Managing peanut allergy

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to carry at least two Epi pens everywhere, in case one malfunctions or the ambulance is delayed in coming. As soon as the child is able they need to carry two themselves. Be sure they know how to use them. Practice regularly with the trainer.

We always also have albuterol and Benadryl.

Ask the allergist when to use. One PP said use upon two symptoms. Ours said use upon confirmed exposure even if asymptomatic.

If you use epinephrine the person needs to go by ambulance to the emergency room.

Epi pens are not magic talismans. They don’t always work. They sometimes need to be repeated.

Your child needs to learn to self-advocate about allergies as soon as possible. Teach them to read every label every time. Ingredients change. No unlabeled or homemade outside snacks. Send your own treats to school. Be very particular in restaurants. Be aware of potential language issues — we were assured that a bakery product contained no nuts. Then informed “only nut flour” when we asked a second time.

They need to be aware of environmental contamination. Like the kid in class who brings a peanut butter sandwich and then uses a finger to scrape out and eat the peanut butter. Or the contaminated trash in a cafeteria trash can. Or the person one row away in an aircraft who is eating peanuts.

I believe there is a sensitivity-reducing shot and desensitization treatments. We are not there yet, so I leave it to others with knowledge to discuss them.

I have a 12 year old peanut allergic kid and agree with most of this with a couple caveats and can add some info about OIT.

As to bolded, some kids really are not this sensitive to peanuts in their environment. Mine isn't. We eat peanut butter in our household. My kid has zero sensitivity to being near peanuts. I understand some kids do. But this is an added level of hyper-vigilance that isn't necessary for some kids.

We did the OIT and it worked. The part I didn't anticipate is my child HATES HATES HATES the taste of peanuts. This makes sense. Her body is trained to really dislike the thing that is going to make her sick. However, when you get to the end the maintenane is eating some amount of peanut daily. We tried all vehicles. The peanut, some peanut butter, a peanut m&m, a reeses pieces. She hated all of them. She was about 10 at the time we did this. It was a nightly battle and we just gave up. I could not see sustaining forcing her to eat something she hated. I think with an older kid it could be eaiser.

As to the follow up bolded, without claiming any scientific/literature based special knowledge, I suggest it is extremely dangerous to be casual about any level of potential exposure. I don’t think it is “hyper vigilance.”

The example given was someone in the next row on an airplane eating peanuts and "contaminated" trash in a trashcan at school. What is your plan for these scenarios? Wear a hazmat suit in the plane and tell your child not to dumpster dive in the trash?

I think a reasonable warning is to say if your friend is eating a peanut butter sandwich, be aware and don't share any utensils or plates.

The plan for the airplane was to ask the person to stop and put the product away or get rid of it. And we did exactly that with good result when it happened.

As for the trash the real concern was that DC’s school had students in groups to clean up after lunch. We asked for an assignment that didn’t involve food residues or trash.

I think this level of vigilance is about your own anxiety level and wanting to assert a level of control over your environment that you don't really have. And I think it makes your kid anxious too.

Read labels, speak up, teach the kid to advocate for themselves. Hammer it home early and often. In particular, do not eat unwrapped candy or baked goods where you don't know the origin. Carry the epi pen at all times. The rest of it, you can't control other people. People around you can and will eat peanuts.

I suspect you don’t have an allergy either.

Nobody in their right mind eats peanuts on public transit any more.

As for the lunchroom, you’re suggesting not handling peanut-contaminated items is anxiety-driven? Please.

Wrong again. You think people respond in this level of detail if they don't have an allergic kid? Why would a person be on this thread?

You're a fool if you think people have stopped eating peanuts in public. They haven't. The world does not revolve around our peanut allergic kids. I think more people are aware of nut allergies than ever before and many kid-based settings are really good about it. But in the general population? No.

Ah, puerile name calling and ad hominem attack. Always the best way to strengthen an argument.

People assert themselves for their own benefit all the time. “Excuse me, I believe I was before you in line.” Why should a person with a life-threatening allergy be expected to remain silent because many, even most, people think of peanuts as a tasty, filling, low carb snack? The people we’ve occasionally asked for an accommodation have always been very gracious.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to carry at least two Epi pens everywhere, in case one malfunctions or the ambulance is delayed in coming. As soon as the child is able they need to carry two themselves. Be sure they know how to use them. Practice regularly with the trainer.

We always also have albuterol and Benadryl.

Ask the allergist when to use. One PP said use upon two symptoms. Ours said use upon confirmed exposure even if asymptomatic.

If you use epinephrine the person needs to go by ambulance to the emergency room.

Epi pens are not magic talismans. They don’t always work. They sometimes need to be repeated.

Your child needs to learn to self-advocate about allergies as soon as possible. Teach them to read every label every time. Ingredients change. No unlabeled or homemade outside snacks. Send your own treats to school. Be very particular in restaurants. Be aware of potential language issues — we were assured that a bakery product contained no nuts. Then informed “only nut flour” when we asked a second time.

They need to be aware of environmental contamination. Like the kid in class who brings a peanut butter sandwich and then uses a finger to scrape out and eat the peanut butter. Or the contaminated trash in a cafeteria trash can. Or the person one row away in an aircraft who is eating peanuts.

I believe there is a sensitivity-reducing shot and desensitization treatments. We are not there yet, so I leave it to others with knowledge to discuss them.

I have a 12 year old peanut allergic kid and agree with most of this with a couple caveats and can add some info about OIT.

As to bolded, some kids really are not this sensitive to peanuts in their environment. Mine isn't. We eat peanut butter in our household. My kid has zero sensitivity to being near peanuts. I understand some kids do. But this is an added level of hyper-vigilance that isn't necessary for some kids.

We did the OIT and it worked. The part I didn't anticipate is my child HATES HATES HATES the taste of peanuts. This makes sense. Her body is trained to really dislike the thing that is going to make her sick. However, when you get to the end the maintenane is eating some amount of peanut daily. We tried all vehicles. The peanut, some peanut butter, a peanut m&m, a reeses pieces. She hated all of them. She was about 10 at the time we did this. It was a nightly battle and we just gave up. I could not see sustaining forcing her to eat something she hated. I think with an older kid it could be eaiser.

As to the follow up bolded, without claiming any scientific/literature based special knowledge, I suggest it is extremely dangerous to be casual about any level of potential exposure. I don’t think it is “hyper vigilance.”

The example given was someone in the next row on an airplane eating peanuts and "contaminated" trash in a trashcan at school. What is your plan for these scenarios? Wear a hazmat suit in the plane and tell your child not to dumpster dive in the trash?

