Going Nuts: Dealing with Nut Allergies During the Holidays

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Do you check with guests about their food allergies before having a party? Every year we hear tragic stories of young lives lost from contact with peanuts, tree nuts or foods containing or exposed to nuts. Many schools are peanut- or tree nut-free zones, and we are seeing more and more food products carrying “school-safe” labeling. Not all kids with peanut allergies have other tree nut allergies, but for those that do, the issue can be even more challenging.

Peanut allergies can be very dangerous and cause a reaction known as anaphylaxis, which is a medical emergency. It can involve many symptoms including tongue and lip swelling, respiratory distress and cardiovascular collapse, which can result in death. It’s every parent’s worst nightmare. This being the holiday season, I felt it timely to write about a personal experience as a host dealing with this very issue.

My daughter’s preschool friend has a peanut and tree-nut allergy. The other day, I had her family over for a little get together. Although I am well informed about the risks related to food allergies and the precautions required, I was crestfallen to see her mom’s facial expression when she walked into my kitchen and spotted a freshly baked pecan pie sitting on the counter.

The pie was not meant for the kids and was not near any other items. I was under the impression that she would be okay if it was served to the adults, in a separate room. She was, of course, but her initial reaction was one of fear and concern. I don’t blame her and was mortified of how insensitive I was to just leave it lying out. Of course, this was not intentional, but this mom’s reaction was genuine, immediate and telling: Nut allergies are no joke. Contact with another kid who’s made contact with tree nuts, such as pecans, can cause a reaction in her child. We all know kids are not as careful about touching their food and mouths and making contact with toys and other kids.

I quickly whisked the pie away and was very apologetic. I learned that while these parents do eat foods containing nuts when at restaurants, they never do so while in the presence of their child. I learned how their entire lifestyle revolves around keeping their daughter safe. This goes beyond car seats or teaching how to look both ways before crossing the street. Every outing, every party, every school event, every snack requires careful contemplation. For those of us who don’t have kids with potent food allergies, we really do take for granted the freedom we have. Her parents are forever educating, clarifying ingredients at birthday parties and carting their own food almost everywhere they go. They are dedicated to their daughter’s safety, and for good reason.

We are having them over for another holiday party where the food is inherently laden with tree nuts or related ingredients. I will be careful to purchase items from a store carrying “nut-free” labeled products, including dessert, ensuring that we can make everyone as relaxed as possible with no surprises. I know this family appreciates my commitment to their concerns. I would expect the same for my child, if needed.

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Bindu Kumar, M.D., is a Philadelphia-area physician with expertise in primary care and occupational medicine. She maintains her family medicine board certification in both the United States and Canada.