Food allergies affect children of different ages in different ways
and can influence relationships with classmates, family and the
general public, according to the study in the Annals of Allergy,
Asthma & Immunology.
"Quality of life issues related to food allergies are ubiquitous,"
said co-author Dr. Ruchi Gupta, director of the Center for Food
Allergy and Asthma Research at the Northwestern Feinberg School of
Medicine in Chicago.
"Coping with food allergies impacts relationship skills with peers
and classmates, emerging independence and sense of self-efficacy,
social skills and confidence, willingness to participate in sports
teams, dating and more," she told Reuters Health by email. "Coping
is an individual internal experience, too: Feelings of worry and
anxiety can color all thinking and generate anxiety about many life
experiences."
About 8% of children in the U.S. have been diagnosed with a food
allergy, according to the American Academy of Pediatrics. Allergic
reactions to foods tend to be among the most severe, and potentially
life-threatening, the study authors note.
Anaphylaxis, the most severe allergic reaction, can be reversed with
a shot of epinephrine from an auto-injector like the EpiPen.
To examine the challenges children with life-threatening food
allergies and their families encounter, which ones cause the most
anxiety and what positive coping patterns work best, Gupta and
colleagues interviewed six board-certified allergists who treat a
large number of children with food allergies.
Overall, the allergists said, diagnosis, management and treatment
occur along a spectrum, and "it's not a one size fits all" practice.
Younger children, for instance, may not be especially anxious about
food, but their parents often are. Although older children may have
better understanding and control of their food allergy, they
participate in more independent activities, which can create
heightened parental anxiety.
Kids with food allergies experience anxiety as a result of their
parents' stress, as well as fear of the auto-injector needle,
anaphylaxis, food allergy tests and oral immunotherapy. The
"fallout" that follows an allergic reaction can also be complex and
interfere with everyday functioning. Successfully using epinephrine,
however, can build confidence and bring a sense of relief after
facing the unknown.
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The allergists also talked about creating thoughtful and balanced
communication, having credible health information to share with
children, and supporting a positive feedback loop between parents
and children rather than one that builds anxiety. "Parents should be
encouraged to transfer their knowledge to children, not all of their
worries," one expert remarked.
"Psychosocial coping with food allergies can be understood and
managed when clear communication is present between parents and
children and between healthcare providers and patients," Gupta said.
"It is a balance between lots of sound medical information and a
good understanding of a child's risks and coping resources."
Coping is often impeded by misinformation about food allergies, the
experts said, so it's important for parents to receive consistent
messaging and counseling for the family, if necessary.
"You are taking care of the kids, but you are (also) managing the
family unit, as you should be," one allergist said.
Brochures, apps, virtual groups and other educational materials can
offer scientifically informed resources for parents and kids to
manage food allergies. Gupta and colleagues are now collecting
information in an online survey about the coping strategies and
integrative medicine that parents and children have used.
"It's important for families to know that it's normal to be stressed
about food allergy and feel overwhelmed, worried, sad or frustrated
at times," said Linda Herbert, director of the Psychosocial Services
Program for the Division of Allergy and Immunology at Children's
National Hospital in Washington, D.C.
"But it's equally important to know that they can get help from a
professional," Herbert, who wasn't involved in the study, told
Reuters Health by email. "The mental health and allergy communities
are paying more and more attention to the needs of food allergy
families, and we are working hard to increase the number of mental
health professionals who are equipped to do so."
SOURCE: https://bit.ly/2utQCOm Annals of Allergy, Asthma &
Immunology, online February 25, 2020.
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