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The 12 allergens of Christmas

The holidays are a time of year when children with allergies are at increased risk for significant accidental exposures. Here are some tips to keep them safe.

Food Allergies

1-8: Peanuts, tree nuts, milk, egg, soy, wheat, coconut, and sesame. Before you reach for those Christmas cookies, make sure to carefully check the ingredients. Food allergens you're vigilant about at home may appear in meals and snacks at school and at the homes of friends and family. Offending ingredients like nuts, dairy, eggs, soy, wheat, coconut and sesame can sneak into cookies (a frequent culprit for accidental exposures) and casseroles. Dips and sauces can harbor any and all of these allergens. Pre-based turkeys may include dairy, soy and wheat as ingredients.

9. Seafood. The feast of the seven fishes is a wonderful holiday tradition, but if you have a child with seafood allergies, you'll want to call as far ahead as possible to let the host know about your child's diet needs.

In general, when planning holiday visits, it's a good idea to review menus with the host. You can also offer to bring a safe dish for your child and suggest that the host and any guests who are bringing food provide an ingredient card for their dishes, so guests with allergies can more safely participate in the fun. Provide the host with information about cross contact and contamination. Cooking for someone with food allergies requires not only avoidance of the allergenic foods in certain dishes, but also the need for frequent washing of hands, prep, and eating areas. Separate serving utensils should be used to prevent accidental exposures.

Friends and extended family who are not a child's primary caregivers may be unaware of or even skeptical about a child's allergy. This may be especially true of older relatives –food allergies were far less prevalent and severe in decades past than they are now. On the way to holiday visits, take a moment while en route to remind your child about safe and unsafe foods. Make sure they check in with you before eating, even if an extended family member or friend offers food and says it's ok. If your child is old enough, review their allergy action plan with them.

Make sure children with allergies eat before attending a party. With something in their bellies, they won't be as bothered about restrictions or tempted by food they wouldn't normally try. Bring something along that your child can safely eat and always have two doses of autoinjectable epinephrine immediately available, if this has been prescribed.

Environmental Allergies

10. Mold. A lot of people think they're allergic to Christmas tree pollen, when really, they might be reacting to mold spores. If your child is mold-allergic, consider an artificial tree. If you are planning to bring a real tree into your home, it might help to allow the tree to dry in the garage for a week and then shake the tree off to dispel mold spores prior to bringing it into the home. Although not technically an allergy, the fragrance from real trees can sometimes cause symptoms for children with asthma due to irritation.

11. Furry animals. Whether you're visiting or hosting, or Santa Claus leaves a new puppy under the tree, pet dander can be a cause of bothersome allergic reactions. Because animal dander travels in the air and on people, pets can cause allergy and asthma symptoms even without direct contact.

12. Dust mites. Dust can be a problem in homes where dust mite precautions may not be practiced as they are in an allergic household. It's also possible to stir up dust mites when taking decorations out of storage. If your child is spending the night away from home, it's a good idea to bring their own pillow.

Always carry your child's allergy and asthma medications along when you go visiting. If you know in advance that the home contains an environmental allergen that may trigger your child's nose or eye allergy, asthma, or eczema symptoms, it may be helpful to give them a non-sedating antihistamine about an hour prior to arrival.

With thoughtful advance planning, your child with allergies will be able to enjoy merry holiday outings that are free of bothersome allergic symptoms.

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