Dealing with severe nut allergies in France

[Anonymous]

Anonymous wrote:As an allergy parent, I’m kind of skeptical your child could have a “severe allergy” you are just discovering in ES.

Putting that aside, epinephrine, if given quickly, is extremely effective and not something you should be wary of using. My daughter sees Dr. Wood at Hopkins, failed a food challenge there, and I’ve seen epinephrine in action. A miracle drug. There is no downside to giving Epi even if you are unsure if the person “needs” it.

Wow. Just wow.

[Anonymous]

Anonymous wrote:

Anonymous wrote:As an allergy parent, I’m kind of skeptical your child could have a “severe allergy” you are just discovering in ES.

Putting that aside, epinephrine, if given quickly, is extremely effective and not something you should be wary of using. My daughter sees Dr. Wood at Hopkins, failed a food challenge there, and I’ve seen epinephrine in action. A miracle drug. There is no downside to giving Epi even if you are unsure if the person “needs” it.

OP here, at age 3 we noticed that she vomited a couple times after ingesting nuts. She'd vomit immediately, and then be totally fine. We took her to an allergist at age 4 to confirm the allergy, and he mentioned that there's always a possibility it could get worse later. We didn't really take this seriously, but she had a pretty severe reaction recently that required an Epipen for the first time. My spouse is a peds ER doc so we're lucky in that regard, but want to avoid any reactions that require it if we can help it.

OP again, and by severe reaction, I mean vomiting multiple times, even a while after the Epipen was given, wheezing, severe stomach pain, pain in throat, etc. It's surprising to me because neither spouse nor I have any allergies, and I didn't think it would get this severe, but here we are.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
I'm French and just had to deal with this several times this past year when we traveled back and forth to various places in France.

Europe is not allergy-friendly, despite huge progress recently when they made it the law that each restaurant, bakery, chocolaterie, etc, have a binder with a table of allergies for each of their product. When we asked, the binder was produced rapidly, was easy to read, and we could look up the possible contaminations. Well and good.

BUT!

At Parc Asterix, a theme park near Paris, the Ile Flottante dessert, which the binder said was nut-free because it's made with beaten egg whites floating on cream, actually had ALMOND SLIVERS all over it. It was lucky the contaminant was highly visible and we avoided that dessert, otherwise my son would have eaten it and had an anaphylactic reaction.

The problem is that this is so new to most people in France, that some don't even know what kinds of foods are included in the nut category. They actually had to create a category, because the translation of nut in French is walnut, a specific type of nut. So they call the nut category "fruits a coque" (literal translation: fruits with shell), which I am sure most French people had never heard about prior to this new law. Just before the law was passed, two years ago, we visited a patisserie and wanted an assortment of little tarts, and asked the owner which ones were nut-free. She did not know what we were talking about, and directed us to something with pistachios, the food to which my son is most highly allergic.

So ask for the binder, tell them which foods he is specifically allergic to, and never separate your child from his Epipen, even if you think you're not eating any time soon. Visually inspect and taste the food, and always be vigilant.

OP here, thanks so much to all PPs, very helpful. I should have mentioned, we will be in the south of France, near Antibes and later in Nice. Would you have any additional suggestions/advice given this location?

Also, would the term "fruits a coque" be familiar in the south of France? Not sure how long the term has been around. I just checked an email from the school nurse (kid attends the French school), and I see that she used the word "noix." Would this be adequate to describe her tree nut allergy? We speak a little French, but neither of us are fluent. Actually, I just realized that maybe we should speak to the school nurse re: any suggestions too.

I'm a little bummed that she won't be able to eat a lot of delicious things while there if it has nuts or may be exposed to nuts in the kitchen, but want to keep her safe.

Of course they will know what 'fruits à coque" means in the south ... French is spoken from north to south ... that's amazing, right? lol
It's not a specific term, it's the translation of "nut'. So anybody you talk to will understand.
Someone has already explained (she's French), that "noix" means "walnut". Therefore you need to say "fruit à coque" and not "noix" when you mention your kid's allergy in French.

[Anonymous]

Anonymous wrote:

Anonymous wrote:As an allergy parent, I’m kind of skeptical your child could have a “severe allergy” you are just discovering in ES.

Putting that aside, epinephrine, if given quickly, is extremely effective and not something you should be wary of using. My daughter sees Dr. Wood at Hopkins, failed a food challenge there, and I’ve seen epinephrine in action. A miracle drug. There is no downside to giving Epi even if you are unsure if the person “needs” it.

Wow. Just wow.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
I'm French and just had to deal with this several times this past year when we traveled back and forth to various places in France.

Europe is not allergy-friendly, despite huge progress recently when they made it the law that each restaurant, bakery, chocolaterie, etc, have a binder with a table of allergies for each of their product. When we asked, the binder was produced rapidly, was easy to read, and we could look up the possible contaminations. Well and good.