I think a reasonable warning is to say if your friend is eating a peanut butter sandwich, be aware and don't share any utensils or plates.

The plan for the airplane was to ask the person to stop and put the product away or get rid of it. And we did exactly that with good result when it happened.

As for the trash the real concern was that DC’s school had students in groups to clean up after lunch. We asked for an assignment that didn’t involve food residues or trash.

I think this level of vigilance is about your own anxiety level and wanting to assert a level of control over your environment that you don't really have. And I think it makes your kid anxious too.

Read labels, speak up, teach the kid to advocate for themselves. Hammer it home early and often. In particular, do not eat unwrapped candy or baked goods where you don't know the origin. Carry the epi pen at all times. The rest of it, you can't control other people. People around you can and will eat peanuts.

I suspect you don’t have an allergy either.

Nobody in their right mind eats peanuts on public transit any more.

As for the lunchroom, you’re suggesting not handling peanut-contaminated items is anxiety-driven? Please.

What is the peanut-contaminated item? If the "peanut-contaminated" item is a trashcan where someone might have thrown out the remnant of their peanut butter sandwich, seems kind of anxiety driven. If it's a plate smeared with peanut butter and it's a young child who doesn't have a lot of awareness yet, makes more sense.

People can be very bad at risk assessment. I guarantee your kid does a bunch of things daily that are a lot more risky than being around a trash can with a peanut butter sandwich in it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to carry at least two Epi pens everywhere, in case one malfunctions or the ambulance is delayed in coming. As soon as the child is able they need to carry two themselves. Be sure they know how to use them. Practice regularly with the trainer.

We always also have albuterol and Benadryl.

Ask the allergist when to use. One PP said use upon two symptoms. Ours said use upon confirmed exposure even if asymptomatic.

If you use epinephrine the person needs to go by ambulance to the emergency room.

Epi pens are not magic talismans. They don’t always work. They sometimes need to be repeated.

Your child needs to learn to self-advocate about allergies as soon as possible. Teach them to read every label every time. Ingredients change. No unlabeled or homemade outside snacks. Send your own treats to school. Be very particular in restaurants. Be aware of potential language issues — we were assured that a bakery product contained no nuts. Then informed “only nut flour” when we asked a second time.

They need to be aware of environmental contamination. Like the kid in class who brings a peanut butter sandwich and then uses a finger to scrape out and eat the peanut butter. Or the contaminated trash in a cafeteria trash can. Or the person one row away in an aircraft who is eating peanuts.

I believe there is a sensitivity-reducing shot and desensitization treatments. We are not there yet, so I leave it to others with knowledge to discuss them.

I have a 12 year old peanut allergic kid and agree with most of this with a couple caveats and can add some info about OIT.

As to bolded, some kids really are not this sensitive to peanuts in their environment. Mine isn't. We eat peanut butter in our household. My kid has zero sensitivity to being near peanuts. I understand some kids do. But this is an added level of hyper-vigilance that isn't necessary for some kids.

We did the OIT and it worked. The part I didn't anticipate is my child HATES HATES HATES the taste of peanuts. This makes sense. Her body is trained to really dislike the thing that is going to make her sick. However, when you get to the end the maintenane is eating some amount of peanut daily. We tried all vehicles. The peanut, some peanut butter, a peanut m&m, a reeses pieces. She hated all of them. She was about 10 at the time we did this. It was a nightly battle and we just gave up. I could not see sustaining forcing her to eat something she hated. I think with an older kid it could be eaiser.

As to the follow up bolded, without claiming any scientific/literature based special knowledge, I suggest it is extremely dangerous to be casual about any level of potential exposure. I don’t think it is “hyper vigilance.”

The example given was someone in the next row on an airplane eating peanuts and "contaminated" trash in a trashcan at school. What is your plan for these scenarios? Wear a hazmat suit in the plane and tell your child not to dumpster dive in the trash?

I think a reasonable warning is to say if your friend is eating a peanut butter sandwich, be aware and don't share any utensils or plates.

The plan for the airplane was to ask the person to stop and put the product away or get rid of it. And we did exactly that with good result when it happened.

As for the trash the real concern was that DC’s school had students in groups to clean up after lunch. We asked for an assignment that didn’t involve food residues or trash.

I think this level of vigilance is about your own anxiety level and wanting to assert a level of control over your environment that you don't really have. And I think it makes your kid anxious too.

Read labels, speak up, teach the kid to advocate for themselves. Hammer it home early and often. In particular, do not eat unwrapped candy or baked goods where you don't know the origin. Carry the epi pen at all times. The rest of it, you can't control other people. People around you can and will eat peanuts.

I suspect you don’t have an allergy either.

Nobody in their right mind eats peanuts on public transit any more.

As for the lunchroom, you’re suggesting not handling peanut-contaminated items is anxiety-driven? Please.

Wrong again. You think people respond in this level of detail if they don't have an allergic kid? Why would a person be on this thread?

You're a fool if you think people have stopped eating peanuts in public. They haven't. The world does not revolve around our peanut allergic kids. I think more people are aware of nut allergies than ever before and many kid-based settings are really good about it. But in the general population? No.

Ah, puerile name calling and ad hominem attack. Always the best way to strengthen an argument.

People assert themselves for their own benefit all the time. “Excuse me, I believe I was before you in line.” Why should a person with a life-threatening allergy be expected to remain silent because many, even most, people think of peanuts as a tasty, filling, low carb snack? The people we’ve occasionally asked for an accommodation have always been very gracious.

You can definitely do that. The point is that will not exert perfect control over your environment, which is clearly what you are after. I think the reason you could be expected to remain silent is because a person several seats away from you minding their own business and eating something of their choosing is not affecting you at all, despite what you have convinced yourself. Unless they are a toddler and about to smear it near your kid or approach your child directly, approaching adults eating food and telling them to stop is obnoxious.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to carry at least two Epi pens everywhere, in case one malfunctions or the ambulance is delayed in coming. As soon as the child is able they need to carry two themselves. Be sure they know how to use them. Practice regularly with the trainer.

We always also have albuterol and Benadryl.

Ask the allergist when to use. One PP said use upon two symptoms. Ours said use upon confirmed exposure even if asymptomatic.

If you use epinephrine the person needs to go by ambulance to the emergency room.

Epi pens are not magic talismans. They don’t always work. They sometimes need to be repeated.

Your child needs to learn to self-advocate about allergies as soon as possible. Teach them to read every label every time. Ingredients change. No unlabeled or homemade outside snacks. Send your own treats to school. Be very particular in restaurants. Be aware of potential language issues — we were assured that a bakery product contained no nuts. Then informed “only nut flour” when we asked a second time.

