Managing Anxiety: A Handout for Families of Children with Food Allergies

Anxiety is common among families of children with food allergies. Anxiety related to food allergies may occur when families fear that their children may come into contact with, or accidentally eat, a food containing an allergen and that they’ll experience an allergic reaction. This can cause significant distress. It can also cause limited participation in daily activities, including social activities (like birthday parties or playdates with friends), family activities (like vacations or holiday celebrations) or participation in daycare or school. Learn tips to manage anxiety around your child’s food allergy and things to consider about your child’s food allergy at various ages and developmental stages.

Tips for managing anxiety

• To feel more confident around managing your child’s food allergies in different settings, review their Food Allergy Action Plan. Depending on your child’s age, educate others about the plan as well. This can include babysitters, daycare staff, school staff, coaches or family members. If your child is old enough, it’s also important for them to know the plan as well.
• Practice being a calm, consistent and confident role model for your child. Children are very perceptive (observe their surroundings and act accordingly) and take cues from their families. If you’re confident and calm, your child is more likely to feel the same.
• Avoid using potentially scary language, especially around young children. For example, describing your child as having “food allergies” rather than “life-threatening food allergies.”
• Remind yourself that safety routines can help increase confidence and educate your child about food allergies. For example, you could say:
  • “We carry epinephrine auto injectors (Epi-Pen®) in case of a reaction.”
  • “I read food labels before buying and serving foods.”
  • “My child is eating food that is safe for body.”
• Engage in social activities that help you and your child learn to safely navigate managing food allergies. Avoiding situations that make you feel nervous may feel easier, but avoiding these situations can lead to more anxiety in the future.
• Be aware of the information related to food allergies that you read or watch. Discuss questions with your child’s allergist (allergy doctor) and/or seek information from reputable (credible or trustworthy) sources. While blogs and social media groups may seem helpful, they may not always contain accurate scientific information. On social media, well-meaning people who try to help may share rare/frightening stories that may make you feel more anxious.
• If your child has an allergic reaction that becomes an emergency, once things have calmed down, reflect on what went well with your Food Allergy Action Plan. This helps improve coping skills and confidence after a stressful or scary event. For example, you could say, “The Epi-Pen® helped my child feel better right away” or “I am familiar with my child’s Food Allergy Action Plan.”

How to manage your child’s food allergies by age/developmental stage

Babies and toddlers (ages 0-2)

• Follow safety routines. This might include keeping foods that your child is allergic to out of reach, washing their hands before and after eating and wiping down surfaces they may touch. Sharing your routine with other caregivers can help you feel more confident when someone else is taking care of your child.
• If you’re introducing new foods, talk with your child’s allergist about a plan that you’re comfortable with. Introducing new foods can be stressful and overwhelming. Research shows that introducing new foods early and keeping those foods in your child’s diet can prevent the development of more allergies.

Preschool age (3-5 years)

• Teach your child basic information and skills about their food allergies. This is important as they begin to spend more time around other people. For example, model reading ingredient labels to find safe and unsafe foods. You could also teach your child to only accept foods that are given by specific adults (such as their teacher or certain caregivers). You could also use pictures to teach your child about their specific food allergies.
• Practice new skills through role play with dolls or action figures. The use of medical play (such as playing with a pretend doctor’s kit) can also help prepare your child for their allergist visits. Medical play is the use of toys, books, games, art and real or pretend medical equipment to help children become more comfortable with medical procedures, diagnoses, doctor’s visits or treatments.

Grade school (6-12 years)

• Provide your child’s school with the Food Allergy Action Plan.
• Before the school year starts, make a plan for food safety at school. For example, check if school lunch is allergen-free. Ask if they can sit with friends at the allergy table or regular lunch table. If treats are allowed for classroom celebrations, consider having back-up snacks available. Remember – Anaphylaxis doesn’t happen because your child is simply near an allergen.
• Help your child develop skills to communicate with others about their allergies. Over time, your child can learn to do this by themselves. For example, while eating at a restaurant, they can tell the server about their allergies with your support. Eventually, they can tell the server on their own while you observe. Role play or practice these skills with them if they are going to be somewhere without a family member present.
• Review safety routines with your child so they can develop confidence with managing their food allergies. For example, you could say, “When we leave the house, we take our allergy medicine with us.”

Teenagers (13-18 years)

• Learn the facts about the risks of being exposed to allergens in new situations. This can include traveling without family or navigating romantic relationships.
• Help your teen develop the perspective that they’ve done well avoiding food allergens, but that it’s important to always carry epinephrine in case of an emergency.
• Remind your teen to always carry their epinephrine autoinjector and teach them how to use it. This is important because teens are working toward the long-term goal of managing their food allergies by themselves in adulthood.
• With your teen’s allergist, you and your teen can talk about how to stay safe without limiting social engagement or extracurricular activities.

When should I reach out for help or support with my anxiety?

Talk to your child’s doctor or allergist about how to connect with a mental health professional if you:

• Are having a hard time managing worries
• Notice yourself regularly avoiding or preventing your child from spending time with peers or engaging in social situation

Where can I learn more about food allergies?

• Your child’s allergist
• Food Allergy Research & Education (FARE)
• American Academy of Allergy, Asthma & Immunology (AAAI)

A note about help or support for managing anxiety…

While some level of awareness about and attention to your child’s food allergies is helpful, it is important to recognize when you are experiencing distress or avoiding activities due to worry about your child’s food allergies. Consider reaching out to your/your child’s doctor for help or support if you notice that your anxiety is interfering with your/your child’s daily life.

Rev. 4/2023. Made in collaboration with the Family Advisory Council (FAC) at Mass General for Children (MGfC). MGfC and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treat any medical conditions.