Food allergies are a frequently discussed topic among parents and medical professionals. If you are not a parent of a child with food allergies, chances are high that someone you love, or someone you see daily may be dealing with this challenging diagnosis.

According to FARE (Food Allergy Research and Education), 32 million Americans are living with food allergies. If you take the statistic a little further, that means 1 in 13 children have food allergies. For a parent, it can be terrifying to have to think about leaving their child at school all day.

Now that school is in full swing, you may have questions, or may be wondering if there is more you can do to keep your child safe. As a pediatric ER nurse and parent of two with food allergies, I am here to tell you that knowledge and preparation are keys to a smooth year! Here are some ways to ensure your child is safe at school.

1. First and foremost, visit your child’s allergist every year. (If your child is newly diagnosed and awaiting your first allergist visit, your pediatrician can help you.) Make sure your child has an updated prescription for Epi-Pens. Make sure you have 2 sets; one for home and one for school to keep with the nurse.
2. Ask your child’s allergist or pediatrician to fill out a personalized action plan. The FARE website has action plans that are simple to understand, and can be found at www.foodallergy.org. Make multiple copies of these plans. Give them to your child’s teachers and the school nurse. These are absolutely essential to have! They outline exactly what to do in the case of accidental exposure to an allergen.
3. Know your rights as a parent. Your school should be accommodating your child in the best way possible. Your child is protected by law due to their food allergy. You can request a 504 meeting at your school. During this meeting, you meet to determine how to best meet the needs of your child at school. As an example, in my children’s 504 plans, we specify that they need to not be seated around anyone eating nuts during the lunch period.
4. Make sure your children know to never, ever eat food that you either did not pack for them, or did not provide for the classroom. Get your kids in this habit early, and it will become second nature.
5. Prepare for classroom celebrations. Elementary school especially seems to have many, many food centered celebrations. Provide a box of safe treats to keep in your child’s classroom so that they are not completely left out.
6. Read every label! Food companies are not required to label for allergens, so it is essential to read every ingredient, even if it’s a food your kiddo has consumed before, as production lines can change.
7. Take care of yourself. Caring for a child with food allergies can be stressful. Take heart in knowing it will get easier over time. Reach out to other food allergy families and know you are not alone.

Both allergies and colds share a lot of similar symptoms:

• Sore throat
• Runny nose 
• Sneezing 
• Coughing 
• Feeling tired 
• Feeling achy

Honestly, it can be hard even for us to tell the difference when we examine kids.

HOWEVER, you don't get a fever with allergies. If you have a little fever (or a big fever), that's most likely a cold.

ALSO,  "itchiness" in general of nose and eyes, makes me think more allergies than cold.

AND, the time is important - Did  it come on really quickly? That's most likely a cold. Has it been going on for months with a slow onset? Most likely allergies.

Both allergies and colds can make you more susceptible to other problems like ear infections and sinus infections. That's why we say if your symptoms are lasting longer than 2 weeks, come in and see us so we can help.

"How do I know what to do?" Well, that depends on a lot of things.

Is your child under age 1? If so - this is more likely a cold than allergies (a child has to be alive longer than a year to develop allergies to their environment). Elevate the head of their crib. Stick a blanket under the mattress. Would you want to lay flat on your back with a bad cold? Suck out all that snot with a Nose Frida (dont knock it til you try it). Use saline drops. Tylenol (or ibuprofen if over 6 months) for the headaches and throat pain. Run a hot shower and sit in a steamy bathroom for a bit. And lots of lovins. There ain't much you can do for the tiny ones. They just have to push through it.

If they're over age 1 and they have what seems to be a cold, try some honey along with all of the above. It's been proven to help just as much as medication. There are some over-the-counter medications that have honey in them too. I wouldn't try cold medicines until they're at least 4. Studies don't even show that they help much.

If it's allergies - you have lots of over the counter options like Benadryl, Zyrtec, Claritin, and Allegra. Some nose sprays are also very helpful and we can prescribe those in the office. And there is a prescription medication called montelukast that I find can help some kids.

Also, a wise allergist once told me that if you rinse out your kid's nostrils when they come indoors, it helps a lot (it washes away all the allergens/pollens clinging to the hairs in the nose and really helps symptoms go away faster). You could also try nasal saline spray here and just have them hold their head over the sink.

Hugs!

