Food Allergies and Halloween
It is that time of the year again. Soon you will be seeing children (and some adults) trick or treating in your neighborhood searching for candy. For children, Halloween is a time to be with their friends, eat a lot of candy, and dress in scary costumes. For millions of parents however, Halloween can also be scary, but for a different reason: Their children have food allergies. According to Food Allergy Research & Education (FARE), approximately 6 million or 1 in 13 children in the U.S. have food allergies. This is about 8% of the U.S. pediatric population which is equivalent to about 2 children per classroom. In addition, more than 26 million adults also have food allergies. Together, there are about 32 million individuals with food allergies in the U.S. which is approximately 10% of the population. What is even more frightening is that the food allergy prevalence among children has increased dramatically within the last 30 years.
To give proper perspective, more than 40% of children with food allergies have experienced a severe allergic reaction to a food such as anaphylaxis. Pediatric hospitalizations for food allergies went up 3-fold in the last 30 years. Every 3 minutes, a reaction to a food causes someone to go to the emergency room, for a total of approximately 200,000 individuals per year requiring emergency care for allergic reactions to a food.
Although there are more than 170 foods that have been identified to cause food allergy reactions in the U.S., approximately 90% of all food allergies are caused by the same 8 common foods which include egg, milk, peanuts, soy, wheat, tree nuts, fish, and shellfish. Sesame seeds are becoming more common as well. The most common food allergies in children are peanut, milk, shellfish, and tree nuts. The most common food allergies in adults are shellfish, milk, peanut, and tree nuts.
The symptoms that a child (or adult) experiences from a food allergy may include nausea, vomiting, abdominal cramping/pain, diarrhea, swelling (i.e., angioedema) of the lips, throat, tongue, or eyes, hives (i.e., urticaria), shortness of breath, worsening eczema (i.e., atopic dermatitis), generalized itching (i.e., pruritus), wheezing. Of course anaphylaxis is a major concern and all food-allergic children and adults should carry a self-injectable epinephrine device (e.g., EpiPen Jr., EpiPen, Auvi-Q, Adrenaclick) or Neffy, an epinephrine-containing nasal spray. The patient should be instructed to go to the closest emergency room, if they use epinephrine.
To help insure that a food-allergic child can take part in Halloween and still have as much fun as a nonallergic child, although nothing is guaranteed, there is a program run by the Food Allergy Research and Education (FARE) organization called the “Teal Pumpkin Project.” This FARE-sponsored international program has been in existence since 2014. The Teal Pumpkin Project began in Tennessee by the mother of a child with severe allergies. The project’s aim is to increase awareness of the severity of food allergies as well as to give support to food-allergic children’s families. In order to participate in the Teal Pumpkin Project, a pumpkin is painted the color teal and then placed on one’s front porch to indicate that “non-food” treats are available at that location on Halloween night. The color teal was chosen because it represents food allergy awareness. Classically, “non-food” treats may include toys, stickers, crayons, necklaces, bracelets, rings, balls, whistles, hair accessories, money, bookmarks, finger puppets, glow sticks, vampire fangs, etc.
It is important to mention that the Teal Pumpkin Project is not exclusionary as it still promotes the option of handing out “normal” trick-or-treat candy to children without food allergies. It however recommends that the “non-food” items be placed in a different bowl or box than that a traditional candy bowl. FARE provides a “Teal Pumpkin Project Participation Map” on its website so that participating houses can be easily assessed by the parents of food-allergic children.
Whether or not a family or child participates in the Teal Pumpkin Project, reading labels on foods is of the utmost importance. Most families of food-allergic children know how to read labels on foods and avoid those foods that contain ingredients that their children are sensitized to. However, it is important to note that most “fun-sized” candies handed out while trick-or-treating either do not have any labeling at all or they may contain different ingredients than regular sized packages. Children with food allergies should also be instructed to graciously refuse homemade foods such as cupcakes, brownies, and cookies that may be unsafe for them.
Preventing children with food allergies to trick-or-treat without adult supervision as well as avoiding candies without proper labeling can prevent a life-threatening reaction. As mentioned above, it is a highly recommended that food-allergic children (and adults) carry a self-injectable epinephrine device (e.g., EpiPen Jr., EpiPen, Auvi-Q, Adrenaclick) or Neffy, an epinephrine-containing nasal spray while trick-or-treating or while eating Halloween candy.
The board certified allergists at Black & Kletz Allergy hope that everyone enjoys Halloween. We are here to meet your allergy and asthma needs for the people of the Washington, DC, Northern Virginia, and Maryland metropolitan area. We treat both adults and pediatric patients. We have offices on K Street, N.W. in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. There is on-site parking at each of the 3 offices. Our Washington, DC and McLean, VA locations are Metro accessible. Black & Kletz Allergy offers a free shuttle service between our McLean, VA office and the Spring Hill metro station on the silver line. If you suffer from allergies, asthma, sinus problems, hives, or immunological disorders, please call us to make an appointment. You may also click Request an Appointment and we will get back to you within 24 hours by the next business day. Again, we wish you a Halloween.