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Seasonal Reminders

Remember that different seasons come with environmental allergies and factors to consider. Here are some recommendations that might help your child when there are environmental changes.

Environmental Changes

Pollen/Environmental Allergies

Spring Pollen Reminder:


Spring is around the corner! We want to reach out to point out a few important recommendations for this time of year that can impact your dosing. If your child is affected by environmental allergies, here are some tips to help support them.

Adjustments in your home:

1. Close windows at night and limit outdoor exposure on days of high pollen counts or windy days
2. If possible, an air purifier in the room can help.
3. After coming inside, rinse off the outdoors/environment allergens. Nasal saline rinses done at least twice a day, ESPECIALLY after coming inside from outdoors are very important to help reduce congestion/throat clearing. Showering after coming inside from the outdoors is also critical. Rinsing your mouth prior to dosing and brushing your teeth just after dosing is all-important.
4. Be alert on spring days that also have heavy winds.
5. Check your local pollen counts at https://www.pollen.com/map/ca

Medication Adjustments:

If these adjustments are not helpful enough, please reach out to your local doctor or our providers and we can look at your child’s situation to see if there are adjustments in their daily antihistamines and nasal spray routines that could be helpful.

Camp Policy Reminders

We understand going to sleep-away camp is an exciting part of childhood. Food freedom is a key part in making safe, restriction-free summer camp possible. For our patients that are still in the process of reaching food freedom, there are some important safety reminders we want to share with you while preparing for camp:

  • Check with your child to see if they truly want to go to camp. Dosing maintenance foods is stressful as it is, it can be exceedingly stressful to do so without their parents present.
  • Summer camps are usually quite remote, located in a different environment, filled with fun heart racing activities in the heat, and provide independence to your children. All of these factors can pose additional risk with dosing. For this reason, SCFAI patients will not be updosing treatment foods while at camp.
  • It is important to let us know you are planning to go to camp at least 3 weeks prior to the last appointment before camp so we can plan the final challenge and introductions accordingly, based on the foods that are being treated and how long your camp experience will be.
  • Please gather the information around camp dates, medical staff present at camp, and the camp’s medical protocol to ensure they are equipped to dose maintenance foods.

 

Have fun at camp and enjoy your summer adventures!

Summer Constipation

As summer approaches there are many increased risk factors for constipation.
Here are some ways to avoid constipation:

  1. Hydrate! Avoid dehydration by consuming an adequate amount of water each day:
  • 26 pounds = 4-5 cups
  • 50 pounds = 6-7 cups
  • 75 pounds = 7-8 cups
  • 100 pounds = 8-9 cups
  • 125 pounds = 9-10 cups
  • 150+ pounds = 10 cups

 

  1. Add dietary fiber to your diet. Include at least 2-3 daily servings of fiber-rich foods in your diet if possible from an allergy standpoint (include beans, fruits, vegetables, whole grains/bran).
  2. Get moving. Daily activity can help to increase motility. Children should have daily high-intensity activity like running or jumping.
  3. Medication. Be aware that increasing antihistamines can contribute to constipation.
  4. Toilet time. Set aside toilet time for your child 30 minutes after their largest meal of the day. Have your child spend 15-20 minutes on the toilet to ensure complete emptying.
  5. Monitor bowel movements. Track bowel movements on the Bristol stool scale to ensure that your child is having daily type 3-4 bowel movements.
  6. Add Miralax if you’re still experiencing constipation.

Wild Fires and Camp Fires

There are many regions at high risk for wildfires. While in TIP, it is important to be aware of any local fires and air quality and take action to protect your child’s lungs.

Here are some ways to be prepared in case of a fire:

  1. Meet with your child’s pediatrician or pulmonologist to make sure they have up-to-date rescue and controller inhalers.
  2. Discuss a rescue plan in advance. You can get ahead of any coughing by starting your child on their prescribed inhaler if there are local fires or air quality alerts.
  3. Keep children indoors and close windows during these times.
  4. Purchase a portable air purifier prior to fire season. These can help to purify the air within your home, but become difficult to source when there are active fires.
  5. Hold off on dosing if your child has any coughing or symptoms related to poor air quality or fire and contact our providers on call.

Back to School

Back to school is an exciting and stressful time for our food allergy families. Here are some ways you can plan ahead and get ready for a safe and healthy school year.

