A Very Careful Thanksgiving

Raising a child with food allergies has shown me how generous people can be. I’m so thankful.

A typical Thanksgiving plate.
A typical Thanksgiving plate includes many potential hazards for a child with food allergies.

Photo by Vstock

Like other American families, mine will celebrate Thanksgiving mostly by eating. However, because of food allergies, we will do so very, very carefully. The younger of my two daughters is allergic to eggs, milk, tree nuts, peanuts, and flaxseed, so before I buy a turkey, I’ll read every ingredient listed on the packaging, as I read every ingredient on every item I bring into our house throughout the year. For our family feast, we’ll make green beans and sweet potatoes with “nondairy buttery spread,” Pillsbury crescent rolls (that buttery flavor isn’t from butter), and vegan pumpkin pie. If we make salad, it won’t have nuts in it, and if we put out crackers, they won’t be accompanied by cheese. As for the bird: If you’ve never needed to consider the issue, you might reasonably assume that turkey contains, well, turkey—but in fact it can also contain an array of other ingredients, including milk and soy.

I have always been a hearty eater, and, growing up, our family dinners represented the intersection of large appetites and raucous conversations. However, there are few meals from my past, including the traditional Thanksgiving one, that I can share with my daughter in their original form.

Since my daughter, now almost 3, was diagnosed with food allergies just before her first birthday, my relationship with food has changed completely, and eating, especially outside our house, requires great caution and planning. Ironically, the more “festive” the situation, the more stressful it tends to be: We go to restaurants as a family only every few months, and though I attempt to do so politely, I always interrogate the server about how the food is prepared. We take our own cupcakes to birthday parties, and when we went to a neighbor’s house for pizza night recently, my daughter and I brought our own pizza (while my husband and older daughter sometimes eat food in front of my younger daughter that she’s allergic to, I try to avoid doing so; based on anecdotal evidence, this pattern seems common among mothers). Another family’s holiday party where the dining room table is loaded with glistening platters—a sight that once would have activated my salivary glands and filled me with delight—is now a source of anxiety. At such parties, I consider myself to be my daughter’s bodyguard.

And yet, in spite of the challenges, I believe my daughter’s allergies have made me a more thankful person. To begin with, I am thankful for everyone who makes life for people with allergies easier and safer rather than harder and more dangerous—the medical researchers trying to figure out why allergies have increased in recent years and how they can be treated, as well as the doctors and nurses actually caring for allergic patients; the relatives and babysitters who must be coached on where the EpiPens are kept and how to use them, just in case; and especially the teachers who every day try to keep their classrooms safe without making allergic students feel singled out.

As most parents of allergic children do, I communicated with my daughter’s teachers and school director before classes began this year to make sure we were all on the same page food-wise. I was touched when, on their own, the teachers decided that birthdays in my daughter’s classroom would be celebrated not with cake or other edible treats but by the students together decorating a paper “birthday crown.” I get that a crown isn’t the same as a sugary snack—in fact, the first time a child in the room received his, it was my own daughter who asked, “Where’s his cake?” But it’s because it’s not the same that I’m grateful. I understand that a trade-off is occurring and that my family members are the beneficiaries.

I am similarly grateful to the friends who matter-of-factly help me figure out ways our family can safely visit their family’s house. This usually means discussing the menu ahead of time so that we can bring allergy-safe versions of the food they’re serving, or their saving packaging on foods so I can read the list of ingredients. Just as with the classroom accommodations, it’s not that I don’t realize that my family is, frankly, a bit of a pain in the ass; it’s simpler when people don’t have allergies than when they do. But my daughter is like other children, our family is like other families, and we want to participate in the world—to play at playgrounds and dress up for holiday parties and see what the inside of other people’s houses look like. We appreciate when we can do so without risking our health.  

I’m also thankful for the ease with which the Internet allows people affected by allergies to find one another. My personal favorite blogger is cookbook author Kelly Rudnicki, who blogs as the Food Allergy Mama. I love Rudnicki. Her cookbooks avoid exactly the foods my daughter is allergic to—eggs, milk, nuts—which are also the foods Rudnicki’s son John is allergic to. Rudnicki’s recipes inspire in me a gratitude akin to what I experience flying from New York to California, when I think of the American pioneers: Just as I get to enjoy in mere hours a trip that required my hardy forebears arduous years to complete, I imagine that I’m benefitting from Rudnicki’s extensive trial and error in her own kitchen.

I’m not a sophisticated or intuitive cook, and I didn’t know before acquiring The Food Allergy Mama’s Baking Book: Great Dairy, Egg, and Nut Free Treats for the Whole Family that it’s possible to make a cake without eggs or butter. On my daughter’s first birthday, her “cake” was a mix of pureed sweet potatoes with nondairy yogurt I’d spread on top to resemble icing. Even with a glowing candle, my daughter was about as tempted by this concoction as you’d probably be. But since then, with Rudnicki as our guiding star, we have baked not only cake but also muffins and pancakes and cookies, pies and doughnuts and pretty much every other tooth-rotting, decadent dessert that makes childhood, and life, sweeter. (One of Rudnicki’s secret weapons is shortening, about which she writes, “If plain Crisco was good enough for James Beard, it’s good enough for me.”)

