Celebrating the Holidays with Food Allergies

By: Stacey Messé, Pediatric Dietitian, RD, CDN, CNSC

With the holiday season here, we all have a lot of things on our minds.  The holiday season can be filled with joy and laughter, but it can also be filled with stress and worry.  For parents of a child with allergies, this can be a particularly challenging time.  The holiday season is filled with parties, family gatherings, and other special occasions, which usually revolve around food and indulgence. These special occasions present many unknown challenges for a parent trying to manage their child’s allergy. Many holiday foods are laced with peanuts, wheat, eggs, milk, soy and other allergenic foods.

Some simple tips to help ease your mind and make the holiday season more enjoyable:

 If your child will be attending a party, contact the host or person in charge of the gathering.  Come up with a plan to ensure your child’s safety.  You could also offer to bring a dish to pass that your child can have to share with others.

 If your child has a holiday event at school that involves the sharing of food, speak with the teacher in advance or get involved in the planning committee to ensure there are allergen-free options available.

 Pack safe food alternatives for your child so your child doesn’t feel left out if there aren’t allergen-free options provided at a holiday event.

If you are preparing a holiday food or meal yourself, involve your child in the planning, shopping and preparation.  This will be a great opportunity for your child to learn safe cooking techniques, research recipes and check ingredients.

Get creative.  Try fun new recipes to help celebrate the occasion.  There are many cookbooks and recipes that alter or offer helpful ideas on how to accommodate for your child’s dietary restrictions. Try these websites for allergy free recipes and other great resources: www.kidswithfoodallergies.org  and www.foodallergy.org .

Ensure that your child understands that restricting food allergens is a full time job and the holidays aren’t an exception.  Discuss the risk factors with your child and prepare them to speak up when they recognize unsafe foods.  This discussion should be had in advance to help minimize temptation and improve compliance.

Encourage meaningful non-food traditions.  A holiday craft project can be a nice distraction from the common emphasis on food. www.pbs.org/parents/fun-and-games/activities-and-crafts/winter-holiday-crafts-for-kids/

If you will be traveling for the holidays be sure to plan ahead.  Verify an airline’s allergy policy if your child has a severe allergy to ensure safety.  Pack snacks and non-perishable foods to eat while traveling.

If your child has a life threatening allergy always have an EpiPen on hand in case of emergency.

Recommended books for young readers about Food Allergies by Mary Laverty, Family Resources and Services Coordinator, MLIS, CAS ESL, Upstate Golisano Children’s Hospital

Medikidz explain Food Allergies: Superheros on a Medical Mission (2009) by Dr. Kim Chilman-Blair. Young readers learn what to expect, how to react and how food allergies are treated in this graphic novel. A great book for older kids and teens. Includes glossary, further resources, and index.

 

Kylie’s Special Treat: A Food Allergy Fairy Tale (2012) by Letizia Barbetta. A  fairy tale about a girl who loves to paint, dreams of a prince, and has a food allergy. One day she receives an invitation to cook the prince a special treat. She happily bakes him her favorite dessert. Of course, it doesn’t include any of the foods she’s allergic to (milk, eggs, peanuts, and tree nuts). Kylie shows the reader how she manages her food allergies with poise and confidence, follows her dreams and goes on to live happily ever after. A simple baking recipe, food allergy tips and resources for adults are included.
The Peanut Pickle: a Story about Peanut Allergy (2012) by Jessica Jacobs. Living with a peanut allergy is hard, and peanuts are everywhere! Ben ate peanut butter when he was young and he had a bad allergic reaction. At first he was too scared to speak up about his allergy and tell people that he couldn’t be around peanuts. Now, he knows that speaking up is very important, since he encounters food with peanuts at school, at T-ball practice, at birthday parties, and during the holidays. The Peanut Pickle will help children learn how to tell others about a food allergy and explain that they need a safe environment. It will teach them how to deal with difficult and awkward situations that inevitably arise when a child has a life-threatening food allergy. It also includes a guide for parents to help their children with food allergies.