  1. Prepare medical forms that outline your child’s allergens and the medications to take in case of a reaction. Remember, school medical forms take up to 10 business days for us to process, so please submit them to FAI at least two weeks before they are due.
  2. Check to make sure you have up to date emergency medications for school including Epi-Pens/Auvi-Q and Benadryl. Talk to your provider about refills or additional prescriptions if you do not have extra medications to keep at school.
  3. Epi-Pen and Auvi-Q should always be kept as a two pack in case the first dose is not effective.
  4. Plan ahead with school nurses, teachers, and administrators to understand your child’s school’s policies around emergency protocol, storage of epi-pens, allergy-free snack and lunch areas, and food sharing during special events.
  5. While schools work hard to keep our children safe, it is important to teach your child to protect themselves. Educate your child about not accepting foods that are offered to them by others. Work with the school to designate a trusted adult who is well educated on food allergies that can be a point person for your child if they have questions about food throughout the school day.
  6. As your child goes back to this new environment, be aware of potential non-food allergens as well. The school environment can be filled with many environmental allergens such as class pets, trees, grasses, or cleaning supplies. There are also many foods hidden in art supplies! Beware of play-doh and finger paint for wheat allergies, chalk for milk allergies, tempera paint for egg allergies, and crayons for soy allergies.

 

We encourage you to create a strong partnership with your child’s school to create a safe environment for a wonderful year ahead. Please let us know if there is any other way we can help. You can find more tips and reminders on our blog!

Preparing for College

As your child makes post-graduate plans, it is important to consider safety with food allergies and logistical planning for TIP. Here are some factors to consider:

  1. Talk to your college or university about accommodations that they have for students with food allergies, such as designated dining halls with cross contamination-free areas, private areas of food storage and food preparation within the dorms and on campus, and awareness around emergency response on campus.
  2. Make a plan for how to keep up with maintenance and treatment foods. This will require a team effort! Many parents will continue to help source and measure maintenance and mail it to their young adult children. Pre-measured and organized packages or prepared maintenance doses are very helpful to stay on schedule.
  3. Schedule your foods into your day. It is the young adults’ responsibility to come up with a system to eat both maintenance and treatment. Planning in advance can help!
  4. Create a system to keep track of dosing that both parent and young adult child can see, such as a Google Sheet. This can reduce stress if a parent can track remotely, and can help the child stay on track if the parent notices doses have not been taken.
  5. Schedule yourself time for treatment dosing before 8 pm. Over-exhaustion can be a stress to your system and a potential cause for reaction.
  6. Make a plan to carry your epi-pens with you at all times. Whether you are in class, at an extracurricular activity, or going out later at night- it is important to ALWAYS carry your epi-pens.
  7. Consider appointment scheduling and necessary travel arrangements for TIP. It can be stressful to leave campus in the middle of important testing times, so consider your long-term schedule before making next appointments.
  8. The composition of alcohol can lead to increased histamines levels and instability in your system and put you at higher risk of reaction. Please avoid drinking and dosing.

Vaccines

In general, during treatment, we recommend that your child continue to get seasonal prophylactic vaccines and hold on getting other vaccinations since the immune system is undergoing significant changes at this time.

Routine Childhood Vaccines
If your child receives a childhood vaccine they may have an inadequate response and falsely be labeled as vaccinated. For this reason, please wait until your child is in remission to receive any vaccines.

However, in cases of an outbreak, it would be wise to go ahead and get the vaccine if your child is age appropriate and has never received it previously, or if your child did receive it previously and their titers are not sufficient.

As mentioned above, it would be difficult to guarantee the effectiveness of the vaccine during treatment. The only way to be certain it is effective would be to check a titer after the MMR vaccine has been given. If your child received their first MMR at 1 year then there is above a 90% chance that they have an effective immunity to measles. If you want to be certain that they are immune, their pediatrician can obtain a measles titer to determine if they responded effectively to the first MMR dose.

Seasonal Prophylactic Vaccines
Flu Shot

The flu shot is a seasonal prophylactic vaccination and can be safely administered during treatment to help prevent illness. Your child will skip treatment dosing the day of your flu vaccination.

For those patients with an egg allergy, they CAN receive the flu vaccine if they have cleared Hen Egg White in the treatment program. If your child has an egg allergy and has not cleared hen egg white, we recommend you speak with their primary care provider about other potential options including an egg-free influenza vaccine formulation, or opt not to receive it at this time. You can read more about CDC recommendations on Flu shots and egg allergies here: https://www.cdc.gov/flu/prevent/egg-allergies.htm
View More Vaccine Information

Viral Season Reminder

Please be evaluated by your pediatrician early for any potential illness so your child can receive a proper diagnosis and treatment and get back to dosing as soon as possible.

While it is recommended to hold off on routine vaccinations when your child is in TIP™, the influenza vaccine is an exception since it is annual. We recommend the flu shot for all patients in the program unless they have an egg allergy. For those patients with an egg allergy, they can receive the flu vaccine if they have cleared hen egg white in the treatment program or have had it in previous years without reaction and your pediatrician feels comfortable administering this vaccination. You should skip dosing the day your child receives the vaccine and resume all foods the following day. If your child has an egg allergy and has not cleared hen egg white, we recommend you speak with their primary care provider about other potential options including an egg-free influenza vaccine formulation or opt not to receive it at this time.

