Holiday Gatherings Can Be Stressful and Dangerous for Kids with Food Allergies

Common allergens hide in surprising holiday favorites, but communication and preparation help families safely enjoy the season

The holidays are a time for gathering with family and friends to catch up, make memories and usually eat a lot of food. But experts at National Jewish Health stress that if you or your child have food allergies, knowing every ingredient in Grandma’s special holiday cookies or your aunt’s famous casserole is crucial to enjoying the season safely.

“One bad mouthful of food can be extremely dangerous for those with food allergies,” said Jessica Hui, MD, a pediatric allergist and immunologist at National Jewish Health. “There are a lot of hidden allergens in holiday foods that are easy to miss if you’re not looking closely at their ingredients. Sauces and dressings can contain nuts, like peanuts or tree nuts, or they may contain soy, dairy, eggs, seeds or wheat. Even the way that you prepare your proteins can include common allergens. For example, pre-basted turkeys are often prepared with soy products, wheat, egg or dairy. And, of course, many of these allergens are often hiding in all kinds of desserts and holiday treats.”

Dr. Hui says the best way to prevent accidental exposures is to have gatherings in a controlled environment. Offer to host events yourself or provide some or all of the food to ensure it is allergy-free. If guests would like to contribute, assign people non-food items to bring, like plates, cups and decor.

“We know that hosting is not always possible, so when you attend events it’s important to communicate with your host and others who are bringing a dish to share,” Dr. Hui said. “Just informing them about a food allergy is not enough, because people’s knowledge of how to spot those allergens and how thoroughly they check their recipes varies greatly.”

Dr. Hui helps her patients make a plan to navigate the many allergy pitfalls the holiday season can present. She says being vigilant about food preparation and presentation can help take the stress out of holiday eating for those with food allergies.

Hang on to food labels and recipes: Ask that anyone sharing food keep ingredient labels and recipes for the food they’re serving, and ask to see them before digging in.

Avoid cross-contamination: Wash your hands before handling, cooking and eating foods, and don’t eat or drink while cooking. Use one cutting board for each food group and sanitize dishes and utensils after each use.

Carry medications: Have emergency medications (epinephrine auto-injector) with you at all times. “No epi, no eating!”

Discuss strategies with your allergist: An allergist can help you prepare for the holiday season and suggest allergy avoidance techniques to help keep you or your child safe. Your allergist also can help you and your child become "label detectives" so you both know what ingredients to watch out for.

Carly Edwards has worked with Dr. Hui for years after learning that both of her daughters — Elsie, age 4 and Della, age 1 — are allergic to eggs. She says these tips have helped her educate family members on their dietary needs when they gather together.

“We have a big family — lots of gathering, lots of eating — and the whole family has become egg experts as well. They text me in advance and let me know what food will be there, and they know the different substitutes in recipes for eggs, like applesauce,” Edwards said. “So oftentimes they have a separate dish for the girls, which just makes them so happy to know there’s something they can eat.”

Edwards always brings allergy-free snacks and treats with them so her girls feel they’re a part of the celebration even if they’re not able to eat the food provided. Both of her daughters are also making strides to lessen and perhaps one day outgrow their food allergies through treatment at National Jewish Health.

“They’re both now able to have baked eggs in certain foods, and Elsie is really excited because she was recently able to try French toast for the first time,” Edwards said.

Edwards’ youngest daughter Della is enrolled in the SUNBEAM Study, which follows babies through age 3 to help researchers learn more about the causes of food allergies and other allergic conditions and inform new treatments and preventive measures.

“We've come an incredibly long way in our understanding of each different food allergy and how we treat them,” Dr. Hui said. “With certain allergies, particularly milk and egg, a majority of kids will outgrow them. But even with the allergens that are more persistent, there certainly are many therapies we can now offer, like oral immunotherapy, that can lessen symptoms and the chances of an accidental ingestion leading to hospitalization or even becoming life-threatening. There's also a lot of research in the pipeline and new information we’re learning that will hopefully lead to even better outcomes in the near future.”