They need to be aware of environmental contamination. Like the kid in class who brings a peanut butter sandwich and then uses a finger to scrape out and eat the peanut butter. Or the contaminated trash in a cafeteria trash can. Or the person one row away in an aircraft who is eating peanuts.

I believe there is a sensitivity-reducing shot and desensitization treatments. We are not there yet, so I leave it to others with knowledge to discuss them.

I have a 12 year old peanut allergic kid and agree with most of this with a couple caveats and can add some info about OIT.

As to bolded, some kids really are not this sensitive to peanuts in their environment. Mine isn't. We eat peanut butter in our household. My kid has zero sensitivity to being near peanuts. I understand some kids do. But this is an added level of hyper-vigilance that isn't necessary for some kids.

We did the OIT and it worked. The part I didn't anticipate is my child HATES HATES HATES the taste of peanuts. This makes sense. Her body is trained to really dislike the thing that is going to make her sick. However, when you get to the end the maintenane is eating some amount of peanut daily. We tried all vehicles. The peanut, some peanut butter, a peanut m&m, a reeses pieces. She hated all of them. She was about 10 at the time we did this. It was a nightly battle and we just gave up. I could not see sustaining forcing her to eat something she hated. I think with an older kid it could be eaiser.

As to the follow up bolded, without claiming any scientific/literature based special knowledge, I suggest it is extremely dangerous to be casual about any level of potential exposure. I don’t think it is “hyper vigilance.”

The example given was someone in the next row on an airplane eating peanuts and "contaminated" trash in a trashcan at school. What is your plan for these scenarios? Wear a hazmat suit in the plane and tell your child not to dumpster dive in the trash?

I think a reasonable warning is to say if your friend is eating a peanut butter sandwich, be aware and don't share any utensils or plates.

The plan for the airplane was to ask the person to stop and put the product away or get rid of it. And we did exactly that with good result when it happened.

As for the trash the real concern was that DC’s school had students in groups to clean up after lunch. We asked for an assignment that didn’t involve food residues or trash.

I think this level of vigilance is about your own anxiety level and wanting to assert a level of control over your environment that you don't really have. And I think it makes your kid anxious too.

Read labels, speak up, teach the kid to advocate for themselves. Hammer it home early and often. In particular, do not eat unwrapped candy or baked goods where you don't know the origin. Carry the epi pen at all times. The rest of it, you can't control other people. People around you can and will eat peanuts.

I suspect you don’t have an allergy either.

Nobody in their right mind eats peanuts on public transit any more.

As for the lunchroom, you’re suggesting not handling peanut-contaminated items is anxiety-driven? Please.

What is the peanut-contaminated item? If the "peanut-contaminated" item is a trashcan where someone might have thrown out the remnant of their peanut butter sandwich, seems kind of anxiety driven. If it's a plate smeared with peanut butter and it's a young child who doesn't have a lot of awareness yet, makes more sense.

People can be very bad at risk assessment. I guarantee your kid does a bunch of things daily that are a lot more risky than being around a trash can with a peanut butter sandwich in it.

I don’t think it is “anxiety driven” for a person with a life threaten allergy to want to avoid accidentally getting contaminated and then transferring the contamination to where they might ingest it. Because people touch their mouths, etc., and don’t always surgery-scrub beforehand. That other life risks exist is irrelevant. One avoids what one reasonably can. What would be your view if the concern was a chemical that might find its way somewhere, as in the case where somebody carelessly threw a rag soaked with turpentine or anotherindustrial solvent into a trash can?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to carry at least two Epi pens everywhere, in case one malfunctions or the ambulance is delayed in coming. As soon as the child is able they need to carry two themselves. Be sure they know how to use them. Practice regularly with the trainer.

We always also have albuterol and Benadryl.

Ask the allergist when to use. One PP said use upon two symptoms. Ours said use upon confirmed exposure even if asymptomatic.

If you use epinephrine the person needs to go by ambulance to the emergency room.

Epi pens are not magic talismans. They don’t always work. They sometimes need to be repeated.

Your child needs to learn to self-advocate about allergies as soon as possible. Teach them to read every label every time. Ingredients change. No unlabeled or homemade outside snacks. Send your own treats to school. Be very particular in restaurants. Be aware of potential language issues — we were assured that a bakery product contained no nuts. Then informed “only nut flour” when we asked a second time.

They need to be aware of environmental contamination. Like the kid in class who brings a peanut butter sandwich and then uses a finger to scrape out and eat the peanut butter. Or the contaminated trash in a cafeteria trash can. Or the person one row away in an aircraft who is eating peanuts.

I believe there is a sensitivity-reducing shot and desensitization treatments. We are not there yet, so I leave it to others with knowledge to discuss them.

I have a 12 year old peanut allergic kid and agree with most of this with a couple caveats and can add some info about OIT.

As to bolded, some kids really are not this sensitive to peanuts in their environment. Mine isn't. We eat peanut butter in our household. My kid has zero sensitivity to being near peanuts. I understand some kids do. But this is an added level of hyper-vigilance that isn't necessary for some kids.

We did the OIT and it worked. The part I didn't anticipate is my child HATES HATES HATES the taste of peanuts. This makes sense. Her body is trained to really dislike the thing that is going to make her sick. However, when you get to the end the maintenane is eating some amount of peanut daily. We tried all vehicles. The peanut, some peanut butter, a peanut m&m, a reeses pieces. She hated all of them. She was about 10 at the time we did this. It was a nightly battle and we just gave up. I could not see sustaining forcing her to eat something she hated. I think with an older kid it could be eaiser.

As to the follow up bolded, without claiming any scientific/literature based special knowledge, I suggest it is extremely dangerous to be casual about any level of potential exposure. I don’t think it is “hyper vigilance.”

The example given was someone in the next row on an airplane eating peanuts and "contaminated" trash in a trashcan at school. What is your plan for these scenarios? Wear a hazmat suit in the plane and tell your child not to dumpster dive in the trash?

I think a reasonable warning is to say if your friend is eating a peanut butter sandwich, be aware and don't share any utensils or plates.

The plan for the airplane was to ask the person to stop and put the product away or get rid of it. And we did exactly that with good result when it happened.

As for the trash the real concern was that DC’s school had students in groups to clean up after lunch. We asked for an assignment that didn’t involve food residues or trash.

I think this level of vigilance is about your own anxiety level and wanting to assert a level of control over your environment that you don't really have. And I think it makes your kid anxious too.

Read labels, speak up, teach the kid to advocate for themselves. Hammer it home early and often. In particular, do not eat unwrapped candy or baked goods where you don't know the origin. Carry the epi pen at all times. The rest of it, you can't control other people. People around you can and will eat peanuts.

