Food Allergy Anxiety in Kids: What Parents Can Do to Address It

00:00:00

Elizabeth Voyles 

Hi, everyone. Thank you for joining us, we've just got some folks who are still logging on, so we're just going to wait a moment before we start. Thanks again for joining us. We're just going to give it one more minute while folks are logging on. Ok, we'll start. Good evening and welcome to the first Backstop food allergy, anxiety exploration events hosted by Backstop and Red Sneakers for Oakley. I'm Liz Voyles, director of partnerships at Backstop and mother of a teen with severe food allergies. For those of you who are unfamiliar, the Backstop is a one-stop-shop virtual care solution and app for parents with children who have food allergies. We believe that confident, well-informed parents make safer kids, and we have blogs, webinars, and a whole online community to help you feel like you have a backup. You can sign up for private coaching sessions with Dr. Sweeney, who I'm going to introduce in a moment today. And then after the holidays, we're also going to launch new support circles for food allergy families who are navigating anxiety. You can find out more about how we simplify the lives of food allergy families and download the free app at getbackstop.com/events. we want to also welcome those of you who are joining us from Red Sneakers for Oakley tonight. They’re our close partners, so now I'm going to hand the mic over to my friend and colleague Annie Smith from Red Sneakers.

00:02:31

Annie Smith

Hi everyone, I'm Annie and I'm the social media and website manager for Red Sneakers for Oakley. I want to welcome everyone here from the Red Sneakers community, as well as those who are just learning about Red Sneakers and Backstop for the first time. So for those of you who are unfamiliar, Red Sneakers for Oakley is a non-profit dedicated to educating and advocating for food allergy awareness. And if you'd like to learn more, I invite you to visit us at redsneakers.org and follow us on Facebook and Instagram at Red Sneakers for Oakley. So now let's talk a little bit about why we're all here. Over the years at Red Sneakers, we have engaged thousands of families, whether it's online or at our in-person events, and I cannot emphasize enough how common food allergy anxiety is and how often we hear from families who are really struggling with this issue at home. So it's a topic that doesn't get enough attention and that needs to change. It really needs to change. So I want to thank Backstop, who is an incredibly valuable partner in this work for convening these experts here today and for creating a safe space where we can explore these issues together. So I will now turn it back over to Liz to introduce our experts.

00:03:59 

Elizabeth Voyles 

Thanks so much, Annie. So today we'll hear from Dr. Julie Sweeney and Dr. Fawn McNeil Haber. Dr. McNeil-Haber is a licensed psychologist with over 20 years in mental health services. She's the parent of children with food allergies and works with children, adolescents, adults, and families in individual group and family therapy. Dr. Sweeney is a board-certified pediatrician based in Darien, Connecticut, and head of the Backstop care team. She's raising three boys with food allergies and has treated countless families who are navigating their pediatric food allergy journey every day. Dr. Sweeney will start us off by speaking to the ways anxiety can create challenges for kids and how she's seen anxiety affect her patients. She will then give us some tips on how to alleviate anxiety in our everyday lives. Then we'll start the Q&A. where both experts can answer your questions, but you can type your question at any time during the presentation. Just use the Q&A box, which is at the bottom of your screen, and then I'll read it out loud to our experts. You can upvote any questions that you want to see prioritized. Ok, thanks again. And now we'll hear from Dr. Sweeney.

00:05:48

Julie Sweeney, MD

Thanks, Liz. So I just would like to start by thanking Red Sneakers for Oakley for co-hosting this event with us tonight at Backstop. As Annie said, anxiety in children with food allergies is such an important topic for us to address, and it's wonderful to have this opportunity to address it. So many of the parents that I speak with bring up food allergy anxiety and they ask about how to help their child cope, and a common scenario that I've been hearing recently is that children who have been learning remotely over the past year or more are having anxiety issues. They've been eating meals at home for so long and feeling safe when it comes to exposure to their potential allergens. And now they're having anxiety about going back to restaurants that they used to go to or anxiety about eating lunch at school again. And it's not just when I talk to families that this is an issue, but it also is a topic that hits close to home for me as well as Liz mentioned. I have three boys with food allergies and intolerances. And one of them had anaphylaxis last year due to a food that she had eaten many times before. I used the epinephrine auto-injector and he was immediately better. And interestingly, his anxiety about the auto-injector decreased dramatically after that night. He said it didn't hurt when I gave it to him and that he would be quick to use it if he ever felt that way again, which was wonderful.

00:07:30

Julie Sweeney, MD

But my younger son, who was six at the time, was there when this all happened. He saw the ambulance come. He experienced the stress of the situation. Clearly, it was like a very nerve-wracking experience. And he ended up being very anxious for months about what he was eating. He was afraid that he might become allergic to a new food as well. He was especially anxious about the foods he ate at school if I wasn't around. And it took a lot of patients, some role-playing, and some help from even our school psychologist. But he's no longer anxious about the food he eats at school, which is amazing. So as a pediatrician, I often refer patients like that to therapists like Dr. McNeil-Haber to help families with anxiety. So she is also a mom of kids with food allergies so she can uniquely speak both as an expert on the topic and as someone who understands what it's really like to raise kids who are growing up with unique needs. It's a great conversation starter about how to recognize and be aware of anxiety in our children and what we can do as parents to help prevent or alleviate it. So I'm happy to hand over the mic to Dr. McNeil-Haber.