 

 

 

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Discussing Ebola with Your Children

By Dr. Jana Shaw, Pediatric Infectious Diseases, Upstate Golisano Children’s Hospital and the American Academy of Pediatrics webpage HealthyChildren.org

Editor’s Note: This page will be updated with new information as it becomes available.

Ebola has been a focus of daily news since the first infected patient arrived in the US in September. Given the severity of the illness, the news can be frightening to children. Hence it is important that parents and caregivers are prepared to discuss Ebola with their children to alleviate their fears.

It is much easier to catch to the flu or other respiratory viruses than Ebola. For example, based on the Ebola statistics we have right now, it is likely that flu will cause far more illness around the globe than Ebola will.

News Coverage Understandably, there is heavy coverage in the media about the spread of Ebola. However, it is a good idea to limit young children’s exposure to news stories about it. This way, parents can decide what information they want to share based on their child’s level of understanding. Here are some things to remind your children if they are concerned:

  • They are safe.
  • Our health care system is among the best in the world for taking care of sick people.
  • Ebola is rare and does not exist everywhere. When cases are found, the person with the infection is taken to a safe place to be cared for so that he can get better and not make anyone else sick.
  • Doctors and scientists who know a lot about Ebola are working hard to find ways to prevent or cure this illness.

Social Media With many children and teens spending a lot of time on social media, there is also the risk that they could read something online about Ebola that they do not understand and may become unnecessarily alarmed. Pay close attention to what your children are seeing online. Talk to your children and help them avoid graphic exposure to the media.

Keeping Calm News about the spread of diseases can be alarming, even for adults. Keep yourself well informed so that your own fears are under control. Talk with your children in ways that make sense to them so they don’t become overly concerned or afraid.​

Important facts for parents when explain Ebola and other viruses

What is Ebola? Ebola is a viral infection, yet it is very rare and is not easy to transmit from person to person. There is a serious outbreak in West Africa, however, in part due to lack of virus prevention and access to adequate medical supplies.

What are the Signs & Symptoms of Ebola? Ebola typically starts suddenly with a fever but symptoms can also include a severe headache, muscle pain, weakness, diarreah, vomiting, stomach pain, or unexplained bleeding or bruising. The time from infection with the virus to the onset of symptoms is from 2 to 21 days (with 8 to 10 days being most common). A person with the Ebola virus can infect others as soon as they begin to have symptoms. Early-stage Ebola disease may be confused with other infectious diseases (e.g., flu) because the initial symptoms are similar to those seen with other viral infections.

How is Ebola Spread? Unlike the flu, Ebola is not spread through the air or water. The chances of you or your children becoming infected are slim. Ebola is only transmitted through direct contact with the body fluids of an infected person or from objects like needles that have been in contact with infected body fluids. This means it does not spread through air, food, water, or by touching things like money and keyboards.

Can You Get Ebola From a Dog or Cat? At this time, there have been no reports of dogs or cats becoming sick with Ebola or being able to spread Ebola to people or animals. The chances of a dog or cat being exposed to Ebola virus in the United States is very low as they would have to come into contact with blood and body fluids of a symptomatic person sick with Ebola.

Can Ebola Be Prevented? Yes, killing the virus is easy. The Ebola virus can be killed with soap and water, heat, or a disinfectant or sanitizing agent.

According to the Centers for Disease Control and Prevention (CDC), washing your hands frequently or using an alcohol-based hand sanititzer is a good precaution. This is perhaps the most important message for children to learn and share.

Because people in West Africa may not be able to follow these precautions and may not have access to soap and water, Ebola has continued to spread.

A book explaining viruses and infections

Recommended by Mary Laverty, UGCH librarian

Infections Diseases by Anne Rooney 2011 published by Smart Apple

Kids will learn about the bacteria, protists, and viruses that have caused some of the world’s most wide spread infectious diseases as well as about important scientific advancements in the treatment of these diseases and the individuals who invented the cures. Young readers will walk away from this book with a deeper understanding of how diseases spread and how to combat them.