I suspect you don’t have an allergy either.

Nobody in their right mind eats peanuts on public transit any more.

As for the lunchroom, you’re suggesting not handling peanut-contaminated items is anxiety-driven? Please.

Wrong again. You think people respond in this level of detail if they don't have an allergic kid? Why would a person be on this thread?

You're a fool if you think people have stopped eating peanuts in public. They haven't. The world does not revolve around our peanut allergic kids. I think more people are aware of nut allergies than ever before and many kid-based settings are really good about it. But in the general population? No.

Ah, puerile name calling and ad hominem attack. Always the best way to strengthen an argument.

People assert themselves for their own benefit all the time. “Excuse me, I believe I was before you in line.” Why should a person with a life-threatening allergy be expected to remain silent because many, even most, people think of peanuts as a tasty, filling, low carb snack? The people we’ve occasionally asked for an accommodation have always been very gracious.

You can definitely do that. The point is that will not exert perfect control over your environment, which is clearly what you are after. I think the reason you could be expected to remain silent is because a person several seats away from you minding their own business and eating something of their choosing is not affecting you at all, despite what you have convinced yourself. Unless they are a toddler and about to smear it near your kid or approach your child directly, approaching adults eating food and telling them to stop is obnoxious.

Somebody several seats or tables away in a lunchroom is worlds different than one row ahead on a sardine can economy class airline who is actually aerosolizing their food while they eat it.

And “obnoxious” is a far better label than “victim.”

[Anonymous]

Anonymous wrote:You’re…”surprised” that people who have kids with potentially FATAL allergies are so vigilant? That takes you by surprise? WTAF?

I get it if your kid has a severe allergy, but I don't view mine as a severe (at least based on what our allergist has said, lack of accidental exposures, freely eating out at restaurants, etc.) I will be more vigilant and carry the epi-pens, but I'm not planning on going overboard like making people around me stop eating peanuts. My kid knows to be careful.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to carry at least two Epi pens everywhere, in case one malfunctions or the ambulance is delayed in coming. As soon as the child is able they need to carry two themselves. Be sure they know how to use them. Practice regularly with the trainer.

We always also have albuterol and Benadryl.

Ask the allergist when to use. One PP said use upon two symptoms. Ours said use upon confirmed exposure even if asymptomatic.

If you use epinephrine the person needs to go by ambulance to the emergency room.

Epi pens are not magic talismans. They don’t always work. They sometimes need to be repeated.

Your child needs to learn to self-advocate about allergies as soon as possible. Teach them to read every label every time. Ingredients change. No unlabeled or homemade outside snacks. Send your own treats to school. Be very particular in restaurants. Be aware of potential language issues — we were assured that a bakery product contained no nuts. Then informed “only nut flour” when we asked a second time.

They need to be aware of environmental contamination. Like the kid in class who brings a peanut butter sandwich and then uses a finger to scrape out and eat the peanut butter. Or the contaminated trash in a cafeteria trash can. Or the person one row away in an aircraft who is eating peanuts.

I believe there is a sensitivity-reducing shot and desensitization treatments. We are not there yet, so I leave it to others with knowledge to discuss them.

I have a 12 year old peanut allergic kid and agree with most of this with a couple caveats and can add some info about OIT.

As to bolded, some kids really are not this sensitive to peanuts in their environment. Mine isn't. We eat peanut butter in our household. My kid has zero sensitivity to being near peanuts. I understand some kids do. But this is an added level of hyper-vigilance that isn't necessary for some kids.

We did the OIT and it worked. The part I didn't anticipate is my child HATES HATES HATES the taste of peanuts. This makes sense. Her body is trained to really dislike the thing that is going to make her sick. However, when you get to the end the maintenane is eating some amount of peanut daily. We tried all vehicles. The peanut, some peanut butter, a peanut m&m, a reeses pieces. She hated all of them. She was about 10 at the time we did this. It was a nightly battle and we just gave up. I could not see sustaining forcing her to eat something she hated. I think with an older kid it could be eaiser.

OP here - interesting, that makes complete sense. Every time my kid sees something with peanuts in it she kind of recoils so I can see her hating it too.

I would love to hear about your experience with OIT. Was it a smooth process? Any advice or things to be aware of? How were all the years before OIT - did your kid have any accidental exposures?

Doing OIT is very time intensive. It's a couple hours at the doctor's office for about 6 months while you updose. Toward the end of the dosing at home when it was the larger doses, you are mixing peanut powder with food. For probably the last month of doses, she was even resisting this. Hated the taste of it. It went smoothly in that she never had any side effects and the treatment was definitely working. I would still do it again and don't regret it. I'm glad we tried. I was very frustrated she wouldn't continue the maintenance. But it was seriously just a total nightmare and she refused. You can't physically force a person to eat something, let alone nightly.

My child had one accidental exposure since we figured out she is peanut allergic in the years leading up to it that luckily led to just an itchy mouth. I was with her when it happened.

Thank you! Do you know if she can eat more than she used to pre-OIT, or did she complete revert back?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to carry at least two Epi pens everywhere, in case one malfunctions or the ambulance is delayed in coming. As soon as the child is able they need to carry two themselves. Be sure they know how to use them. Practice regularly with the trainer.

We always also have albuterol and Benadryl.

Ask the allergist when to use. One PP said use upon two symptoms. Ours said use upon confirmed exposure even if asymptomatic.

If you use epinephrine the person needs to go by ambulance to the emergency room.

Epi pens are not magic talismans. They don’t always work. They sometimes need to be repeated.

Your child needs to learn to self-advocate about allergies as soon as possible. Teach them to read every label every time. Ingredients change. No unlabeled or homemade outside snacks. Send your own treats to school. Be very particular in restaurants. Be aware of potential language issues — we were assured that a bakery product contained no nuts. Then informed “only nut flour” when we asked a second time.

They need to be aware of environmental contamination. Like the kid in class who brings a peanut butter sandwich and then uses a finger to scrape out and eat the peanut butter. Or the contaminated trash in a cafeteria trash can. Or the person one row away in an aircraft who is eating peanuts.

I believe there is a sensitivity-reducing shot and desensitization treatments. We are not there yet, so I leave it to others with knowledge to discuss them.

I have a 12 year old peanut allergic kid and agree with most of this with a couple caveats and can add some info about OIT.

As to bolded, some kids really are not this sensitive to peanuts in their environment. Mine isn't. We eat peanut butter in our household. My kid has zero sensitivity to being near peanuts. I understand some kids do. But this is an added level of hyper-vigilance that isn't necessary for some kids.