00:09:14

Fawn McNeil-Haber, PhD

Thank you so much, Dr. Sweeney. So I am happy to be here and happy to be with all of you. I want to start off by talking a little bit about what food allergy anxiety is. Food allergy anxiety when it's really beginning to impact us or our kids really has to do with when it is safe when there are safe foods. We feel this anxiety and avoid those circumstances, even though they can be safe. And I think this is an important thing to think about as we think about what anxiety is.

00:10:56 

Fawn McNeil-Haber, PhD

Anxiety is a brain reaction that is pulling the alarm and telling us that there's something dangerous or threatening in the area, and thus we want to. Our brain goes into this fight or flight reaction. It dumps stress hormones into the body so that we can run away from the danger or go at it head-on and fight the danger. And I think this is really important because we in the food allergy community have certain tools in our toolbox to help us with food allergies. We have healthy anxiety, which helps us to prepare and to anticipate things. And we have avoidance in our toolbox and we avoid allergens. We avoid those things that are dangerous, And so when we think about anxiety that may be getting out of hand, we want to think about how this anxiety gets heightened. Our physical reaction, that heart racing, stomach-churning reaction, that worry, rumination, what if, how that leads to avoidance, and seeing that avoidance in our kids can really help clue us in on what level of anxiety they're experiencing? So I think reflecting on highlighting different things as far as what may be clues to look into further conversations with our kids, or even to look into what's going on with us if we notice that we're avoiding a number of things and that we're feeling anxious in certain circumstances.

00:12:37

Fawn McNeil-Haber, PhD

And so that is going to kind of move me into our role as parents. So the thing about kids and parents and anxiety is that anxiety is contagious. When some people in the family are anxious about something, it tends to work its way through to other people in the family. And that's why when we talk about anxiety and kids, it's so important that we're also looking at anxiety and us as parents and what's happening. And so I mentioned those physical sensations that we experience. That's our body communicating that our body or brain feels like there's something dangerous around, as well as ways that we may be avoiding certain circumstances and really reflecting on. Are we avoiding these circumstances because this is really necessary for safety? Or are we avoiding circumstances in places that are actually safe? But it relieves our anxiety in order to avoid them? So in addition to that, I think it's important for us to be thinking about how we communicate with our kids. They are always listening and paying attention. I think about all of us. We're parents here and many of us, if we're not in the toddler stage, we've had toddlers and we know when a toddler is running and they fall, one of the first things they do is they look up to their parent to see, Am I OK? And if their parent is, Oh, you're fine. I used to say to my son touched down and he would get up.

00:14:15

Fawn McNeil-Haber, PhD

And so even if their knees skidded and there's blood like pouring down their knee, they may keep going. They may not even pay attention. And when I think about food allergies and anxiety, our kids are looking towards us and taking note of our reactions in order to gauge what their reaction should be. “Should I be brave in this situation? Should I be pulling away? Should I be hiding? Should I be clinging?” They are looking to us, so it's really important for us to be able to figure out and be mindful of how we're communicating with them. And so I'm going to highlight particular points before I move into a few forms of effective communication around how when we're anxious and we begin to question our kids or we begin to repeat ourselves or our volume raises, or we suddenly seem really agitated. Some of the things I want you to remember is that this can create unnecessary worries in our kids, but it also decreases their self-confidence about what they're capable of doing. Because if you think that the situation is really scary and dangerous, then I don't know if I can handle it as the kid. And then if you really seem out of sorts, I'm not sure you can handle it as the parent.

00:15:30

Fawn McNeil-Haber, PhD

So it really starts to reduce their sense of safety when we become visibly anxious and visibly worried and asking them questions potentially repeatedly about their anxiety, about what's going on and seem worked out. So if that's the case, then how do we effectively communicate with our kids? How do we effectively communicate in a way that creates safety for them? And so one of the things that I like to tell parents is that it's really important for us to be paying attention to our verbal and nonverbal communications with our kids. Is our voice calm? What is our facial response? How is our demeanor changing? How are we worked up? How are we talking to our children? Also, how are we planning? So when we're thinking about anxiety with kids, we have to also be thinking about how do we encourage empowerment, bravery and being courageous around food allergies. And part of the ways that we can do these kinds of things is to plan. Reaching out to schools, as we do about coordinating things with teachers and coordinating things with principals. Making plans with camp, making sure that we and other family members are trained in how to effectively use the epinephrine shot. So being planful also thinking about how we talk about other things in our kids' lives. So this is one of the many things we are training them and raising them to be able to be confident in the world and think about, “How do I share other things with my kids? Am I using the same tone? Am I able to be firm?” But also matter of fact, like this is just the way we do it.