Dr. Diane

1. Make sure your house is safe while you are away. Alert the neighbors that you will be out of town. Stop the mail and newspaper from delivering or make sure a neighbor can pick it up for you. Now there’s even technology available to set a timer on the lights in your house. The timer lets you keep your lights on and turn them off the same as you would if you were actually at home, making any potential bad guy think you are there.
2. Don’t let everyone know your plans. Remember it’s not only old high school friends and co-workers following your every move. Crooks are definitely Facebook and Twitter savvy. Don’t announce to everyone that you are taking off soon or that you are trying to get packed tomorrow. Do things the old fashioned way and call the people who need to know you will be out.
3. Get your rest. A report released by the AAA Foundation for Traffic Safety states that drivers who sleep only five or six hours in a 24-hour period are twice as likely to crash as drivers who get seven hours of sleep or more. Crash rates increase with every hour of lost sleep.
4. Make sure your child is secure in their car seat or booster before you travel. You can’t be too careful on the road, both in the U.S. and out of the country. Motor vehicle crashes are the No. 1 killer of kids 14 years and under in the United States.
5. And secure on the plane too. Buy the extra ticket for your baby and make sure your child is properly protected in an approved safety seat. The No. 1 way children are injured in planes is due to turbulence. For safety, children need to be either restrained in their safety seat or in the lap belt in the plane seat.
6. Bring a current picture of your child with you on your trip. Have a very specific description of what your child is wearing in case your son or daughter gets lost. In this day and age of cameras on your phone, it’s easy to take a picture of your child that morning.
7. This is an uncomfortable one, but so important. Let your child know it’s OK to scream and fight if someone tries to grab them. However, just throwing a fit may not work. We’ve all seen kids screaming and crying as parents carry them out of the store. If the child is old enough they need to know to scream “this isn’t my Mommy or Daddy, help me” instead of just screaming like they are upset because they were told “no.”
8. Traveling with asthma. Be sure to pack your child’s quick-relief medicine and long-term control medicine. Keep them where you can reach them and not packed away. Pack your peak flow meter, health insurance cards and your asthma action plan. Consider purchasing a portable nebulizer. Call ahead to where you are traveling and discuss your child’s triggers. Bring your child’s pillow and blanket from home.
9. Childproof your grandparents’ home. Make sure they know about any nut allergies or any other allergy they should know about during your stay. Check all the rooms for any electrical cords, cleaning supplies and loose pills on the floor. Grandparents usually leave them out so they can remember to take them. Don’t let this happen. Put the pills away. Often times they aren’t child proofed and kids can easily mistake them for candy. Also remember to unpack and put away any medications that you bring with you.
10. Avoiding food allergies takes extra prep work. Research local hospitals and medical care wherever you are traveling. Also call ahead or go online to find out about area grocery stores, restaurants and any other place you may stop along the way. Make your family aware. Yes grandma makes the best pecan pie, but make sure everyone knows your child has allergies and one bite can mean horrible consequences. Pack your own food if necessary. Stay alert and be prepared with your child’s medications
11. Be aware of the new surroundings for your kiddo. If they have a family pool without a fence, talk to your children about them. Make them aware of the dangers of stairs and banisters, and go outside with them to point out dangers, such as rakes, power tools, spots where there may be snakes and other critters.
12. Be safe. Cook Children's Trauma team sees lots of ATV/4-wheeler injuries during the holiday break. If your child is on an ATV, please make sure it's built for a child. No child under 5 should be on one at all, let alone driving it. If your child is on a bike, hover board or skateboard, please be sure your kids have on the proper safety equipment (helmets please) and establish the rule of safety first. With family over, it can be easy to think someone else is watching your kids. Mom and dad, make sure you are the ones responsible for supervision.

Hope this list helps during this busy time of year. Happy holidays from Cook Children’s.

Don't panic!

Kim Mangham, a Cook Children's pediatrician in Keller, said to get your kids outside even in the winter.

Spending time outdoors is a critical part of kids' fun, but it might also help promote a healthy and happy childhood.

The National Wildlife Federation points out that the decline in the average time kids spend outdoors correlated with escalating childhood obesity rates and Johns Hopkins researchers estimate that 1 in 10 U.S. children have a vitamin D deficiency, a vitamin they would naturally get from sun exposure. 

Numerous studies have concluded that Mycobacterium vaccae, a bacteria found in dirt, can help improve mood and brain function. 

There's also a reason mud makes your child so happy. Kids who play outside have higher levels of serotonin, a chemical in the brain linked to good moods and reduced stress.

"Getting dirty is an important part of being a kid," Dr. Mangham said. "The things that don't seem like a big deal to adults are wonderful and fascinating to children. Letting them draw patterns in the dust, shaping mudpies and making a mess can be a magical part of growing up."

About the author

Kim Mangham, M.D., is a Cook Children's pediatrician at 1601 Keller Parkway in Keller, Texas. She earned her medical degree at University of Texas Southwestern Medical School in Dallas. She completed the pediatric residency program at University of Oklahoma Health Sciences Center in Oklahoma City. Her interests include breastfeeding education as well as disease and injury prevention. Dr. Mangham is board certified in pediatrics.