We did the OIT and it worked. The part I didn't anticipate is my child HATES HATES HATES the taste of peanuts. This makes sense. Her body is trained to really dislike the thing that is going to make her sick. However, when you get to the end the maintenane is eating some amount of peanut daily. We tried all vehicles. The peanut, some peanut butter, a peanut m&m, a reeses pieces. She hated all of them. She was about 10 at the time we did this. It was a nightly battle and we just gave up. I could not see sustaining forcing her to eat something she hated. I think with an older kid it could be eaiser.

As to the follow up bolded, without claiming any scientific/literature based special knowledge, I suggest it is extremely dangerous to be casual about any level of potential exposure. I don’t think it is “hyper vigilance.”

The example given was someone in the next row on an airplane eating peanuts and "contaminated" trash in a trashcan at school. What is your plan for these scenarios? Wear a hazmat suit in the plane and tell your child not to dumpster dive in the trash?

I think a reasonable warning is to say if your friend is eating a peanut butter sandwich, be aware and don't share any utensils or plates.

The plan for the airplane was to ask the person to stop and put the product away or get rid of it. And we did exactly that with good result when it happened.

As for the trash the real concern was that DC’s school had students in groups to clean up after lunch. We asked for an assignment that didn’t involve food residues or trash.

NP. You feel comfortable telling strangers to stop eating peanuts in the row in front of you? Yikes. How do you even know they are eating peanuts?

I have been on a plane once where there was an announcement that there is a peanut allergic person on the plane and to refrain from eating peanuts. If I was inclined to be this vigilant, I would suggest going this route with the airline rather than approaching passengers individually.

Also, from this site:
https://www.nationwidechildrens.org/

MYTH:
Just being in the same room as peanuts is life threatening for my child.
FACT:
Touching, smelling, or inhaling particles from peanuts does not usually
cause a severe reaction. It typically requires ingestion to cause serious allergic
complications. Since reactions are unpredictable, every allergic individual
should maintain a food allergy action plan to help keep them safe

NP. Do you understand the difference between “asking someone” to do something, and “telling someone” to do something? This is a yes or no question.

Yes.

I would neither ask nor tell someone to stop eating a food near me or my kid.

Phew, it’s a relief to see you know the difference, but also confusing. If you do know the difference, then why when PP clearly wrote that she “ASKED” someone not to eat a product containing peanuts did you accuse her of “TELLING” strangers not to eat something.

Can you answer that question?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to carry at least two Epi pens everywhere, in case one malfunctions or the ambulance is delayed in coming. As soon as the child is able they need to carry two themselves. Be sure they know how to use them. Practice regularly with the trainer.

We always also have albuterol and Benadryl.

Ask the allergist when to use. One PP said use upon two symptoms. Ours said use upon confirmed exposure even if asymptomatic.

If you use epinephrine the person needs to go by ambulance to the emergency room.

Epi pens are not magic talismans. They don’t always work. They sometimes need to be repeated.

Your child needs to learn to self-advocate about allergies as soon as possible. Teach them to read every label every time. Ingredients change. No unlabeled or homemade outside snacks. Send your own treats to school. Be very particular in restaurants. Be aware of potential language issues — we were assured that a bakery product contained no nuts. Then informed “only nut flour” when we asked a second time.

They need to be aware of environmental contamination. Like the kid in class who brings a peanut butter sandwich and then uses a finger to scrape out and eat the peanut butter. Or the contaminated trash in a cafeteria trash can. Or the person one row away in an aircraft who is eating peanuts.

I believe there is a sensitivity-reducing shot and desensitization treatments. We are not there yet, so I leave it to others with knowledge to discuss them.

I have a 12 year old peanut allergic kid and agree with most of this with a couple caveats and can add some info about OIT.

As to bolded, some kids really are not this sensitive to peanuts in their environment. Mine isn't. We eat peanut butter in our household. My kid has zero sensitivity to being near peanuts. I understand some kids do. But this is an added level of hyper-vigilance that isn't necessary for some kids.

We did the OIT and it worked. The part I didn't anticipate is my child HATES HATES HATES the taste of peanuts. This makes sense. Her body is trained to really dislike the thing that is going to make her sick. However, when you get to the end the maintenane is eating some amount of peanut daily. We tried all vehicles. The peanut, some peanut butter, a peanut m&m, a reeses pieces. She hated all of them. She was about 10 at the time we did this. It was a nightly battle and we just gave up. I could not see sustaining forcing her to eat something she hated. I think with an older kid it could be eaiser.

As to the follow up bolded, without claiming any scientific/literature based special knowledge, I suggest it is extremely dangerous to be casual about any level of potential exposure. I don’t think it is “hyper vigilance.”

The example given was someone in the next row on an airplane eating peanuts and "contaminated" trash in a trashcan at school. What is your plan for these scenarios? Wear a hazmat suit in the plane and tell your child not to dumpster dive in the trash?

I think a reasonable warning is to say if your friend is eating a peanut butter sandwich, be aware and don't share any utensils or plates.

The plan for the airplane was to ask the person to stop and put the product away or get rid of it. And we did exactly that with good result when it happened.

As for the trash the real concern was that DC’s school had students in groups to clean up after lunch. We asked for an assignment that didn’t involve food residues or trash.

NP. You feel comfortable telling strangers to stop eating peanuts in the row in front of you? Yikes. How do you even know they are eating peanuts?

I have been on a plane once where there was an announcement that there is a peanut allergic person on the plane and to refrain from eating peanuts. If I was inclined to be this vigilant, I would suggest going this route with the airline rather than approaching passengers individually.

Also, from this site:
https://www.nationwidechildrens.org/

MYTH:
Just being in the same room as peanuts is life threatening for my child.
FACT:
Touching, smelling, or inhaling particles from peanuts does not usually
cause a severe reaction. It typically requires ingestion to cause serious allergic
complications. Since reactions are unpredictable, every allergic individual
should maintain a food allergy action plan to help keep them safe

Just a FYI, my daughter had a severe reaction to first ingestion of egg which is supposedly unlikely. It required an epi and ambulance ride. Our allergist encouraged us to NOT fry or cook eggs unless we had her in both an a) separate room and b) well ventilation either direct vent from stove to outside or windows open in the kitchen because egg protein can aerosol.
Typically, unpredictable, does not usually are the key words in the FACT you listed above.
The reason for the hyper vigilance in planes is because you are in the air away from medical care.
Not the PP but I would think as an allergy parent yourself you would know that there are a range of severities and would also, god forbid, your child be on the severe range, take every precaution and ALSO not want them limited because of peoples inability to stop eating for X hours while in flight where medical care is not available.
And I promise you that the hyper vigilant mom is also doing everything in their control- wiping, etc- along with educating their child on how to protect themselves. A little grace goes a long way.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to carry at least two Epi pens everywhere, in case one malfunctions or the ambulance is delayed in coming. As soon as the child is able they need to carry two themselves. Be sure they know how to use them. Practice regularly with the trainer.