 

 

 

 

 

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Some Tricks for Enjoying Halloween !!!

   By Mardie Ninno –  Margaret L. Williams Developmental Evaluation Center, Kohl’s Autism and Related Disorders Program       

 Most children really enjoy Halloween!!  They love the pumpkin faces, the candy they get trick or treating, the costumes, and many of the older children love the scary movies and haunted houses that seem to be everywhere during October.  But for some children, especially children with Autism Spectrum Disorders or children with sensory or anxiety disorders, Halloween can be a really difficult time. Many of these children are uncomfortable with new and different routines, foods, clothing, etc, and Halloween certainly brings with it many novel and unusual sights, activities, and even foods.  Children with sensory issues may be hypersensitive to such things as the feel of the insides of pumpkins, the texture or fit of their costumes, or the unexpected and eerie sounds and music that might accompany a Halloween Party or trick or treating.  So how can families celebrate Halloween in ways that will help their children with these issues to feel comfortable and hopefully actually enjoy the season?

Offer Choices  so your children can decide what would be fun for them to do at Halloween.  Listen to their comments about what they would and would not like to do, and make sure they are an active participant in the decision making.

Prepare, prepare, prepare your child ahead of time!  All of us are more comfortable when we know what to expect, and for children on the Autism Spectrum, this is crucial.  Think about what activities your family would like to participate in. 

Outside Activites Do you want to visit a pumpkin patch that involves going on a wagon ride?  Then you might want to read books about visiting a pumpkin patch, look at the web site of the farm you will be visiting with your child, or look for You Tube or other videos of this activity.  Share these visuals with your child.  Remember, children with Autism tend to process visual information very well, so showing rather than just telling them what the pumpkin patch will be like will be even more effective.

 Costumes Do you want to dress up and go trick or treating in your neighborhood as a family?  Again, introduce your child to the idea of dressing up in a costume way before the big day.  Show them pictures of costumes in catalogs or on line.  Visit the costume section of a store to see costumes.  Help your children to choose their own costumes, and then let them have lots of opportunities to wear them before Halloween.  Some children may have difficulty with the tags, seams or textures of their costumes, so be sure to have them try on the costume before they have to wear it.  That will avoid melt downs and upsets by children whose bodies just don’t feel good surrounded by a slippery fabric or too tight hat.

Trick or Treating  Think about walking your trick or treat route with your children ahead of time, so that they are familiar with where they are going.  And practice the actual act of trick or treating at home.  Trick or treating can be broken down into these 4 easy steps:

  1. Knock on the door
  2. When someone answers, say “Trick or Treat”
  3.  Open your bag so that the person at the door can put in candy or a treat
  4. Say thank you

You might want to make a visual card to take with you to remind your child of these steps.  Or you might want to program these phrases into your child’s communication device.  Or you might want to write a social story about what trick or treating will be like and read it several times at home with your child.

Decorating Pumpkins: Some families like to decorate pumpkins together.  Your child with sensory issues may not like the feel of the insides of the pumpkin.  Or your child may be frightened or disinterested in this activity.   If that is the case, consider one of these options:

  • Offer your child gloves to wear or a spoon to use for the pumpkin scooping
  • Provide other craft materials to decorate the pumpkin that the child does like.  These might be markers, paints, colored tape, stickers, etc.
  • Dress up your pumpkin with your child’s clothing or toys.  Put her hat on the pumpkin’s head or have the pumpkin pose with a favorite stuffed animal.

 Halloween Treats If your child does not like the treats that are likely to be handed out at trick or treating or at Halloween parties, consider bringing foods that he/she will like.  Or bring non-food treats you know your child will enjoy.  You can also try introducing your child to new Halloween foods such as pumpkin cookies and candy corn at home ahead of time.  Your child will be more likely to try a new food in the comfort of his own home than in a strange place.

            Halloween can be a really fun time for families.  Thinking about the activities you would like your family to do ahead of time and preparing your child for them will go a long way to making sure it’s a real treat for everyone!