You can read more on the FDA report from earlier today: It should be fairly easy to distinguish as the containers have “a Rocky Road pint with a Cookies 'n Cream lid, and contain Cookies 'n Cream Ice Cream.” They also will contain Cookies ‘n Cream ice cream and not Rocky Road, which should be hard to miss.

This mixup might be important for families with soy and wheat allergies which are contained in the Cookies ‘n Cream variety but not Rocky Road. Parents of children or adults with celiac disease should also be aware.

Children with soy and wheat allergies who ingest these substances present similar to other food allergies. Symptoms might start as itching around the mouth or hives which is a large, red and circular rash that covers the whole body.

Children with celiac disease who ingest gluten (which is present in wheat) can have with a wide variety of symptoms. These might include symptoms of belly pain, bloating, vomiting or diarrhea. Other issues that can be attributed to celiac disease are fatigue and behavioral changes or irritability. Other long term health consequences can result from untreated celiac disease.

If you have any of the mis-packaged product, you can return them to the place of purchase for a full refund.

About the author

Justin Smith is a pediatrician and the Medical Advisor for Digital Health for Cook Children's in Ft. Worth, TX. He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's checkupnesroom.com. His interest in communications started when he realized that his parents were relying more on the internet for medical information. He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” is set to open in Trophy Club in the Fall of 2016.

Unfortunately, for many children, allergies are simply a way of life in Texas. Usually, allergies occur in kids beginning at the age 2 years and older.

Physicians don’t know why some children suffer reactions when exposed to allergens such as pollen, ragweed and mold that can cause allergic symptoms, while others experience no problems at all.

Sometimes parents aren’t sure if their child has a cold or allergies. Some say you can tell by looking at the mucus. That’s not really the case. The only way to tell for sure is by seeing your pediatrician. But if your child develops cold-like symptoms at the same time every year (now for instance), he or she probably suffer from seasonal allergies.

Symptoms of allergies are often times similar to a cold – sneezing, itchy nose and/or throat, nasal congestion, clear, runny nose and coughing. With a cold, the symptoms run its course over a matter of days. With an allergy, the symptoms last as long as the child is exposed to allergens.

Parents should be especially careful that their child doesn’t develop wheezing and/or shortness of breath. That may mean your child’s allergies have progressed into asthma.

It’s possible to relieve allergy symptoms by eliminating or reducing a child’s exposure to allergens. A key, as you hear so often with colds and flu, is for your child to wash his or her hands often. Also, children should change clothing and shower after playing outside. Please don’t let your child mow the lawn during this time of year if they suffer from allergies.

Educating your child early about what causes allergic reactions and allergy symptoms is a crucial step in helping your child reduce or prevent allergic reactions.

Sometimes no matter how much you try to prevent allergy symptoms in your child, they still occur. Fortunately, various treatments are available to help your child when an allergic reaction happens, including:

• Over-the-counter medications. Some decongestants, antihistamines and nasal sprays can be purchased without a prescription. But even if you are thinking about picking up something from the drug store, please do not do so without contacting your pediatrician.
• Prescription medications. Those with more severe allergies might need stronger versions of over-the-counter medications prescribed by their pediatrician.
• Immunotherapy. Also known as allergy shots, these injections of allergens into the body help patients build tolerance to help relieve symptoms.

Eventually, your child might grow out of his or her allergy. However, until he or she does, talk to a pediatrician or allergy specialist to determine the best treatment option for your child.

But, is he allergic?

Listing medications as an allergy may not seem like a big deal, but it can have significant consequences:

1. Your doctor may have to choose “stronger” antibiotics that have more risk of side effects.
2. Your doctor may have to choose more expensive antibiotics.
3. Your doctor may have to choose antibiotics that are known to be less effective against your child’s infection.

If a medicine is listed as an allergy for your children, it will carry on with them into adulthood. When they are 30 and having to make big decision about their medical care, many will have no idea why a drug is listed as an allergy for them.

A recent study conducted in adults at the Mayo Clinic in Florida showed that, out of 384 adult patients who listed a penicillin allergy, 94 percent did not actually have an allergy after being tested. I knew it would be pretty high but, WOW!

Even if a child has a true reaction, the authors report that some people “outgrew” their allergic reaction over time. This is true no matter how severe the first reaction was.

Here are some questions to ask yourself and your doctor about possible drug allergies:

1. Was this an allergy or a side effect? There is a big difference.
2. If we are going to list this medicine as an allergy, does this mean to never try it again? Some doctors might recommend retrying an antibiotic later if the reaction was mild or possibly not truly related to the antibiotics. Some reactions are clearly allergic and the medicine should not be used again.
3. Should we have testing done (at some point) if we are unsure?

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . View more from The Doc Smitty at his Facebook page. He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.