Once the correct diagnosis is made, the most important factor in the successful management of food allergies is avoidance of the foods that are problematic.   
Without careful planning, the risk of an accidental exposure is high, which in turn can be fatal.    Unfortunately, this is a difficult process-but if done
consistently, it will become much easier.   

The key is to read food labels carefully.   While the labeling of food ingredients has improved in recent years, the individual with a food allergy, as well as the
care giver and family members should examine food labels consistently in order to find possible hidden ingredients.   Even foods that have been purchased for
years should be examined each time they are purchased, as the manufacturer may elect to change their recipe at anytime, resulting in the possible addition of a
food that the allergic individual may be sensitive to.   

Tips For The Home:

  • Eliminate from the house all foods that are causing food allergies.   This is especially important if a young child has food allergies.   If your small child is
    allergic to peanuts, you should not have any products that contain peanuts at home.   
  • Avoid peanut butter substitutes if you have a small child with peanut allergies.   While peanut butter substitutes do not have any peanuts in them, having
    them in the house may confuse your child who will think it is okay to eat it elsewhere.
  • Request that food brought in the house have ingredient labels.
  • Make sure everyone knows where you keep the epinephrine auto-injector and that everyone knows how to use it, including the baby sitter.
  • Look for foods manufactured from companies that specialize in food allergy avoidance - they can often be found in the "natural" sections of grocery
    stores and online such as  Peanut Free Planet, Enjoy Life Foods, Cherrybrook Kitchen,  Cookies for Me, and allergyfreefoods.

Tips For The Traveler:

Avoidance is fairly simple in the comfort of one’s home, but can much more difficult in other areas, such as friend’s houses, schools, restaurants, and other
public places.    In fact, most fatal and near-fatal food allergic reactions occur away from home.   These steps can help minimize the risks:

  • Do not assume that others know about your food allergy and what specific ingredients need to be avoided.  Educate family members, friends, teachers,
    and others about your food allergy.   Even if they tell you they know what to look for, tell them anyway.    
  • Make a card that list ingredients that need to be avoided for family, friends, and teachers.
  • If you have small children and visiting playmates, consider wiping their toys clean before letting your child play with them.
  • In restaurants, be sure to stress the life threatening potential of your food allergy, and ask to speak to the cook if possible.   Give a list of ingredients to
    avoid, raise awareness of the risk of cross-contamination, and ask for clean utensils and cookware to be used for your dish.  Do not share utensils with
    others at your table.
  • Ensure people wash their hands after meals.  Studies confirm that hand soaps, liquid soaps, and commercial wipes are effective in removing food
    allergens from the skin.   Note that alcohol-based hand sanitizers are not effective in removing food allergens from the skin.
  • Wipe the restaurant table or the airplane fold down tray to eliminate any possible food particles left from a previous person.
  • Bring your own food.  The school or airline cooking staff may be very good at dealing with food allergies, but mistakes do happen.   Bringing your own
    food is safest.
  • Have your child bring lunch from home, instead of buying the school lunches
  • Give your child’s teacher an alternate snack for “surprise events”.  The teacher can give this to your child should other students bring a treat for a
    special event (birthdays)
  • Before traveling, write down information about your food allergy in the language of the country you are visiting.   You can also download a free food
    allergy dictionary here - they have one for over 20 different languages, including Chinese, Polish, and Greek!
  • Get a medic alert bracelet and have it inscribed with your food allergies. Remember to always wear it.  You can get medic alert bracelets from
    various places including MedicAlert,  911medalert, and American Medical ID.  
  • Always bring your epinephrine auto-injector where ever you go.  If flying, keep you auto-injector in the original box that it came with, or bring a
    letter from your physician stating the need for you to bring it in the plane.

Consider joining the
Food Allergy & Anaphylaxis Network which offers additional tips, newsletters, and safety alerts when mislabelled food is identified.

Other useful links include:

The Food Allergy Initiative

Living Without magazine

updated 9 Sep 2009

References include:
Young et al. Management of food allergies in schools: A perspective for allergists.    
J Allergy Clin Immunology 2009;124:175-82.

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Coping with food allergies