Please skip SLIT, Maintenance Food and Treatment Foods for:

  • Fever over 100.4F
  • Vomiting and diarrhea
  • First 24 hours after starting antibiotics

 

If you are concerned if you should dose or not and have not heard from TIPHelp for confirmation, it is best to skip a day. Please let us know if your child will be skipping more than 2 days of dosing, as their dosing may need adjustments.

Holiday Safety Reminder

Patients In Active Treatment
As your child approaches puberty, it is important to be aware of adjustments during TIP as hormonal changes impact dosing.

For females, menstrual cycles can increase histamine levels, so patients may be more sensitive to dosing at that time. If this is the case for your child, please contact us and we can discuss if reduced dosing is needed. We can also track out cycles and avoid challenge appointments during these sensitive times.

Teen Dosing Safety:
  • Make a plan to take your Epi-Pens with you everywhere
  • Even if you are staying up late, keep your dosing before 9 pm
  • Stress and exhaustion can be hard on your body. If you feel you are in higher than usual states of stress, skip your dosing. Do not skip more than two days in a row of dosing without consulting TIPhelp@tpirc.org
  • Be cautious when checking labels, as many health foods or workout supplements can hide ingredients that can be allergenic

 

Patients in Remission

This time of year we celebrate many graduations and transitions. It is very exciting, but we know for food allergic children and young adults these transitions open up a lot of questions as they move away from home and what has become their comfort zone.

We want to remind you that we are here to help your family and brainstorm ways to be safe in this new environment. As your child makes post-graduate plans, it is important to consider safety with food allergies and logistical planning for TIP™.

Here are some factors to consider:

  1. Talk to your college or university about accommodations that they have for students with food allergies, such as designated dining halls with cross-contamination free areas, private areas of food storage and food preparation within the dorms and on campus, and awareness around emergency response on campus.
  2. Make a plan for how to keep up with maintenance and treatment foods. This will require a team effort! Many parents will continue to help source and measure maintenance doses and mail it to their young adult children. Pre-measured and organized packages or prepared maintenance doses are very helpful to stay on track with the program.
  3. Schedule your foods into your day. It is the young adults’ responsibility to come up with a system to eat both maintenance and treatment foods while away from home. Planning in advance can help!
  4. Create a system to keep track of dosing that both parent and young adult children can see, such as a Google Sheet. This can reduce stress for parents to track remotely, and can help the child stay on track if the parent notices doses have not been taken.
  5. Schedule time for treatment dosing before 8 pm. Over-exhaustion can be a stress to your immune system and potential cause for reaction.
  6. Make a plan to carry your epi-pens with you at all times. Whether you are in class, at an extracurricular activity, or going out later at night, it is important to ALWAYS carry your epi-pens.
  7. Consider appointment scheduling and necessary travel arrangements for TIP™. It can be stressful to leave campus in the middle of important testing times, so review your school schedule before making future appointments.

Gummy Storage Reminder

We know at-home dosing can be a challenge. From minuscule measurements to masking the taste of tree nuts to cross-checking for safety, we want to help you dose your child as safely and effectively as possible.

Here are safety tips to reference when handling your gelatin gummy dosing:

  1. A recommendation we give is also to travel with gummies in a light-tight container, as the gummies are sensitive to light exposure.
  2. The gelatins are not candy and should be stored out of reach of children until they are ready to be dosed.
  3. Each gelatin contains proteins that can potentially harm your child if more than the prescribed dose is consumed.
  4. It is recommended to drink room-temperature water immediately after chewing gelatin to ensure the entire dose is swallowed.


Read more on the Gelatin Gummy dosing here.

Camp Policy Reminders

We understand going to sleep away camp is an exciting part of childhood. Food freedom is a key part in making safe, restriction free summer camp possible. For our patients that are still in the process of reaching food freedom, there are some important safety reminders we want to share with you while preparing for camp:

  • Check with your child to see if they truly want to go to camp. Dosing maintenance foods is stressful as it is, it can be exceedingly stressful to do so without their parents present.
  • Summer camps are usually quite remote, located in a different environment, filled with fun heart racing activities in the heat, and provide independence to your children. All of these factors can pose additional risk with dosing. For this reason, SCFAI patients will not be updosing treatment foods while at camp.
  • It is important to let us know you are planning to go to camp at least 3 weeks prior to the last appointment before camp so we can plan the final challenge and introductions accordingly, based on the foods that are being treated and how long your camp experience will be.
  • Please gather the information around camp dates, medical staff present at camp, and the camp’s medical protocol to ensure they are equipped to dose maintenance foods.

 

Have fun at camp and enjoy your summer adventures!