Severe food allergies can traumatize kids, but new program helps ease fears
By Alan Mozes Health Day Reporter
WEDNESDAY, Oct. 5, 2022 (HealthDay News) — For a young child with life-threatening food allergies, “the world feels like a minefield,” says a New Jersey mom.
It’s a stress-filled landscape that financial advisor Amy Leis knows all too well. Her daughter Zoe was just a few months old when she suffered her first serious reaction to food, a life-threatening event known as anaphylactic shock.
“I was terrified,” Leis recalled. “I had made cupcakes, and I gave her a taste, and she started to turn blue.”
Before long, Zoe was diagnosed with congenital allergies to a wide range of foods. Eggs, dairy products, peanuts and tree nuts have been considered potentially deadly. Soy, wheat, seafood and shellfish were all considered prohibited.
Since then, the stakes couldn’t be higher. So like millions of Americans”food allergy families,” Leis and her family have embraced a life of 24/7 vigilance, avoidance, and well-founded fear.
It’s a recipe, experts say, for the kind of overwhelming anxiety that can leave families feeling paralyzed and trapped.
The Food Allergy Bravery Program is a one-of-a-kind behavior therapy effort launched in 2018 under the auspices of Children’s Hospital of Philadelphia (CHOP).
“The anxiety around food allergy can be incredibly difficult,” noted Megan Lewis, Pediatric Nurse Practitioner, Program Manager in the Division of Allergy and Immunology at CHOP’s Food Allergy Center.
“Families and patients with food allergies often rate their quality of life worse than those with chronic conditions like diabetes and childhood cancers,” Lewis noted. “Food is everywhere and a part of almost every social situation. Navigating it safely can be incredibly stressful for families.”
To solve the problem, Lewis and his colleagues designed a program centered around five to eight sessions of cognitive-behavioral therapy (CBT). Each lasts 30 to 45 minutes. Meanwhile, kids ages 6-18 are slowly encouraged to face their food-related fears through a series of carefully supervised “bravery challenges.”
A form of exposure therapy, challenges may involve briefly touching or sniffing a problematic food, or being encouraged to adopt non-problematic foods without undue fear. Challenges are also designed to be repeated at home. The goal is to build children’s confidence and sense of control without putting them at risk.
At the same time, parents and children learn what really constitutes safety – or “safe enough” – so that everyone can better distinguish between real risk and manageable risk.
After 10 children (ages 8 to 12) and their parents completed a six-session diet, general anxiety and food-related anxiety declined sharply in the children, Lewis and his team reported. After treatment, parents and children experienced notable improvements in quality of life, and all parents said the program was “very” or “extremely” helpful.
An outside expert who reviewed the results said the use of cognitive behavioral therapy to treat food allergy trauma is “very exciting.”
“CBT is a mode of treatment that really gives the individual a heightened sense of their ability to deal with problems, their ability to see problems, assess them to figure out how to deal with them, and then the ability to learn new techniques “, said Connie. Diekman. She is a food and nutrition consultant in St. Louis and former president of the Academy of Nutrition and Dietetics.
“Given the considerable benefits of CBT, it’s no surprise that it has helped these children and their families reduce their anxiety about their safety when dealing with a food allergy,” Diekman added.
No one is probably more excited about the results than Leis.
When she was still just a toddler, Zoe began “oral immunotherapy” treatment, essentially a lifelong habit that aims to develop a protective amount of allergy tolerance by regularly exposing patients to very small amounts of problematic foods.
“We wanted her to be ‘bite safe,’ which means if she accidentally has a bite of this food, she probably won’t die,” Leis said. “And it helped her. It took years and years, but it really helped.”
Even so, the family was still on high alert, she added.
“It was awful,” Leis recalled. “Never let your guard down. And by the time Zoe was around 7, she started having panic attacks.”
Then and there, Zoe was enrolled in the CHOPS program. And the change, Leis said, was evident within weeks.
“Imagine a child who every day used to have lunch alone at school,” she said. “A child who had never been to a birthday party alone. She had never been to a sleepover. I don’t think she realized at the time how anxious she had become.”
But, Leis said, this program gave the family a “tremendous gift.”
“We learned what was possible – what we could do safely, how to do things safely,” she said. “It was in the real world. It was practical. And it taught us as a family to take calculated risks, to be brave and to really live our lives, and to hold our child accountable when it comes to manage food allergies.
Now 11, Zoe has blossomed, her mother said.
“She’s grown into this confident young person,” Leis said. “And it allows all of us to interact with her in the world in ways we never imagined. This program has been life changing. Our whole family’s life has been changed.”
SOURCES: Megan Lewis, MSN, CRNP, RN, pediatric nurse practitioner and program manager, Food Allergy Center, Children’s Hospital of Philadelphia; Connie Diekman, MEd, RD, CSSD, LD, food and nutrition consultant, St. Louis, and past president, Academy of Nutrition and Dietetics; Amy Leis, PhD, New Jersey, mother of a pediatric patient with food allergies; Annals of Allergy, Asthma and ImmunologySeptember 23, 2022
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