BUT!

At Parc Asterix, a theme park near Paris, the Ile Flottante dessert, which the binder said was nut-free because it's made with beaten egg whites floating on cream, actually had ALMOND SLIVERS all over it. It was lucky the contaminant was highly visible and we avoided that dessert, otherwise my son would have eaten it and had an anaphylactic reaction.

The problem is that this is so new to most people in France, that some don't even know what kinds of foods are included in the nut category. They actually had to create a category, because the translation of nut in French is walnut, a specific type of nut. So they call the nut category "fruits a coque" (literal translation: fruits with shell), which I am sure most French people had never heard about prior to this new law. Just before the law was passed, two years ago, we visited a patisserie and wanted an assortment of little tarts, and asked the owner which ones were nut-free. She did not know what we were talking about, and directed us to something with pistachios, the food to which my son is most highly allergic.

So ask for the binder, tell them which foods he is specifically allergic to, and never separate your child from his Epipen, even if you think you're not eating any time soon. Visually inspect and taste the food, and always be vigilant.

As a French person, what do you think of OP's idea to pack their own food for their child when they go to restaurants. Do you think most restaurants would be ok with that?

I've never seen someone do that, but since it's for a child with a severe allergy, no one will criticize. Children are important in Latin countries

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As an allergy parent, I’m kind of skeptical your child could have a “severe allergy” you are just discovering in ES.

Putting that aside, epinephrine, if given quickly, is extremely effective and not something you should be wary of using. My daughter sees Dr. Wood at Hopkins, failed a food challenge there, and I’ve seen epinephrine in action. A miracle drug. There is no downside to giving Epi even if you are unsure if the person “needs” it.

Wow. Just wow.

Agree - how not very helpful. In case it's of interest, we discovered our DD's severe peanut allergy when she was 5 1/2. Again, there had been hints, but we didn't figure it all out, until the reaction was pretty severe, but fortunately not the worst possible. Got her in to be tested the next day. Please, as a fellow food allergy parent, consider helping people navigate this stressful world, not put them down.

OP, I hope you have a great trip. I am sure it'll be stressful, but the card idea is a good one. Also, bring some safe snacks (or buy them once there), so you can always have a substitute if you stop impromptu and don't feel confident with the information you're getting.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
I'm French and just had to deal with this several times this past year when we traveled back and forth to various places in France.

Europe is not allergy-friendly, despite huge progress recently when they made it the law that each restaurant, bakery, chocolaterie, etc, have a binder with a table of allergies for each of their product. When we asked, the binder was produced rapidly, was easy to read, and we could look up the possible contaminations. Well and good.

BUT!

At Parc Asterix, a theme park near Paris, the Ile Flottante dessert, which the binder said was nut-free because it's made with beaten egg whites floating on cream, actually had ALMOND SLIVERS all over it. It was lucky the contaminant was highly visible and we avoided that dessert, otherwise my son would have eaten it and had an anaphylactic reaction.

The problem is that this is so new to most people in France, that some don't even know what kinds of foods are included in the nut category. They actually had to create a category, because the translation of nut in French is walnut, a specific type of nut. So they call the nut category "fruits a coque" (literal translation: fruits with shell), which I am sure most French people had never heard about prior to this new law. Just before the law was passed, two years ago, we visited a patisserie and wanted an assortment of little tarts, and asked the owner which ones were nut-free. She did not know what we were talking about, and directed us to something with pistachios, the food to which my son is most highly allergic.

So ask for the binder, tell them which foods he is specifically allergic to, and never separate your child from his Epipen, even if you think you're not eating any time soon. Visually inspect and taste the food, and always be vigilant.

OP here, thanks so much to all PPs, very helpful. I should have mentioned, we will be in the south of France, near Antibes and later in Nice. Would you have any additional suggestions/advice given this location?

Also, would the term "fruits a coque" be familiar in the south of France? Not sure how long the term has been around. I just checked an email from the school nurse (kid attends the French school), and I see that she used the word "noix." Would this be adequate to describe her tree nut allergy? We speak a little French, but neither of us are fluent. Actually, I just realized that maybe we should speak to the school nurse re: any suggestions too.

I'm a little bummed that she won't be able to eat a lot of delicious things while there if it has nuts or may be exposed to nuts in the kitchen, but want to keep her safe.

PP you replied to. The law is the same for the entire European Union, but some people will not be familiar with the "fruits a coque" term. "Noix" is the go-to translation of nut, but it actually means walnut, hence the confusion. I say: "Mon fils est allergique aux fruits a coque, c'est-a-dire les arachides, les pistaches, les amandes, les noisettes et les noix de cajou, et les pignons de pin." Ironically, one of the only nuts he's not allergic to is the walnut, the "noix"! "Arachide" and "cacahouete" are used interchangeably for peanut.