We always also have albuterol and Benadryl.

Ask the allergist when to use. One PP said use upon two symptoms. Ours said use upon confirmed exposure even if asymptomatic.

If you use epinephrine the person needs to go by ambulance to the emergency room.

Epi pens are not magic talismans. They don’t always work. They sometimes need to be repeated.

Your child needs to learn to self-advocate about allergies as soon as possible. Teach them to read every label every time. Ingredients change. No unlabeled or homemade outside snacks. Send your own treats to school. Be very particular in restaurants. Be aware of potential language issues — we were assured that a bakery product contained no nuts. Then informed “only nut flour” when we asked a second time.

They need to be aware of environmental contamination. Like the kid in class who brings a peanut butter sandwich and then uses a finger to scrape out and eat the peanut butter. Or the contaminated trash in a cafeteria trash can. Or the person one row away in an aircraft who is eating peanuts.

I believe there is a sensitivity-reducing shot and desensitization treatments. We are not there yet, so I leave it to others with knowledge to discuss them.

I have a 12 year old peanut allergic kid and agree with most of this with a couple caveats and can add some info about OIT.

As to bolded, some kids really are not this sensitive to peanuts in their environment. Mine isn't. We eat peanut butter in our household. My kid has zero sensitivity to being near peanuts. I understand some kids do. But this is an added level of hyper-vigilance that isn't necessary for some kids.

We did the OIT and it worked. The part I didn't anticipate is my child HATES HATES HATES the taste of peanuts. This makes sense. Her body is trained to really dislike the thing that is going to make her sick. However, when you get to the end the maintenane is eating some amount of peanut daily. We tried all vehicles. The peanut, some peanut butter, a peanut m&m, a reeses pieces. She hated all of them. She was about 10 at the time we did this. It was a nightly battle and we just gave up. I could not see sustaining forcing her to eat something she hated. I think with an older kid it could be eaiser.

As to the follow up bolded, without claiming any scientific/literature based special knowledge, I suggest it is extremely dangerous to be casual about any level of potential exposure. I don’t think it is “hyper vigilance.”

The example given was someone in the next row on an airplane eating peanuts and "contaminated" trash in a trashcan at school. What is your plan for these scenarios? Wear a hazmat suit in the plane and tell your child not to dumpster dive in the trash?

I think a reasonable warning is to say if your friend is eating a peanut butter sandwich, be aware and don't share any utensils or plates.

The plan for the airplane was to ask the person to stop and put the product away or get rid of it. And we did exactly that with good result when it happened.

As for the trash the real concern was that DC’s school had students in groups to clean up after lunch. We asked for an assignment that didn’t involve food residues or trash.

NP. You feel comfortable telling strangers to stop eating peanuts in the row in front of you? Yikes. How do you even know they are eating peanuts?

I have been on a plane once where there was an announcement that there is a peanut allergic person on the plane and to refrain from eating peanuts. If I was inclined to be this vigilant, I would suggest going this route with the airline rather than approaching passengers individually.

Also, from this site:
https://www.nationwidechildrens.org/

MYTH:
Just being in the same room as peanuts is life threatening for my child.
FACT:
Touching, smelling, or inhaling particles from peanuts does not usually
cause a severe reaction. It typically requires ingestion to cause serious allergic
complications. Since reactions are unpredictable, every allergic individual
should maintain a food allergy action plan to help keep them safe

NP. Do you understand the difference between “asking someone” to do something, and “telling someone” to do something? This is a yes or no question.

Yes.

I would neither ask nor tell someone to stop eating a food near me or my kid.

Phew, it’s a relief to see you know the difference, but also confusing. If you do know the difference, then why when PP clearly wrote that she “ASKED” someone not to eat a product containing peanuts did you accuse her of “TELLING” strangers not to eat something.

Can you answer that question?

some of you are lol insufferable

you can't have any friends in your real life or if you think they do they hate you

[Anonymous]

DD (now nearly 6) started OIT for cashews at around 2.5. The first 6 months or so, we had to go in every month or so. She does a skin test and bloodwork yearly. Her allergy level (as reflected in the bloodwork) has considerably decreased (she’s supposed to eat four cashews daily) but I always carry her EpiPen. They don’t take up that much space.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to carry at least two Epi pens everywhere, in case one malfunctions or the ambulance is delayed in coming. As soon as the child is able they need to carry two themselves. Be sure they know how to use them. Practice regularly with the trainer.

We always also have albuterol and Benadryl.

Ask the allergist when to use. One PP said use upon two symptoms. Ours said use upon confirmed exposure even if asymptomatic.

If you use epinephrine the person needs to go by ambulance to the emergency room.

Epi pens are not magic talismans. They don’t always work. They sometimes need to be repeated.

Your child needs to learn to self-advocate about allergies as soon as possible. Teach them to read every label every time. Ingredients change. No unlabeled or homemade outside snacks. Send your own treats to school. Be very particular in restaurants. Be aware of potential language issues — we were assured that a bakery product contained no nuts. Then informed “only nut flour” when we asked a second time.

They need to be aware of environmental contamination. Like the kid in class who brings a peanut butter sandwich and then uses a finger to scrape out and eat the peanut butter. Or the contaminated trash in a cafeteria trash can. Or the person one row away in an aircraft who is eating peanuts.

I believe there is a sensitivity-reducing shot and desensitization treatments. We are not there yet, so I leave it to others with knowledge to discuss them.

I have a 12 year old peanut allergic kid and agree with most of this with a couple caveats and can add some info about OIT.

As to bolded, some kids really are not this sensitive to peanuts in their environment. Mine isn't. We eat peanut butter in our household. My kid has zero sensitivity to being near peanuts. I understand some kids do. But this is an added level of hyper-vigilance that isn't necessary for some kids.

We did the OIT and it worked. The part I didn't anticipate is my child HATES HATES HATES the taste of peanuts. This makes sense. Her body is trained to really dislike the thing that is going to make her sick. However, when you get to the end the maintenane is eating some amount of peanut daily. We tried all vehicles. The peanut, some peanut butter, a peanut m&m, a reeses pieces. She hated all of them. She was about 10 at the time we did this. It was a nightly battle and we just gave up. I could not see sustaining forcing her to eat something she hated. I think with an older kid it could be eaiser.

As to the follow up bolded, without claiming any scientific/literature based special knowledge, I suggest it is extremely dangerous to be casual about any level of potential exposure. I don’t think it is “hyper vigilance.”

