This post was originally published as a guest post for Allergy Aware Kitchen, see Biography below.
My name is Louise and I have two children, a son (aged 3 ½) who has a severe peanut allergy and a daughter (almost 2) who, touch wood, has no known allergies as yet.
The first reaction
We discovered my son’s peanut allergy the hard way. When he was 20 months old he took a bite of a peanut butter cookie. It was the first time he had knowingly been given peanut. He suffered an allergic reaction that was immediate and severe. His lips puffed up and his eye swelled shut. His breathing became loud and wheezy.
Luckily, his grandmother, a retired nurse, recognised the signs of anaphylaxis and dialled 999. The early response paramedic arrived within minutes with the life saving adrenaline injection. However, when he was taken to hospital, the doctors became concerned that the swelling in his throat was not subsiding. They made the decision to induce him into a coma, so that they could insert a breathing tube, before his throat swelled closed. He spent three days in intensive care, on a life support machine, whilst the doctors waited for signs of a “trickle” around the breathing tube, which would show them that the swelling was going down.
Fortunately, he recovered well and by the end of the week he was back home playing with his Lego and watching CBeebies. You would not guess by looking at him what he had been through. However, then began our task of learning to live with a life threatening nut allergy…
How does a severe food allergy change your life?
My son’s peanut allergy impacts on all areas of our family life. That may sound extreme: I’m not saying it dominates. However, it does add an extra layer of organisation for everyday things. For example:
- Wherever we are and whatever we’re doing, we always have to have my son’s emergency medication to hand. On entering the world of allergies, we had to learn how to recognise the symptoms of an allergic reaction and make sure that we know the drill for what to do in an emergency (including adminstering his “EpiPen” adrenaline auto-injector). The same is true for anyone who cares for our son: babysitters, nursery, school, his friends’ parents when he goes for a playdate. They all need to be trained in what to do.
- We have to check EVERY food label for the mention of nuts. On doctor’s advice, we avoid all types of nuts. So, if a food label mentions “peanut” or any other type of nut in the ingredients list, then my son doesn’t eat that food. We also avoid any foods which have a nut warning label (for example, “may contain nuts” or equivalent wording).
- Going out for the day? As well as carrying his emergency meds, I need to make sure I have some safe snacks too, in case there are no nut allergy friendly options when we are out and about.
- Choosing a school? I need to find out which are food allergy savvy and check they have safeguards in place to protect allergic children and deal with a reaction, if it happens.
- Booking a holiday? What’s the airline’s peanut policy? Do I need a GP’s letter to carry my son’s EpiPens onboard? Does the resort have a supermarket where I can buy safe foods? Where’s the nearest hospital? Do I know the emergency number for calling an ambulance and can I report “anaphylaxis” in the local language?
Saying that, despite his peanut allergy, as a parent, I want him to have as normal a childhood as possible. Yes, we have to be careful. However, I feel strongly that his allergy shouldn’t prevent him from going to, for example, parties, playdates and restaurants. Although it may require more planning and organisation, I don’t want him to be deprived of those experiences. We just have to figure out a safe way of achieving them.
Eating out with a nut allergy
Going to a restaurant can often feel like a fairly daunting prospect. As tourists in Keswick one lunchtime, the thought of going into a café or tea room and having the “nut chat” (the conversation with the manager where I ask if they can cater for my son) just felt too exhausting a prospect. We ended up buying supermarket bread rolls and a packet of ham and sitting on a bench eating a bland, makeshift picnic.
What would have made things easier for us that day? Maybe if we had spotted a chain restaurant which had a reputation for being allergy friendly, or if one of the cafes had a sign outside saying “Dietary requirements? Just ask!”? I’m sure that would have lured us inside and we might have forked out £10 a head, rather than a few pounds between us for bread and ham.
The perfect eating out experience?
One of our first attempts at eating out post peanut allergy diagnosis was at our local Pizza Express. Having explained about my son’s allergies to the waitress, she told me that one of the chefs had a severe nut allergy, having recently suffered anaphylaxis to some soft cheese which contained nuts, unbeknownst to him. Although you wouldn’t wish a food allergy on anyone, that was music to my ears. If anyone was going to “get” the need to serve my son a nut free dish, a nut allergic chef would.
So, short of there being a nut allergic chef, here are my suggestions for restaurants as to what would happen on an ideal visit:
- No blagging! Firstly, I should say that if you genuinely CAN’T cater, please say! I’d much rather be told “we’ve got a tiny kitchen and there are nuts everywhere” than someone say “yeah, yeah, yeah… no problem” and then serve my son something that isn’t safe.