Bread products and pastries are the most dangerous, but be aware of ice cream, and also mortadella, that sliced ham with pistachios. Since my son is allergic to pine nuts and cashews, and pesto can be made with this, we also have to avoid pesto.

[Anonymous]

Anonymous wrote:As an allergy parent, I’m kind of skeptical your child could have a “severe allergy” you are just discovering in ES.

Putting that aside, epinephrine, if given quickly, is extremely effective and not something you should be wary of using. My daughter sees Dr. Wood at Hopkins, failed a food challenge there, and I’ve seen epinephrine in action. A miracle drug. There is no downside to giving Epi even if you are unsure if the person “needs” it.

I'm the French PP, and OP's experience with her child was ours as well. My son started to vomit spectacularly as a preschooler, and symptoms got progressively worse, and with a wider variety of nuts, to which he did not initially test positive. We need to retest frequently. Recently he had his first weekend away with his school club, and I was a basket of nerves the entire weekend, not knowing how he would deal with bringing his epipen everywhere and asking the right person for ingredients. There were no problems, thank goodness, but it's so stressful raising a child with an anaphylactic allergy.

We are considering doing OIT, oral immuno therapy. Still have some research to do.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
I'm French and just had to deal with this several times this past year when we traveled back and forth to various places in France.

Europe is not allergy-friendly, despite huge progress recently when they made it the law that each restaurant, bakery, chocolaterie, etc, have a binder with a table of allergies for each of their product. When we asked, the binder was produced rapidly, was easy to read, and we could look up the possible contaminations. Well and good.

BUT!

At Parc Asterix, a theme park near Paris, the Ile Flottante dessert, which the binder said was nut-free because it's made with beaten egg whites floating on cream, actually had ALMOND SLIVERS all over it. It was lucky the contaminant was highly visible and we avoided that dessert, otherwise my son would have eaten it and had an anaphylactic reaction.

The problem is that this is so new to most people in France, that some don't even know what kinds of foods are included in the nut category. They actually had to create a category, because the translation of nut in French is walnut, a specific type of nut. So they call the nut category "fruits a coque" (literal translation: fruits with shell), which I am sure most French people had never heard about prior to this new law. Just before the law was passed, two years ago, we visited a patisserie and wanted an assortment of little tarts, and asked the owner which ones were nut-free. She did not know what we were talking about, and directed us to something with pistachios, the food to which my son is most highly allergic.

So ask for the binder, tell them which foods he is specifically allergic to, and never separate your child from his Epipen, even if you think you're not eating any time soon. Visually inspect and taste the food, and always be vigilant.

OP here, thanks so much to all PPs, very helpful. I should have mentioned, we will be in the south of France, near Antibes and later in Nice. Would you have any additional suggestions/advice given this location?

Also, would the term "fruits a coque" be familiar in the south of France? Not sure how long the term has been around. I just checked an email from the school nurse (kid attends the French school), and I see that she used the word "noix." Would this be adequate to describe her tree nut allergy? We speak a little French, but neither of us are fluent. Actually, I just realized that maybe we should speak to the school nurse re: any suggestions too.

I'm a little bummed that she won't be able to eat a lot of delicious things while there if it has nuts or may be exposed to nuts in the kitchen, but want to keep her safe.

PP you replied to. The law is the same for the entire European Union, but some people will not be familiar with the "fruits a coque" term. "Noix" is the go-to translation of nut, but it actually means walnut, hence the confusion. I say: "Mon fils est allergique aux fruits a coque, c'est-a-dire les arachides, les pistaches, les amandes, les noisettes et les noix de cajou, et les pignons de pin." Ironically, one of the only nuts he's not allergic to is the walnut, the "noix"! "Arachide" and "cacahouete" are used interchangeably for peanut.

Bread products and pastries are the most dangerous, but be aware of ice cream, and also mortadella, that sliced ham with pistachios. Since my son is allergic to pine nuts and cashews, and pesto can be made with this, we also have to avoid pesto.

OP again, thank you. Our kid can actually eat peanuts; allergy is only to tree nuts. The bolded reminds me of an incident in Whole Foods when my then toddler tried a pesto sample, and immediately vomited near checkout--that was fun. We didn't know she had an allergy back then.

Kid has actually been to Paris a couple years ago and everything was fine, but again, just want to take more precautions now since the allergy seems to have gotten worse.

I'll look at the suggested allergy card, talk to school nurse, make sure to carry Epipen and snacks, and hope for the best. Thanks all!

[Anonymous]

Anonymous wrote:

Anonymous wrote:As an allergy parent, I’m kind of skeptical your child could have a “severe allergy” you are just discovering in ES.

