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nut allergy protocol nut allergy restaurant
When “just a little bit of peanut sauce” teaches a lot

When “just a little bit of peanut sauce” teaches a lot

It’s OK to watch them breathe. To just sit there, watching their tiny chests move up and down.  To feel their breath on your hand.  To ask them repeatedly to say the words, “I’m OK, Mommy,” just so you can be sure. That’s what I did on the way to the hospital tonight. See, my littlest love has nut allergies.  He has an anaphylactic reaction to almonds, hazelnuts and peanuts.  To be safe, I keep him away from all nuts.  I have ever since we first learned of his allergy 4 and a half years ago.  But tonight, at one of our favorite restaurants, even after we mentioned the nut allergy and were told there were no nuts of any kind being used, the chef inadvertently put a little bit of peanut sauce into the noodles, which my son then ate. Spoiler alert:  He only ate a little bit before the chef realized the error and notified us, at which point we took away the noodles.  My son did not have an anaphylactic reaction today. But here’s the thing:  He could have.  He did get a few little red dots under his lip, which was the first thing that happened when he had his full-blown reaction the first time he ever ate peanut butter.  And while the reaction didn’t seem to progress beyond that this time, I just kept feeling in my gut that I needed to do something, and I kept hearing over and over in my head the doctor’s words from last time: The reaction can occur any time within 48 hours of the nut exposure. So what’s the point of this blog post if the reaction didn’t progress and there was a happy ending where we came home after just 30 minutes in the pediatric ER?  To remind parents — and myself — that you truly never can be too careful.  A nut allergy is no joke.

When a little bit of peanut sauce teaches a lot
AFter the ER

Speak up, every time

Food allergy parents are used to reading ingredient labels, to having designated plates or places in the house where siblings or friends can consume food that may contain nuts, strict hand-washing instructions for afterwards . . . a whole routine we’re used to for keeping our allergic child safe. We’re used to speaking up.  We ask in restaurants if we can see ingredient labels or talk to the chef.  We bring alternative snacks in our bags in case there is nothing safe for our child to eat. And we have our go-to places that we have come to trust. But we still need to ask and be reassured every time. The restaurant we were at tonight was a hibachi grill.  My usual routine is to tell the server that my son has a nut allergy.  She typically confirms there are no nut oils being used, and then she tells the chef.  When the chef arrives at the hibachi table and reviews our order before he starts cooking right there on the table, he usually confirms “and this one has a nut allergy.  Nothing with nuts is being used.” Tonight, we followed the first half of the routine.  The server confirmed. The chef came out and cooked.  But he didn’t mention the nut allergy. I mostly thought nothing of it, since the server had already confirmed, and we had never had an issue at this restaurant. But shortly after the meal was cooked and we were devouring it, the chef came back to the table and said he realized there is a nut allergy at the table, and he had put “just a little bit of peanut sauce in the noodles.” He did the right thing by telling us.  And the server had done the right thing by noting it on our order.  But I failed to double-check on behalf of my son.  Always double-check.  And then ask again.  Don’t worry about seeming annoying, or about seeming distrusting at a place you trust.  ASK.  And then ASK AGAIN.

Don’t assume others understand, but don’t fault them if they don’t

Thank you for apologizing, Mr. Chef, and for noting it was “just a little bit of peanut sauce.”  But even a little bit of peanut sauce could kill my kid. I know there are people out there who will say that if the allergy is that severe, shame on us for taking a risk by eating out.  I get it.  That’s not what this is about. My point is that the chef was appropriately apologetic, but clearly didn’t realize the potential severity of what was at stake.  I’m not sure I fully understood before having a child with food allergies.  Again, it’s up to us to make sure we are keeping our kids safe, which means educating friends and being willing to demand to see ingredient labels.  I’ve had friends say to me at birthday parties, for example, “I’m sure it’s fine”as they hand my kid a cupcake.  But I’m not sure.  Because that cupcake came from a bakery where they made it next to almond cake.  Or from scratch in a house where peanut butter chips are right next to other ingredients.  Or a box mix that says “may contain nuts.” My son was lucky tonight.  The amount of nut ingested was clearly tiny.  But the fact is, an allergic reaction to nuts can vary in severity every time.   So even though years ago D had an anaphylactic reaction and tonight he didn’t, that doesn’t mean that “just a little bit” is OK or that next time the reaction won’t be more severe. Even if those around you don’t fully understand, you need to do what your gut says is right.

