Commentary: A slice of bread could kill my child

SINGAPORE: Thirty minutes. That was all it took for my baby to go from licking a slice of bread to struggling to breathe.

During breakfast one morning last year, she grabbed hold of a slice of cranberry bread that I was eating. She probably licked it a couple of times before I snatched it out of her hands.

Within minutes, she started rubbing her eyes and scratching her face. Her eyelids swelled. She tried to speak but her voice came out funny, incoherent, and slower than normal.

Within 30 minutes of her licking that slice of bread, she was gasping for air and struggling to stay awake.

I called for an ambulance. At the children’s hospital, her symptoms eased after a dose of antihistamine. Doctors confirmed that my daughter had experienced an anaphylactic reaction. Anaphylaxis is a severe and potentially life-threatening allergic reaction that triggers the immune system to release a flood of chemicals, potentially leading to respiratory distress.

I used to handle large-scale emergency situations at work. I led teams of co-workers in real-life casualty scenarios as well as rescue exercises. I was a certified first-aider.

Even with all that training, I was scared out of my wits when the person I had to save was my own child. The incident permanently changed my way of parenting because it became clear that just a tiny bit of food can potentially kill my child.

FOOD ALLERGIES INCREASINGLY COMMON AMONG CHILDREN

There are quite a few misconceptions surrounding food allergies: They are rare, they aren’t serious and eating a little won’t hurt.

I have lost count of the number of times we have been told about how people in the past didn’t know of allergies and their children still survived eating whatever their parents served.

According to Dr Mohana Rajakulendran, a paediatrician who specialises in food allergies and eczema, one in 20 Singaporean children has a diagnosed food allergy.

“The top allergens are milk and egg, but increasingly other allergies such as peanuts, tree nuts, sesame and wheat are seen. More children without family history of allergies are presenting with food allergies,” she said. 

Well-intentioned friends and family members have encouraged us to allow our children to consume foods they are allergic to in order to “build up tolerance”. However, for families with severe allergies, food is something we take very seriously because even small exposures can lead to deadly results.

IMMEDIATE VERSUS DELAYED ALLERGY SYMPTOMS

Allergic reactions to food can be differentiated into two categories. The better-known category, with symptoms such as swelling of eyes and difficulty breathing, is known as IgE-mediated food allergy. Symptoms present themselves almost immediately upon exposure to allergens.

My baby who licked the bread – now a boisterous two-year-old - has multiple, severe allergies in this category. When she was younger, she would sneeze and cough if we carried her past a bakery. Her allergies were so severe that even flour in the air would set her off. Because of that, she rarely left the house. On the rare occasions that we did, our family took pains to avoid going near food establishments.

The next category is known as non-IgE-mediated. Allergic reactions are delayed, with symptoms such as diarrhea, bloody stools, vomiting or skin irritation that take hours or even days to appear.

My older daughter has this. She is allergic to dairy, eggs, nuts and seafood. At just six years of age, she knows that the consequence of eating those items would be an eczema flare-up, followed by weeks of intense itch and broken skin from scratching.

The worst of her eczema appeared after she enrolled into pre-school and started eating food that the school served. Since then, we have been carefully tracking and identifying the foods that trigger her eczema, and have been preparing home-cooked meals for her to bring to school.

With two eczema children at home, the amount of blood I wash off their little faces and bodies in one year is probably more than what any normal parent might handle in their child’s life.

LIVING WITH FOOD ALLERGIES

We now carry an emergency bag everywhere we go. The bag contains antihistamines and an epinephrine autoinjector (commonly known as EpiPen) that costs S$160 each, with a shelf life of one year.

In case of another anaphylaxis episode, we would stab our child with the EpiPen to counter the allergic reactions before emergency medical services arrive. Now imagine a family with financial constraints, having to buy EpiPens every year while hoping to never have to use them on their kids.

Living with severe food allergies is an isolating experience. Can you think of any social event without food? I can’t.

My six-year-old came home from school feeling sad the other day because there was a birthday party in school. She described in detail the treats at the party: A chocolate birthday cake, frosted cupcakes and mini custard tarts on the side.

But she couldn’t indulge in any of those because of her allergies. After singing the birthday song and taking photos with the birthday child, she sat down to eat the fruit snack that she had packed for school.

At family gatherings, we bring our own food and utensils for the children. Throughout the event, we have to watch them closely so we can intercept and politely decline foods offered to them and explain their allergies.

On several occasions, I have caught my toddler picking pieces of food off tables or floors and have dramatically dug food out of her mouth, scaring the wits out of her and everybody watching.

Sometimes, if an entire gathering is centered around food, like a barbecue for example, we choose not to attend because what’s the point of going to a barbecue just to sit far away from the pit and eat a pack of home-cooked food?

HOW CAN YOU BE INCLUSIVE TO PEOPLE WITH ALLERGIES?

What can you do to support families living with food allergies?

First, think about non-food treats when you organise anything for children. Some schools have policies that stipulate non-food party treats. This allows children with food allergies or religious dietary restrictions to not be excluded.

Second, always ask about dietary restrictions when hosting meals. Sometimes, it only takes simple accommodations like providing fresh fruit, to be inclusive to persons with allergies.

Finally, never offer food to a young child without first asking for permission.

Most parents fear losing their children to accidents, careless drivers or serious illness. My worst fear comes in the form of a well-intentioned person offering food to my child without my knowledge. Because all it takes is two licks of a bread to take away my child.

Yong Qiao Qing raises two daughters with allergies and is the founder of Little Warriors, an online business that specialises in clothes for children with sensitive skin.