Sanjay Gupta, MD, Everyday Health: How tough is it to really keep a kid, especially a kid, away from a potential allergen, maybe peanuts?

Jennifer Shih, MD, Allergy and Immunology, Emory Children’s Center: It’s difficult, and the worst part of it I think is it invokes a lot of anxiety from the parents as well as children. We know that children with allergies get bullied more than someone who has asthma or diabetes. People with food allergies get bullied more than that even.

Dr. Gupta: Why is that?

Dr. Shih: We don’t know. We’re not sure why that is.

Dr. Gupta: The packaging. You want to read the labels, I’m sure.

Dr Shih: Absolutely.

Dr Gupta: I mean, you’ve got to get pretty detailed in this.

Dr. Shih: Yeah. You’d be surprised. For instance, McDonald’s french fries have milk protein on them, but you wouldn’t even know that.

Dr. Gupta: You probably wouldn’t even know to ask.

Dr. Shih: Exactly. Most of the time you don’t think about that when you’re going in to order something.

So a lot of my patients who have food allergies, they make a lot of their food on their own, because they know what goes into it. And that’s the safest way because you know.

Dr. Gupta: But what about everything else in life, where the kids are going to a friend’s house, a party, movie theater, plane ride, things like that?

Dr. Shih: That is a risk. When you plan to go out anywhere, again it’s a very serious disease and you have to plan ahead and make sure you brought your medications with you. People with food allergies, about 40 percent of them will have anaphylaxis.

Dr. Gupta: When you’re talking to parents how do you emphasize that point? I mean, how do you really get that to be part of their lives?

Dr. Shih: It’s tough. Children can carry particular meds with them, which includes epinephrine injector.

Dr. Gupta: It seems like there are some airlines who are very diligent about not having any peanuts on planes, and there are some that are not. I was on a plane ride yesterday, and they served peanuts. First of all, it doesn’t take much to create a potentially allergic reaction. What would you recommend?

Dr. Shih: Generally we say you need to ingest the particular food, you need to ingest it to have an anaphylactic type reaction, but I certainly have patients who have a great history for not necessarily having to ingest the food. In fact, things like seafood – boiling it, sometimes that seems to cause some of the reactions.

Dr. Gupta: Really?

Dr. Shih: Yeah, so we don’t have great, definitive things to say: You have to get rid of the peanuts. But I always think that being cautious is better.
