•  Book Review: Child Safe •  Food Allergies and Asthma in Kids

The Parent's Guide to Food Allergies
By Marianne S. Barber with Maryanne Bartozek Scott, MD and Elinor Greenberg, PhD
Henry Holt and Co.
Paperback 356 pp $17

A child I know was taught to say, "If I eat peanuts, I could die." He's been telling this to those around him for almost as long as he's been speaking, rather than saying, "I have a peanut allergy." There's a good reason. Most people are used to allergy symptoms like sneezing and watery eyes. But they have a hard time grasping how serious an anaphylactic reaction can be -- that for the severely allergic, something as common as a peanut can be as lethal as a snakebite.

Marianne S. Barber's son Lucas had a reaction to peanuts similar to my young friend's, and was prey to other life-threatening allergies. Barber had to learn to pay attention to every detail of her child's diet, from the snacks he eats at school to treats he has at birthday parties. In her book, The Parent's Guide to Food Allergies, she offers an eloquent first-person account of her journey with Lucas, as well as medical information about asthma and allergies, a list of resources, and psychological support.

Barber sets the emotional tone of the book by starting with Lucas's first reaction to peanuts. When he was 14-months-old, Lucas took three bites of a peanut butter sandwich. Within a few minutes, he developed a rash and his breathing became labored. It took Barber and her husband 35 minutes to get Lucas to the emergency room because an ice storm had made the roads slick and snarled traffic.

Every parent can identify with the terror of that desperate ride. As minutes ticked by, Barber sang and laughed to keep Lucas as calm as possible while she prayed for his life. At the emergency room, a shot of epinephrine magically arrested the anaphylactic reaction. After the worst was over, a nurse warned her, "Watch every bite he takes."

"Watch every bite he takes" could serve as the subtitle for the rest of the book. How does a family accomplish this in the real world of siblings, school, birthday parties, and restaurants that cook with peanut oil? Lucas turned out to be "highly allergic to peanuts, most legumes, soy, and fish." He was also, for a while, highly allergic to milk, eggs, corn, peas, and tomatoes, foods that he was eventually able to tolerate. But some children aren't so fortunate.

Most parents are challenged to throw together a nutritious meal that children will eat at the end of the day. We are grateful when a school provides lunch or snack. Cooking for a child like Lucas, and overseeing by proxy every bite he takes away from home, can seem next to impossible.

Barber is the first to admit that it's not easy. She points out that resistance to creating a peanut-free environment usually comes from ignorance, but she recognizes, too, that it is an extra burden for caregivers and other parents to be vigilant of the problem.

With the help of her consultants, Maryanne Bartozek Scott, an allergist, and Elinor Greenberg, a psychologist, Barber sifts through the adjustments that must occur when a child is diagnosed with a life-threatening allergy. Everyone has to learn and change: parents, siblings, teachers, classmates, parents of classmates, waiters, flight attendants. So far, Barber has attended every birthday party with Lucas, now in elementary school, and provided his snacks herself.

The book is not just a rundown of the dangers in the outside world. Much of the book is devoted to how parents themselves cope with these threats.

It is this advice that makes the book special. In the section titled "Coping," Barber writes about two ways people manage anxiety. "Controllers" make themselves feel better in difficult situations by taking charge. "Avoiders" make themselves feel better by deflecting attention away from the difficult situation, either telling themselves that things are not as bad as they seem or fixating on something else. The trouble arises when, for example, a controller Mom assumes that an avoider Dad is not concerned because he doesn't want to announce the child's allergies to everyone in the family's social circle. Or when the avoider Dad resents what he perceives as constant instructions from the controller Mom. Barber suggests that parents try to talk out their differences so they can work together to protect their child.

The rest of the book does a good job of covering the medical information; it explains allergy tests and wheezing and tells how to use an Epipen (a pre-filled syringe with an automatic needle) to inject a child with epinephrine at home in an emergency. The author includes egg-free recipes and instructions for household mold control. She refers parents to the Food Allergy & Anaphylaxis Network and the Food Allergy Initiative for support and up-to-date information.

Many parents today micromanage their children's diets for a variety of reasons. One child may be allowed only organic food, another forbidden to eat dairy products. In this context, a mother talking to another about a peanut allergy may sound like just one more anxious parent overstepping social boundaries to control her child's world.

While this book is aimed at parents of allergic children, it reminds all of us, in a quiet, factual way, that this problem is different. Peanut allergies, in particular, seem to be burgeoning as the consumption of peanuts and peanut products increases worldwide, so the danger is more common than it used to be. Barber's poignant and readable book is not just for parents. With the wisdom we gain from this book, any one of us might someday save a child's life.

-- Toni Martin, MD, is a board-certified internist and geriatrician based in Oakland, California who has written for Hippocrates magazine. She also is an instructor and member of the clinical faculty at the University of California at San Francisco Medical School.

First published February 28, 2002
Last updated October 30, 2008
Copyright © 2002 Consumer Health Interactive

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