- Website allergy info. Wherever possible, I will research restaurants online before venturing out. My eyes will light up if I see a statement along the lines of “Please talk to us about any food allergies, full information is available”. A downloadable allergy guide, detailing which dishes contain which allergens, is also extremely useful. Although this would only cover intentionally added ingredients and I would still need to talk to the restaurant about cross contamination, the fact there is an allergy guide hints that the restaurant is alert to its allergic customers.
- A confidence inspiring greeting. On arrival at a restaurant, my stock opener is “my son has a severe nut allergy, is this something you can cater for?”. The most confidence inspiring response I can receive to this would be “Yes, many of our dishes have no nuts in the ingredients and we are well used to cooking for people with allergies. Come in, and I will ask the manager / chef to come and talk to you.”
- Recommending a safe option. When we talk to the manager or chef, I don’t expect them to say that every item on the menu can be made nut safe (although obviously it would be fantastic if that were the case). I think it’s perfectly reasonable to tell me, for example, “these dishes are fine, but avoid anything made on the grill”, if that’s where there’s a risk. If we’re only offered one or two nut safe options, I am grateful… even if it means my son eating pasta and tomato sauce for the 50th time running.
- Reassure me about cross contamination! After we’ve identified a nut free meal, I need some reassurance on how that will be prepared. It’s fine to tell me “we can’t guarantee that any food is 100% nut free”. One manageress explained that whilst there were nuts in the kitchen, these were kept in sealed containers and that my son’s meal would be prepared in a separate area. I was reassured. I’m happy if you tell me (1) there are no nuts in the ingredients and (2) you understand the need to use fresh pans and utensils and everyone will know that nuts must not come anywhere near this meal.
- Then keep reassuring me… When we get to the point of placing an order, in the most confidence inspiring restaurants, the wait staff will tell me (before I’ve had a chance to ask!) that they’ve made a note of my son’s allergy on their pad. Once our order has gone into the kitchen, I’m really appreciative when our waiter comes back over to us and says something like “the chef knows about your son’s nut allergy and that the [tomato pasta] needs to have no nuts”.
- Nut free desserts? When it comes to ordering dessert, if the waiter/waitress recommends a nut free option without me having to ask (or even comes over and says “I’m sorry, there are no nut free dessert options”), that makes me feel like the restaurant is on the ball and is still keeping my son’s allergy in mind.
Our experiences of eating out with a nut allergy have certainly varied. All too often, on entering a pub/restaurant/cafe, we’re met with an expression of raised eyebrows teamed with puffed out cheeks then a nervous comment which tells me they’re not willing to cook for my son. We then need to search for somewhere else or my son eats a packed lunch whilst everyone else tucks into a restaurant meal.
However, on those occasions where an eatery can provide a safe meal and their service does inspire confidence, I am incredibly grateful and will go home and sing their praises on Nutmums.com and social media. That nut allergy friendly restaurant will then become a regular haunt and the place I recommend when family or friends are thinking about arranging a get together.
How things might improve from December 2014
At present, if a prepacked food or alcoholic drink contains one of the top 14 food allergens (or an ingredient made from one of them), this must be declared on the label. The “top 14 allergens” include peanuts and, separately, nuts. At present, allergen information does not have to be provided for foods sold loose and when eating out. However, this is about to change.
On 13 December 2014, the EU Food Information for Consumers Regulation will require cafes and restaurants to provide information on food allergens. This could be done in writing (for example, on a menu or a blackboard) or the information could be given verbally by a member of staff. So, if I go into a restaurant, they should either be able to tell me which dishes contain nuts as an ingredient, or point me to where the allergen information is written down.
Whilst the new rules are an improvement in that restaurant staff will not be able to simply shrug and claim not to know what a dish contains, they unfortunately only cover ingredients which have been intentionally added to the recipe. They do not cover accidental cross contamination. So a restaurant will still be able to say “that pizza doesn’t have any nuts in the ingredients… but our kitchen is tiny and there are nuts everywhere!”. We will still have to have the “nut chat” on arrival, to seek some reassurance that they understand cross contamination.
Even without addressing cross contamination statements, the new regulations mean all cafes and restaurants are forced to think more about allergens, and therefore hopefully in turn become more allergy aware generally. I think a likely key factor in the legislation’s success is the extent to which consumers demand the allergen information to which they are entitled. If we report those restaurants who continue to meet requests for allergen information with a shrug and a “dunno”, then standards are likely to improve.
In summary? The new rules are a welcome step in the right direction to make eating out with an allergy a safer, and therefore more relaxing, experience.