Is that a peanut or a landmine? Experiences when dining out with food hypersensitive children

Many families look forward to dining out as a way of both lessening parent and caregiver workload while also engineering an often rare opportunity for families to catch up with one another in a leisure setting. Admittedly, dining out with young children can sometimes prove to be a difficult task; for some parents there is an added level of difficulty. In a qualitative study recently published in BMC Public Health, Fiona M Begen et al. examined the experiences and behaviors of caregivers' when eating out with their food hypersensitive children. Through a series of interviews, parents describe the impact of their child’s food hypersensitivity on both their families as well as the children themselves

Dining out

Preparing a child for eating out at a dine–in restaurant may present a challenge for some families. Children can be picky and fickle with their preferences; smell, color and even shape of food may drive a child to an extreme opinion, forever prejudicing them against an otherwise inoffensive foodstuff.

Finding a restaurant that their child is excited to visit is no small victory for caregivers. Though, for caregivers of children with food hypersensitivities, eating out with the family can prove to be more complex. Restaurants serving foods prepared with peanuts, tree nuts, eggs, milk, cereals containing gluten and crustaceans require careful approach. Or, frequently in cases where compromise appears improbable, total avoidance.

Food hypersensitivity is a generic descriptor, used for anyone who suffers reproducible and objective symptoms that occur after the ingestion of a particular food. Total avoidance is a common strategy for families of food hypersensitive children; both food items and the restaurants serving them can be abstained from to remove the chance of endangering a food hypersensitive child.

Given that eating out is attributed with 50% of deaths related to food allergen consumption, constant vigilance is required. Living with food hypersensitivity is an ongoing day-to-day challenge that can be described as “living with risk” for both the families and children with food hypersensitivities.

Additional pressures

stick to the same place if you’ve been there once and its ok, and if he doesn’t have a reaction…if he likes it, it’s a bonus

Anxiety for many caregivers can stem from an anticipated lack of competence or understanding on the part of restaurants, school cafeterias or other outside food venues. Worries can worsen when caregivers are not present to ensure their child’s safety. Accidental cross contamination of triggering foodstuffs may place a child at risk.

However, in some worrying cases, children may be directly served the food item that they have a hypersensitivity to even after being told the nature of the child’s allergy. One caregiver stated so much when they shared that “[At] the start (nursery) struggled….They have had a couple of slip ups like the (ready mix dessert) and a couple of times because the teacher will go on holiday… I feel quite let down sometimes because I stress to them when I go in.”

To avoid potential issues, monotony in dining can quickly become the norm, with a focus on safety over enjoyment. One parent explained that they would “…tend to stick to the same place if you’ve been there once and its ok, and if he doesn’t have a reaction…if he likes it, it’s a bonus.”  However, the authors describe the necessity for creating a balance between caution with variety; safety with social freedom; and preferences of the food hypersensitive child with preferences of their siblings.

I feel quite let down sometimes because I stress to them when I go in

Alleviating stressors

The transfer of responsibility from caregiver to child during adolescent development may alleviate some of the anxiety experienced by caregivers; through the incorporation of a number of strategies to support self-management and autonomy in their children, caregivers may feel relief knowing that their child has the tools to navigate the world safely when outside of their homes.

By encouraging their children to clearly state their hypersensitivity and consequent dietary needs many children effectively avoid their allergen without the need of their caregiver’s direct supervision.

Giving food hypersensitive children the tools to operate without the immediate support of their caregivers is an important step towards providing them with a level of personal responsibility, while also relieving caregiver anxieties. However, a need exists for food proprietors to further their support and understanding of the tools and strategies to ensure positive eating out experiences for children with food hypersensitivity.

Ultimately, Fiona M Begen et al. suggest that there is a potential to reduce the day-to-day anxieties of caregivers and to provide them and their children with improved quality of life.

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