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

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

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