the EpiPen was one-of-a-kind. Currently, there is another company that makes a similar product, but the EpiPen has maintained 97 percent of the market.

For the entire EpiPen article, click here.

- Nita

While we usually write about common food allergy symptoms, such as diarrhea or eczema, more severe reactions like anaphylaxis are possible for many children and adults with allergies. Allergens that cause anaphylaxis include food, insect stings, drugs, latex, and even exercise.  When anaphylaxis happens as a result of contact with an allergen, a rapid immune reaction occurs that can quickly make breathing very difficult.  For those patients an immediate injection of epinephrine can prevent very serious complications.  Sometimes even the few minutes it takes emergency medical care to arrive is too long, and a personal device with automated injectable epinephrine, an auto-injector, such as the EpiPen® Auto-Injector, is essential.

The EpiPen, made by Dey Pharma, works by delivering a quick shot of epinephrine to the thigh.  There are also similar devices available, such as the Adrenaclick® and TwinJect®, both made by Shionogi Inc. Twinject is unique in that it has a built-in backup dose of epinephrine, which can take the place of two auto-injectors in an emergency.

Epinephrine helps the body to keep the airway open so that breathing does not become as difficult, allowing time for emergency medical care to arrive. But many parents worry that one auto-injector might not be enough or that something might go wrong that could require additional auto-injectors. For instance, someone nearby might experience a severe allergic reaction and need to use your child’s auto-injector. Or what if your child’s only auto-injector was unknowingly broken? What if the auto-injector were accidentally put in the fridge or left in the sun? What if the contents were cloudy? Or if it had expired? So many scary possibilities!

So, what is the right number of auto-injectors? The answer to that question depends on a number of factors. Bear in mind that the Twinject has two doses of epinephrine, but according to the company the second dose should only be used as a backup to the first dose and should not be saved for future allergy emergencies.

How Many to Carry?

On their websites, Dey Pharma and Shionogi recommend that patients at risk for allergic emergencies carry two doses of epinephrine. This is because up to 20% of patients who have an allergic emergency requiring epinephrine will require a second dose. At all times the injector should be kept close to room temperature, out of sunlight, and replaced by the expiration date. You can even sign up for an expiration date reminder on either of the websites. It’s a good idea to occasionally check the solution in the auto-injector to make sure it hasn’t discolored, which can be a sign of a possible loss of effectiveness.

If a long trip is planned, especially one overseas where similar products may not be readily available in pharmacies; two auto-injectors (or one that contains two doses) may not be enough.

Should you or your child carry more than two auto-injectors? Not necessarily. Additional backups would likely be for peace of mind. A second dose of epinephrine may be needed in an emergency, but more than two doses during an emergency should only be given with medical supervision. Some caregivers choose to carry two auto-injectors from different lots for added precaution.

Multiple Locations

Some patients who use auto-injectors prefer to carry the standard two with them and also keep backup injectors in one or more strategic locations. These might include an extra one or two at work, school, daycare, and/or a relative’s house. These are great because they can serve as backup in case someone forgets their daily go-everywhere auto-injectors. Just make sure you follow the recommended storage instructions everywhere you keep an auto-injector and check your backups for discoloration and expiration dates. Knowing that you have extra auto-injectors in places like this, in addition to the daily carry-with auto-injectors you have, may bring you more comfort.

How about you? How many auto-injectors does your family keep on hand, and where? Please share your thoughts in the comment section of this blog post.

- Rob

[Image Source]

It’s time for back to school and whether it’s your child’s first day of school or they’re returning to school for another year, introducing a child with food allergies into a new environment can be nerve-racking.  This is why it is important to educate and remind your children’s teachers and caregivers about food allergy precautions and safety before school starts.

Here are some simple steps you can follow to make sure that the transition is a safe one for your child:

1. Schedule a back-to-school checkup with your pediatrician or allergist to make sure that your current treatment plan is still effective.
2. Document your child’s allergies and treatment plan in school or daycare paperwork.
3. Provide teachers and caregivers with brochures and information on your child’s allergy to prevent accidents.
4. Create a one page “Cheat Sheet” with information about your child’s allergies for substitutes or new employees.
5. Discuss what to do in case of an emergency.  Ask your pediatrician about keeping an EpiPen on-site.  Be sure to train the caregiver on when and how to use one.
6. Make sure that your child fully understands what can trigger their allergy.
7. Look at upcoming lunch or snack menus and identify safe options, also provide the school with a list of safe foods that your child can enjoy at any time.
8. If no safe options are available, pack food from home and warn your child not to trade food with his/her classmates.
9. Offer to bring in allergy-safe treats for holidays and special events.  This way you know that your child is safe, and they won’t feel excluded from the fun!

Communication and education is the most important part of going back to school with food allergies.  Hopefully these tips will provide you with some ideas on how to best educate your child’s new classroom on living with food allergies.

If you have any creative strategies to help prepare for a safe school year, we’d love to hear about them in the comments!