The example given was someone in the next row on an airplane eating peanuts and "contaminated" trash in a trashcan at school. What is your plan for these scenarios? Wear a hazmat suit in the plane and tell your child not to dumpster dive in the trash?

I think a reasonable warning is to say if your friend is eating a peanut butter sandwich, be aware and don't share any utensils or plates.

The plan for the airplane was to ask the person to stop and put the product away or get rid of it. And we did exactly that with good result when it happened.

As for the trash the real concern was that DC’s school had students in groups to clean up after lunch. We asked for an assignment that didn’t involve food residues or trash.

I think this level of vigilance is about your own anxiety level and wanting to assert a level of control over your environment that you don't really have. And I think it makes your kid anxious too.

Read labels, speak up, teach the kid to advocate for themselves. Hammer it home early and often. In particular, do not eat unwrapped candy or baked goods where you don't know the origin. Carry the epi pen at all times. The rest of it, you can't control other people. People around you can and will eat peanuts.

I suspect you don’t have an allergy either.

Nobody in their right mind eats peanuts on public transit any more.

As for the lunchroom, you’re suggesting not handling peanut-contaminated items is anxiety-driven? Please.

Wrong again. You think people respond in this level of detail if they don't have an allergic kid? Why would a person be on this thread?

You're a fool if you think people have stopped eating peanuts in public. They haven't. The world does not revolve around our peanut allergic kids. I think more people are aware of nut allergies than ever before and many kid-based settings are really good about it. But in the general population? No.

Ah, puerile name calling and ad hominem attack. Always the best way to strengthen an argument.

People assert themselves for their own benefit all the time. “Excuse me, I believe I was before you in line.” Why should a person with a life-threatening allergy be expected to remain silent because many, even most, people think of peanuts as a tasty, filling, low carb snack? The people we’ve occasionally asked for an accommodation have always been very gracious.

You can definitely do that. The point is that will not exert perfect control over your environment, which is clearly what you are after. I think the reason you could be expected to remain silent is because a person several seats away from you minding their own business and eating something of their choosing is not affecting you at all, despite what you have convinced yourself. Unless they are a toddler and about to smear it near your kid or approach your child directly, approaching adults eating food and telling them to stop is obnoxious.

Somebody several seats or tables away in a lunchroom is worlds different than one row ahead on a sardine can economy class airline who is actually aerosolizing their food while they eat it.

And “obnoxious” is a far better label than “victim.”

I'm genuinely curious if there is any case on record of a person having an allergic reaction based on a nearby plane passenger eating peanuts. I have an allergic kid. This never crossed my mind to worry about this.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You’re…”surprised” that people who have kids with potentially FATAL allergies are so vigilant? That takes you by surprise? WTAF?

I get it if your kid has a severe allergy, but I don't view mine as a severe (at least based on what our allergist has said, lack of accidental exposures, freely eating out at restaurants, etc.) I will be more vigilant and carry the epi-pens, but I'm not planning on going overboard like making people around me stop eating peanuts. My kid knows to be careful.

LOL, OK. So your kid has been making sure to have an epi-pen kit with her at play dates, takes it to every restaurant, and talks to servers and restaurant managers about her allergy? Wow. Impressive! At such a young age.

It’s also amazing that your kid understands that even mild allergies can become severe with no warning, especially when there are exposures over time. It’s wonderful that she realizes that even though she has not had a severe reaction as of yet, it could be a severe reaction at any time. Interesting that she knows that when you didn’t seem to know that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to carry at least two Epi pens everywhere, in case one malfunctions or the ambulance is delayed in coming. As soon as the child is able they need to carry two themselves. Be sure they know how to use them. Practice regularly with the trainer.

We always also have albuterol and Benadryl.

Ask the allergist when to use. One PP said use upon two symptoms. Ours said use upon confirmed exposure even if asymptomatic.

If you use epinephrine the person needs to go by ambulance to the emergency room.

Epi pens are not magic talismans. They don’t always work. They sometimes need to be repeated.

Your child needs to learn to self-advocate about allergies as soon as possible. Teach them to read every label every time. Ingredients change. No unlabeled or homemade outside snacks. Send your own treats to school. Be very particular in restaurants. Be aware of potential language issues — we were assured that a bakery product contained no nuts. Then informed “only nut flour” when we asked a second time.

They need to be aware of environmental contamination. Like the kid in class who brings a peanut butter sandwich and then uses a finger to scrape out and eat the peanut butter. Or the contaminated trash in a cafeteria trash can. Or the person one row away in an aircraft who is eating peanuts.

I believe there is a sensitivity-reducing shot and desensitization treatments. We are not there yet, so I leave it to others with knowledge to discuss them.

I have a 12 year old peanut allergic kid and agree with most of this with a couple caveats and can add some info about OIT.

As to bolded, some kids really are not this sensitive to peanuts in their environment. Mine isn't. We eat peanut butter in our household. My kid has zero sensitivity to being near peanuts. I understand some kids do. But this is an added level of hyper-vigilance that isn't necessary for some kids.

We did the OIT and it worked. The part I didn't anticipate is my child HATES HATES HATES the taste of peanuts. This makes sense. Her body is trained to really dislike the thing that is going to make her sick. However, when you get to the end the maintenane is eating some amount of peanut daily. We tried all vehicles. The peanut, some peanut butter, a peanut m&m, a reeses pieces. She hated all of them. She was about 10 at the time we did this. It was a nightly battle and we just gave up. I could not see sustaining forcing her to eat something she hated. I think with an older kid it could be eaiser.

As to the follow up bolded, without claiming any scientific/literature based special knowledge, I suggest it is extremely dangerous to be casual about any level of potential exposure. I don’t think it is “hyper vigilance.”

The example given was someone in the next row on an airplane eating peanuts and "contaminated" trash in a trashcan at school. What is your plan for these scenarios? Wear a hazmat suit in the plane and tell your child not to dumpster dive in the trash?

I think a reasonable warning is to say if your friend is eating a peanut butter sandwich, be aware and don't share any utensils or plates.

The plan for the airplane was to ask the person to stop and put the product away or get rid of it. And we did exactly that with good result when it happened.

As for the trash the real concern was that DC’s school had students in groups to clean up after lunch. We asked for an assignment that didn’t involve food residues or trash.

I think this level of vigilance is about your own anxiety level and wanting to assert a level of control over your environment that you don't really have. And I think it makes your kid anxious too.

Read labels, speak up, teach the kid to advocate for themselves. Hammer it home early and often. In particular, do not eat unwrapped candy or baked goods where you don't know the origin. Carry the epi pen at all times. The rest of it, you can't control other people. People around you can and will eat peanuts.