Armond Goes to a Party: A book about Asperger’s and Friendship by Nancy Carlson and Armond Isaak 2013 recommended by Mary P. Laverty Golisano Children’s Hospital in-house Librarian

A perfect book to share with children nervous about going to a party or any new social event. The colorful pictures and realistic dialogue make this a perfect read for guests and hosts alike.

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Healthy Back-to-School Habits: Hand Washing

By Mary Laverty MLIS

For many families and children in Upstate New York, the first day of The Great New York State Fair also begins the countdown to the first day of school. The first days of school can mean reconnecting with favorite teachers, making new friends and creating some new healthy habits. According to the American Academy of Pediatrics parenting website www.healthychildren.org “hand washing may be the single most important act you and your child have for disease prevention.”
Why do I have to wash my hands so much?
Hand washing can stop the spread of germs. As early as possible, get your children into the habit of hand washing often and thoroughly. All school aged children are exposed to germs – opening door handles, moving chairs, reading books, working at desk tops, using bus handles to climb aboard, sliding into the bus seats, typing or playing keyboards, using learning toys, playing with sports equipment, touching a playmate, or sharing toys. The whole process of infection can happen in seconds and cause an illness that can last for days, weeks, or even longer. The key is to encourage your child to wash her hands throughout the day. For example, help her or remind her to wash her hands:
• Before rubbing her eyes
• Before touching her nose
• Before placing her fingers in her mouth
• Before eating – including snacks
• After a trip to the bathroom
• Whenever she comes in from playing outdoors
• After touching an animal like a family pet
• After sneezing or coughing if she covers her mouth
Studies on hand washing in public restrooms show that most people don’t have very good hygiene habits. “Hand washing” may mean just a quick splash of water and perhaps a squirt of soap, but not nearly enough to get their hands clean.
How do I wash my hands?
The Centers for Disease Control and Prevention (CDC) recommends the following steps to washing your hands well:
• Wet your child’s hands.
• Apply clean bar soap or liquid soap to the hands, and then place the bar on a rack where it can drain before the next hand washing.
• Rub the hands vigorously together. Scrub every surface completely.
• Keep rubbing and scrubbing for 10 to 15 seconds to effectively remove the germs. Pick a song that lasts for 15 seconds and sing it while you wash. Two verses of “Happy Birthday,” “Row, Row, Row Your Boat,” or “Twinkle Twinkle Little Star” will teach your child how short 15 seconds can be. Frequently, kindergarten and first grade teachers will have a special hand washing song. Your child can teach it to you child as they wash their hands at home. Encourage your child to wash her hands not only at home, but also at school, at friends’ homes, and everywhere else. This is an important habit for her to get into, and hopefully one that is hard to break!
• Rinse the hands completely, and then dry them.
What kind of soap?
Drugstore shelves are full of antibacterial soaps, but studies have shown antibacterial products are no better at washing away dirt and germs than regular soap. Some infectious disease experts have even suggested that by using antibacterial soaps, you may actually kill off normal bacteria and increase the chances that resistant bacteria may grow.
Is waterless washing just as good as soap and water washing?
The best solution is to wash your child’s hands with warm water and ordinary soap that does not contain antibacterial substances (e.g., triclosan). When your child’s hands are visibly dirty, regular use of soap and water is better than using waterless, alcohol-based soaps, gels, rinses, and hand rubs. However, when there is no sink available (e.g., the car), hand rubs can be a useful alternative.

Story time and healthy habits: A few books that can help answer your child’s questions about germs and why washing with soap and water is so important to good health.
Whiffy Wilson: The Wolf Who Wouldn’t Wash by C. Hart and L. Lord 2014; preschool to kindergarten. There was a little wolf called Whiffy Wilson who never brushed his hair. He never washed his paws or face, or changed his underwear. Will anyone be able to persuade Whiffy Wilson to change his gross ways for something far less stinky?