Putting that aside, epinephrine, if given quickly, is extremely effective and not something you should be wary of using. My daughter sees Dr. Wood at Hopkins, failed a food challenge there, and I’ve seen epinephrine in action. A miracle drug. There is no downside to giving Epi even if you are unsure if the person “needs” it.

I'm the French PP, and OP's experience with her child was ours as well. My son started to vomit spectacularly as a preschooler, and symptoms got progressively worse, and with a wider variety of nuts, to which he did not initially test positive. We need to retest frequently. Recently he had his first weekend away with his school club, and I was a basket of nerves the entire weekend, not knowing how he would deal with bringing his epipen everywhere and asking the right person for ingredients. There were no problems, thank goodness, but it's so stressful raising a child with an anaphylactic allergy.

We are considering doing OIT, oral immuno therapy. Still have some research to do.

OP here. We have friends with a child who has a tree nut allergy who did OIT--they mentioned that not many providers do it in the DC area, but they have had good success finding an allergist who does it out West where they moved.

I guess it also depends on the type of allergy a kid has? We raised OIT with our kid's allergist, and he said that she's not a good candidate, and that she's not likely to outgrow hers.

[Anonymous]

Anonymous wrote:

Anonymous wrote:As an allergy parent, I’m kind of skeptical your child could have a “severe allergy” you are just discovering in ES.

Putting that aside, epinephrine, if given quickly, is extremely effective and not something you should be wary of using. My daughter sees Dr. Wood at Hopkins, failed a food challenge there, and I’ve seen epinephrine in action. A miracle drug. There is no downside to giving Epi even if you are unsure if the person “needs” it.

Wow. Just wow.

Yeah, totally rude.

Signed, parent to a kid allergic to peanuts and almost all treenuts

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As an allergy parent, I’m kind of skeptical your child could have a “severe allergy” you are just discovering in ES.

Putting that aside, epinephrine, if given quickly, is extremely effective and not something you should be wary of using. My daughter sees Dr. Wood at Hopkins, failed a food challenge there, and I’ve seen epinephrine in action. A miracle drug. There is no downside to giving Epi even if you are unsure if the person “needs” it.

Wow. Just wow.

Yeah, totally rude.

Signed, parent to a kid allergic to peanuts and almost all treenuts

NP here and you, 1st PP, are not just rude but dangerous. First, OP and others' experiences with increasingly symptomatic reactions in subsequent exposures are well-documented. Just because it wasn't your experience doesn't mean it doesn't exist and you should not be making uninformed statements that could cause someone experiencing this type of escalation, or at risk of this type of escalation, to dismiss the possibility of a future severe reaction.

Second, of course epi pens can be highly effective and of course you should not be wary of giving it if it's called for, but you should avoid the potential need to give it as much as possible and OP is right to be asking questions and making plans for travel. People die even after epi pen treatment, such as this girl, whose father was a doctor and was present the whole time:
https://www.cbsnews.com/news/13-year-old-dies-at-sacramento-camp-from-peanut-allergy-despite-receiving-medicine/

OP, I'm sorry my post isn't helpful to you. It seems like you are on top of things, as much as any of us can be.

[Anonymous]

Anonymous wrote:As an allergy parent, I’m kind of skeptical your child could have a “severe allergy” you are just discovering in ES.

Putting that aside, epinephrine, if given quickly, is extremely effective and not something you should be wary of using. My daughter sees Dr. Wood at Hopkins, failed a food challenge there, and I’ve seen epinephrine in action. A miracle drug. There is no downside to giving Epi even if you are unsure if the person “needs” it.

Allergies can develop at any time. My son's grandmother developed a life threatening fish allergy overnight in her 70's after eating fish her whole life.

[Anonymous]

Hi OP,

Allergy mom here. I would highly highly recommend looking into oral immunotherapy therapy (OIT) where they desensitize your child to their allergen gradually over time.

My child was anaphylactic to peanuts but just graduated from OIT and now eats peanuts every day. Our OIT allergist is in Gaithersburg, MD if you would like their contact info. And if you'd like to learn more about it, there is a great OIT 101 group on FB: https://www.facebook.com/groups/OIT101/

Also, I would take at least 2-3 sets of epi-pens and make sure to keep at room temp and protected from extreme hot or cold temps. If you suspect a reaction, always epi without delay. The only side effect for an epi is increased heart rate so its always best to use it even when you're not sure if you should.

As far as meals, I would pack all meals as much as possible since France does not seem very allergy-friendly. Hope this helps and hope you have a great trip!

[Anonymous]

I’d think about renting a place and doing your own cooking. While American restaurants are used to orders like “no, tomatoes, dressing on the side” type orders, from what I’ve seen, French restaurants do less of this.

The popular nuts there are hazelnut and almonds. I can’t see how you can get anything from a boulangerie or pâtisserie because of the risk of cross contamination.