Always have the meds on hand

I always have an EpiPen with me.  I always have Benadryl in the house.  But I never think I’ll need it. Tonight was a good reminder that you really can’t ever be caught without those supplies. If D had had a severe reaction at the restaurant and for some reason we didn’t have the EpiPen with us, this story likely would not have had a happy ending.  The thought of that is terrifying.  Always have your meds on hand — they’re literally an insurance policy you hope to never use, but one that is critical in times of need.

Stay calm and in charge, modeling good behavior

Since my son was 2 years old, he has been asking “is this nut-free?” before eating something.  We taught him that, and through routine, he has incorporated it into his snacking, mealtime, party behavior, playdates, visits to grandparents’ houses, etc. So tonight, even though I was having a mini-internal-panic, I calmly took the noodles away, repeatedly — but calmly — asked my son if he felt OK and peeked at his belly to check for hives, and every minute or so, engaged him in conversation to make sure he was breathing fine and was perfectly responsive. I explained to my other sons what was going on, but made sure not to use scary words or talk about worst case implications.  “D might need to go to the hospital, just so we can keep an eye on him.”  “He might feel sick, but right now he’s OK.” Once I spotted the red bumps under his lip, I gave him Benadryl and calmly collected some things to bring to the hospital, arranged with my husband that he should drive so I could sit in the back seat and watch D, and confidently left my other kids at their friends’ house across the street. No major reaction was occurring, but we needed to get D monitored, and doing so reminded all involved of the potential severity of a reaction and the seriousness of nut exposure.  I saw a post on Instagram this week that said something like “What you’re modeling, you’re teaching.” {I wish I could credit the author but I don’t recall who posted it– if it’s you, tell me).  I tried to remember that my kids were watching me and learning how to handle this in the future.

Trust your gut

A mother’s intuition.  Is it legit?  Seems like it. I admit I sent a “hey,what do you think?” text to two of my friends who are nurses, but to be honest, even before they replied, I knew I was taking D to the ER.  I knew I had to get him checked. But for about an hour, I doubted it.  Why?  If I felt in my gut that he had to be checked, which was even an informed gut feeling based on the fact that I knew a reaction could bubble up later, why did I bother second-guessing? I’m not sure.  But when the ER was done monitoring D and agreed he could go home, where I should continue to keep an eye on him, and they reassured the hubs and me that we had done the right thing by bringing him there, I realized I would never second-guess that gut again. It was helpful to have medical professionals review the appropriate action steps with us again. It was reassuring to have them say the amount ingested likely does impact the severity of the reaction, and that D looked good and was OK. It was extra-reassuring to have a doctor look at D’s tongue and throat multiple times to confirm there was no swelling.

Thank your village

I am so lucky to have a village.  Thank you to my sister, for the reassuring texts.  Thank you to my neighbors, for always being there — for your medical opinions and for watching my other kids so they didn’t have to come to the hospital with us.  Thank you to the friends who — even if they don’t have food allergy kids of their own — save ingredient labels for me to review at birthday parties or playdates, and who text me in advance to make sure whatever they’re serving is OK.  Thank you to the daycares who are nut-free and the preschools that are peanut-free.  Thank you to the school policies that have nut-free tables at lunchtime and for encouraging other kids to sit with the food allergy kids if they have a safe lunch.  Thank you to the doctors and nurses who answer our questions and serve as great role models themselves, equally expressing the severity of food allergies and the calm, controlled steps to managing them.  Thank you to the neighbors who make up special bags of Halloween candy they know are nut-free to give to D.  Thank you to the restaurants and theme parks who make ingredient labels readily available and who confidently describe the process in the kitchen when preparing food for food allergy customers. We food allergy parents would have it much rougher without you.  Thank you for helping me look out for my little D.     I’m not sure I’ll be comfortable going back to this favorite restaurant of ours.  But for now, I’m just happy D is OK, as he lies here sleeping next to me and I watch him breathe.

 

On the way home from the ER

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Dealing with nut allergies?  Here are some of our favorite nut-allergy-friendly snacks:

(be sure to read the ingredient label every time to confirm the allergens).

  • Wow Butter (soy spread that tastes just like peanut butter)
  • Enjoy LIfe brand of snacks (salty and sweet options!)
  • Fresh fruit
  • Plain Cheerios
  • Stonyfield Farm squeeze yogurt
  • Hoodsie cups and Breyer’s vanilla ice cream
  • Popsicle brand popsicles

2 thoughts on “When “just a little bit of peanut sauce” teaches a lot

  1. Great post, Karen! Glad D is ok.
    J has peanut allergy, but has never had anaphylaxis with it so far. But we always keep the Benadryl and Epi with us too. We also like the “Don’t Go Nuts” and “Made Good” products.
    Above all, thank you for the reminder to trust our gut. I second guess myself too, when I shouldn’t.

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