 

 
Germs! By M.Howard and C. Stimpson 2012; K-3rd grade. Sam, a young germ, is conscripted to fight in the Germ Army. What is the ultimate goal of the germ monarch, Queen Bacteria? To make the boy in striped pajamas sick. When he fails to wash his hands one day after using the toliet, the germs seize their opportunity to attack, only to be met with the friendly Antibody Army led by King Antibod. This active and dynamic book with giant germs and toilets has a funny story for a serious message – wash your hands to stay healthy!

 
Dirty Bertie: Germs by D. Roberts and A. Macdonald 2012 1st to 3rd grade. On Monday, Suzy, Dirty Bertie’s sister, stays home from school with the chickenpox. She will have to stay home all week. Bertie wants to stay home too. Bertie uses his sister’s pink toothbrush and drinks from her glass in try to catch her germ but with no luck. Until Saturday morning.

 

 

 

 
Source material on health issues from Healthy Children.org sponsored by the American Academy of Pediatrics www.healthychildren.org
Books reviewed and recommended by Mary Laverty  Golisano Children’s Hospital Family Resources and Services coordinator for the Family Resource Center in GCH.

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Summer Time Eczema

Summer Time Eczema

By Alyson Weiner

Eczema is a common skin condition that affects children. Affected children usually have dryer skin in the wintertime and end up having more severe symptoms. However, many children become more self-conscious about their eczema when they are wearing shorts and tank tops over the summer. Additionally, sweat, chlorine from pools and sun exposure can actually worsen eczema. Children can still do the summertime activities they love as long as they bathe, use sunscreen when outdoors and apply moisturizing cream or ointment after the bath or getting out of the pool.

What is eczema?
Also known as atopic dermatitis, it is a chronic disease of patchy skin redness and itching caused by a normal inflammation in the skin. IT is not caused by a virus or bacteria and it is not contagious. The rash usually begins in early childhood and the symptoms vary in severity. Asthma and allergies frequently, but not always, go along with eczema, and occur in the family members of kids with eczema.

How can it be treated?
The primary goal of treatment is to avoid flare-ups, keep your child comfortable and avoid long term skin changes. Children with eczema have a less effective skin barrier and are more likely to have irritation from skin irritants; such as detergents, perfumes, hot water, wool, solvents, down feathers, and tight clothing. Sweat, food allergies, infections, and stress can also worsen eczema. To avoid flare-ups, children should take short baths and/or showers in warm water without washcloths. They should use non-detergent, non-scented soaps like Dove, Tone, and Cares. After the bath, the skin should be patted dry and then a moisturizing cream or heavier ointment should be generously applied. The moisturizer should be applied an additional 2-3 times every day. This prevents dry skin. Dry skin leads to increased itching and scratching which may lead to a flare-up. Nivea or Eucerin creams are frequently recommended for slightly to moderately dry skin. A heaver over the counter ointment, such as Aquaphor, or petroleum jelly is useful for severely dry skin. Your child’s doctor can help determine the most useful cream or ointment to use.

For flare-ups resulting in red, inflamed, and blistered skin, steroid cream or ointment may be prescribed by your child’s doctor and applied to the skin for 7-14 days. Caution should be used when applying steroid cream to your child’s face, diaper area, and underarms. The skin in those areas is thinner and may show greater side effects from the steroid cream. Short-term use of steroid cream is beneficial in other parts of the body. See your doctor right away open sores and drainage, or for a flare-up that is not getting better.

What are some complications?
It is important to monitor and treat your child’s eczema and follow-up with your pediatrician. Potential complications include skin blisters and skin infections. Some children have difficulty sleeping due to their itchiness and become irritable during the day.

Eczema usually decreases in severity, as children get older. The frequent use of over the counter moisturizing creams and ointments is a great way to avoid flare-ups and prevent complications. If you have any questions about the best way to manage your child’s eczema, please talk to your child’s primary doctor.

 Alyson Weiner is a fourth year medical student at SUNY Upstate Medical University, and she is interested in becoming a pediatrician.

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