I also appreciate the cheerful pictures of Rudnicki’s family that appear in her cookbooks; she and her husband have five children total, four of whom don’t have allergies. I wish that everyone who imagines kids with allergies, and their parents, to be Purell-dispensing, hazmat suit–wearing freaks of nature could see these delightful photos. (And by the way, hand sanitizers such as Purell don’t actually remove allergens from hands or surfaces—wipes or plain, old-fashioned soap and water are necessary.)

Despite public misunderstanding of and negative stereotypes around allergies, there surely has never been a better time to be allergic. The reason for this—the unexplained increase in allergies—is unfortunate. A 2013 study by the Centers for Disease Control and Prevention showed a 50 percent increase in food allergies among American children between 1997 and 2011, and an estimated 15 million people in the U.S. now have food allergies, according to the advocacy organization Food Allergy Research & Education. But these discouraging numbers also mean we’ve reached a kind of allergic critical mass.

On Nov. 13, President Obama signed into law the School Access to Emergency Epinephrine Act, encouraging schools to keep epinephrine autoinjectors—commonly referred to as EpiPens, though there are other brands—for students who don’t have their own, including those students having a reaction to a previously undiagnosed allergen. (As it happens, the Obamas themselves know something about food allergies because Malia Obama is allergic to peanuts.) Also this fall, the CDC released guidelines for managing food allergies in schools. These guidelines represent a milestone in setting standards for thoroughness and consistency across the country; they recommend best practices for everyone from cafeteria employees to bus drivers.

In addition to recent legislative advances, people with allergies have benefitted for almost a decade from the Food Allergen Labeling and Consumer Protection Act of 2004, which requires that the eight most common allergens—peanuts, tree nuts, eggs, milk, soy, fish, shellfish, and wheat, which combined account for 90 percent of all food allergies—be clearly identified on packaging.

Prior to 2004, as Susan Weissman describes in her book Feeding Eden, if you wanted to know what was really in that box of crackers, you’d have to spend hours writing to or waiting on the phone with manufacturers. “If invited,” Weissman writes in her account of the early years after her son’s allergies were diagnosed, “I would have happily donned a hairnet to inspect a General Mills factory.”

Weissman also writes of blending sunflowers to make a “paste”; today, SunButter, which is similar in texture, appearance, and nutrition to peanut butter, is manufactured commercially and sold everywhere from Whole Foods to Target. In my own family, we go through so much of it that we order six-packs online.

Indeed, in 2013, there’s practically a cottage industry devoted to the allergic community: Cherrybrook Kitchen makes cake and cookie mixes free of peanuts, tree nuts, eggs, and milk, and Enjoy Life avoids all of the top eight allergens. Chocolate candy is often made on equipment that also processes nuts, meaning even if a particular bar doesn’t contain milk or, say, almonds, it still isn’t safe to serve my daughter because of potential cross-contact. So we buy Enjoy Life’s Ricemilk Crunch bars, similar to Nestlé Crunch bars, in bulk. And yes, there are greater tragedies than not eating chocolate bars; at the same time, when you’re a 2-year-old, it’s nice to get to see what all the fuss is about.

Among other current allergy innovations I’m thankful for is AllergyEats, the allergy-focused equivalent of Yelp—a dining database that relies on the public to assign “Allergy Friendliness Ratings” to restaurants. Paul Antico, a Massachusetts father of allergic children, started the company in 2008 after an evening during which he drove his increasingly ravenous sons from one restaurant to another in search of a place he felt confident they could safely have dinner.

These days, even the American Girl doll company makes an “allergy-free lunch” bag that comes complete with a tiny epinephrine autoinjector. While I applaud American Girl’s thoughtfulness, perhaps this is an appropriate place to mention that, as with life in general, allergies are easier if you have money; obviously, for most parents, the most pressing concern isn’t whether their daughter’s medical equipment matches her doll’s. The Journal of the American Medical Association recently estimated that having a child with allergies costs $4,180 more per year than a child without them, with $750 going toward food and the rest to medical costs and parental time off work. Although allergies are sometimes misunderstood to be a malady of the upper-middle class, they’re not. Many assistance programs exist for epinephrine autoinjectors, and the challenges of families on food stamps, or those who rely on food banks, are only magnified when the foods they’re able to eat are restricted due to allergies. At my local grocery store in St. Louis, the discrepancy in cost between allergy-friendly products and “regular” products is glaring: This past weekend, a 10-ounce jar of Jif peanut butter was on sale for $2.99—the usual price is $3.29—while a 10-ounce jar of SunButter was $6.99.

In spite of progress, there’s obviously still plenty of work to be done; the reality is that living with allergies requires extreme caution whenever eating occurs, and eating occurs everywhere, all the time. My own family is in the early stages of dealing with allergies, and I know that the challenges shift over time: food allergy–related bullying is a problem with older children, and adolescents experience the highest rate of anaphylaxis, both because of physiological changes in their bodies and because of teenagers’ propensity for taking risks. Still, when I think of how much better things are for my daughter now than they would have been even 10 years ago, I feel not only grateful but also optimistic about the future—and usually, I’m not much of an optimist. So to everyone out there who makes life safer, tastier, and more inclusive for people with allergies, thank you. From my family to yours, Happy Thanksgiving.