Friday, February 25, 2011

No cake walk

My daughter ran to Joseph squealing, "I got cake!" He looked at me and immediately asked if it was OK to touch her. Once he knew he was safe when I explained that we had thoroughly washed her hands and face, his next response came in the form of tears. Joseph once again felt left out because of his life-threatening food allergies to peanuts, tree nuts, wheat, milk, egg and soy. But this time his disappointment felt even worse because it was his own sister.

Pamela has followed her big brother's allergen-free diet all 21/2 years of her life because of her risk of developing allergies and also to continue to make his home the one place Joseph feels safe. Pamela's tendency to throw food, walk around with parts of her meal, and send food splattering by banging her food-filled utensils on the table made my decision to keep her on Joseph's diet simple. After all, one splash of yogurt in Joseph's dinner could send him to the emergency room or worse.

Joseph faces the risk of exposure to unsafe food everywhere he goes. For example, another child eating a peanut butter sandwich at the park and then hanging on the bars before Joseph touches them; or friends sitting closely while eating pizza, ice cream and cake at a birthday party. I didn't want the toys my children play with at home to be a source of risk for Joseph if Pamela were eating allergens then mouthing those toys or kissing her big brother. But once my daughter turned 2, I knew it was time to make sure her two negative food allergy tests panned out in real life. I didn't want to let her have a piece of birthday cake at a friend's party thinking she'd be fine without really making sure first.

So, I bought her a slice of cake and got out the Benadryl just in case. I watched her, looking for any signs of an allergic reaction, as she savored a huge forkful of dessert. Her only reaction was asking for more, which I refused until I was satisfied that she was OK. Introducing any new food — even after I've checked the ingredients and called the company to ensure there was no cross-contamination — has been nerve-racking since Joseph's diagnosis seven years ago. I was still anxious with Pamela's cake, after all I've witnessed my son's anaphylactic reactions to one tiny bite of food, so I knew what I might face if Pamela were to react to the cake. But this time was different because Pamela has not shown signs of any food allergies and she's been exposed to the allergens through nursing. I did read the label to ensure there were no peanuts or tree nuts (those were not entering my house under any circumstances). When we were done, I made sure there was no cake residue on Pamela or the table, and then I prepared for Joseph's return home from an outing with his Dada. 

I knew Joseph would be upset about the cake. He understands the severity of his food allergies and he loves all of the safe desserts we make, but that doesn't make it easy for a 7-year-old to be left out. I will be letting Pamela try some foods when Joseph is not home or when she and I are out just to make sure they are safe for her. But I don't plan on making Pamela's cake experiment a habit. Joseph's allergies mean he often feels isolated or excluded when food is involved. That doesn't have to be the case in his own home. I would like to avoid adding to his tears as much as possible. 

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