I suspect you don’t have an allergy either.

Nobody in their right mind eats peanuts on public transit any more.

As for the lunchroom, you’re suggesting not handling peanut-contaminated items is anxiety-driven? Please.

Wrong again. You think people respond in this level of detail if they don't have an allergic kid? Why would a person be on this thread?

You're a fool if you think people have stopped eating peanuts in public. They haven't. The world does not revolve around our peanut allergic kids. I think more people are aware of nut allergies than ever before and many kid-based settings are really good about it. But in the general population? No.

Ah, puerile name calling and ad hominem attack. Always the best way to strengthen an argument.

People assert themselves for their own benefit all the time. “Excuse me, I believe I was before you in line.” Why should a person with a life-threatening allergy be expected to remain silent because many, even most, people think of peanuts as a tasty, filling, low carb snack? The people we’ve occasionally asked for an accommodation have always been very gracious.

You can definitely do that. The point is that will not exert perfect control over your environment, which is clearly what you are after. I think the reason you could be expected to remain silent is because a person several seats away from you minding their own business and eating something of their choosing is not affecting you at all, despite what you have convinced yourself. Unless they are a toddler and about to smear it near your kid or approach your child directly, approaching adults eating food and telling them to stop is obnoxious.

Somebody several seats or tables away in a lunchroom is worlds different than one row ahead on a sardine can economy class airline who is actually aerosolizing their food while they eat it.

And “obnoxious” is a far better label than “victim.”

I'm genuinely curious if there is any case on record of a person having an allergic reaction based on a nearby plane passenger eating peanuts. I have an allergic kid. This never crossed my mind to worry about this.

Doesn’t fully answer your question but read on:
https://simpleflying.com/delta-air-lines-passenger-removed-flight-shellfish-allergy/

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to carry at least two Epi pens everywhere, in case one malfunctions or the ambulance is delayed in coming. As soon as the child is able they need to carry two themselves. Be sure they know how to use them. Practice regularly with the trainer.

We always also have albuterol and Benadryl.

Ask the allergist when to use. One PP said use upon two symptoms. Ours said use upon confirmed exposure even if asymptomatic.

If you use epinephrine the person needs to go by ambulance to the emergency room.

Epi pens are not magic talismans. They don’t always work. They sometimes need to be repeated.

Your child needs to learn to self-advocate about allergies as soon as possible. Teach them to read every label every time. Ingredients change. No unlabeled or homemade outside snacks. Send your own treats to school. Be very particular in restaurants. Be aware of potential language issues — we were assured that a bakery product contained no nuts. Then informed “only nut flour” when we asked a second time.

They need to be aware of environmental contamination. Like the kid in class who brings a peanut butter sandwich and then uses a finger to scrape out and eat the peanut butter. Or the contaminated trash in a cafeteria trash can. Or the person one row away in an aircraft who is eating peanuts.

I believe there is a sensitivity-reducing shot and desensitization treatments. We are not there yet, so I leave it to others with knowledge to discuss them.

I have a 12 year old peanut allergic kid and agree with most of this with a couple caveats and can add some info about OIT.

As to bolded, some kids really are not this sensitive to peanuts in their environment. Mine isn't. We eat peanut butter in our household. My kid has zero sensitivity to being near peanuts. I understand some kids do. But this is an added level of hyper-vigilance that isn't necessary for some kids.

We did the OIT and it worked. The part I didn't anticipate is my child HATES HATES HATES the taste of peanuts. This makes sense. Her body is trained to really dislike the thing that is going to make her sick. However, when you get to the end the maintenane is eating some amount of peanut daily. We tried all vehicles. The peanut, some peanut butter, a peanut m&m, a reeses pieces. She hated all of them. She was about 10 at the time we did this. It was a nightly battle and we just gave up. I could not see sustaining forcing her to eat something she hated. I think with an older kid it could be eaiser.

As to the follow up bolded, without claiming any scientific/literature based special knowledge, I suggest it is extremely dangerous to be casual about any level of potential exposure. I don’t think it is “hyper vigilance.”

The example given was someone in the next row on an airplane eating peanuts and "contaminated" trash in a trashcan at school. What is your plan for these scenarios? Wear a hazmat suit in the plane and tell your child not to dumpster dive in the trash?

I think a reasonable warning is to say if your friend is eating a peanut butter sandwich, be aware and don't share any utensils or plates.

The plan for the airplane was to ask the person to stop and put the product away or get rid of it. And we did exactly that with good result when it happened.

As for the trash the real concern was that DC’s school had students in groups to clean up after lunch. We asked for an assignment that didn’t involve food residues or trash.

I think this level of vigilance is about your own anxiety level and wanting to assert a level of control over your environment that you don't really have. And I think it makes your kid anxious too.

Read labels, speak up, teach the kid to advocate for themselves. Hammer it home early and often. In particular, do not eat unwrapped candy or baked goods where you don't know the origin. Carry the epi pen at all times. The rest of it, you can't control other people. People around you can and will eat peanuts.

I suspect you don’t have an allergy either.

Nobody in their right mind eats peanuts on public transit any more.

As for the lunchroom, you’re suggesting not handling peanut-contaminated items is anxiety-driven? Please.

What is the peanut-contaminated item? If the "peanut-contaminated" item is a trashcan where someone might have thrown out the remnant of their peanut butter sandwich, seems kind of anxiety driven. If it's a plate smeared with peanut butter and it's a young child who doesn't have a lot of awareness yet, makes more sense.

People can be very bad at risk assessment. I guarantee your kid does a bunch of things daily that are a lot more risky than being around a trash can with a peanut butter sandwich in it.

I don’t think it is “anxiety driven” for a person with a life threaten allergy to want to avoid accidentally getting contaminated and then transferring the contamination to where they might ingest it. Because people touch their mouths, etc., and don’t always surgery-scrub beforehand. That other life risks exist is irrelevant. One avoids what one reasonably can. What would be your view if the concern was a chemical that might find its way somewhere, as in the case where somebody carelessly threw a rag soaked with turpentine or anotherindustrial solvent into a trash can?

I agree with this. The part I don't agree with is the assessment that someone throwing their peanut butter sandwich in a trash can could somehow transfer to you (or your kid) and you might ingest it. To give the benefit of the doubt, you are envisioning a world where the peanut butter is dragged down the inside of the trashcan and then you (or your kid) subsequently touch or hold onto that same side of the trashcan. That's the scenario? I'm just not operating in that head space that I think that is happening.

I can't really respond to equating a peanut butter sandwich to a turpentine soaked rag.