00:17:19

Fawn McNeil-Haber, PhD

This is what we do. This is what you do, as opposed to being kind of overly agitated about what's going to happen. In addition, being able to set the stage for kids to be able to be brave and be able to be assertive, so that may mean before you're going to a birthday party, being sure to talk to the parent of the birthday party or before a family event, you may reach out to the person running the event or the other people there to give them a heads up about what might be helpful for your child's food allergies so that when they're there, and even if they're asserting themselves, the other adults kind of know how to react and can reinforce that assertiveness, that courageousness and things can go smoothly. And I'm going to talk in a moment about how this looks different at different ages because when we're talking about younger kids, we're doing a lot of the holding so they can be courageous. And as they get older, we're passing more and more responsibility onto our teenagers and our young adults to be able to take hold of this and be able to be confident and manage their anxiety around this.

00:18:35

Fawn McNeil-Haber, PhD

And so when I think about age and developmental level, I think about what your kid's age is, what their developmental level is and what their maturity is, and you being able to know, “What can my kid handle at this point?” Because not all six-year-olds look the same. Not all eight-year-olds look the same. Not all twelve-year-olds. Not all sixteen-year-olds look the same. So you really do have to know, “What can my kid handle?” And so with toddlers, I'm thinking, “How can I create a safe space so they can explore their environment without running into dangerous things?” We don't have knives lying around, and if they do stumble upon something like that, we remove it and we tell them, “No, that's not for you.” And we want to. When I talk about that matter-of-fact tone, we want to be able to keep that tone even with food allergies that like, “No, we don't do that. We don't touch that if we're over at somebody else's house.” So we want to kind of contain and protect their environment. We want to be redirecting them and distracting them. And then I move into thinking about those elementary school kids, those six to nine-year-olds, ten-year-olds. Kids at that age can easily pick up on our emotions.

00:19:47

Fawn McNeil-Haber, PhD

All kids are watching their parents, but they're easily picking up on our emotions and really kind of paying attention to how we move in the world. And this is a great time to instill in kids how to move in the food allergy world, what to do, what to call rest. They may see you calling restaurants ahead of time and talking to them. They may see how you phrase different things. So we're planning a vacation and we're going to be figuring out what restaurants we want to go to and what restaurants we don't want to go to. And I use that particular phrase as opposed to restaurants we can't go to as though we're kind of being confined versus us having that choice. We don't want to go. We don't want to go to that restaurant. These are the restaurants we do want to go to. So really helping them to see how all of this works and making it fun. This is a great age where kids really can get into fun things around. There are kids with food allergy songs, there are books. There are lots of different fun ways to expose kids to different things with food allergies. In addition, helping them learn to advocate for themselves and setting up situations where they can advocate for themselves and you know that they're going to get a positive response that you've already spoken to everyone and you set them up to get a positive response from whatever adults.

00:21:19

Fawn McNeil-Haber, PhD

And so really, this is still the age where we are framing things kind of like when they're toddlers for how they can be successful. And when I think about being successful with food allergies and dealing with anxiety around it, I try to think of a really strength-based approach. How can we grow bravery, grow their courageousness? And so an example I like to think of with that is that my son frequently gets blood work done around his food allergies. He's had blood taken. I don't know. I don't know how many times at this point. And let me tell you, no matter how it goes, we've had crying. We've had him having to sit on my lap and having to hold him. We've had him just going in there and giving his arm and it's like, OK, we've had all of the gamuts. And let me tell you, no matter how he gets it done, he is a champion. He did it. He succeeded. He got that bloodwork done, and we always leave out of there having accomplished that and having to be able to say that, look what you did. You gave the bloodwork, you took care of yourself, you took care of your body so that we can learn more about different things going on with your body and different things about your food allergies. So no matter how it goes.

00:22:36

Fawn McNeil-Haber, PhD

Once we get it done, it is something that we can celebrate and something that I can point out that they did this before that they're able to accomplish different things. And so I think about like eating new foods. I, you know, it's hard sometimes getting kids with food allergies and kids without food allergies to try new things. And so this would also be something any time you see your child, try something new to be like, Oh my goodness, check you out being brave. Wow, you're getting older. You know you're seven, you're going to be eight soon. You're trying different things. That's impressive. I wonder what you're going to be doing in the future. Not that I'm pushy. I'm not saying, but noticing when they're doing different things and then identifying and it kind of celebrating it. Now you want to be mindful of how your child reacts to that sort of thing, but be noticing their strengths, noticing when they're accomplishing something. As I move into thinking about tweens thinking about that kind of in-between age, tweens are very self-conscious. They want to fit in, and this continues to be a good time to build upon the things that you've already established and to be setting up times where you can start bridging into them, having opportunities to do more, more things that will set them up to be more independent as they get older.

00:24:05

Fawn McNeil-Haber, PhD

So if they've been able to talk to their friends about it in the past, suddenly maybe they're able to talk to their friends prior to playdates or remind their friends that they have food allergies when they're going on a playdate, even if that playdate is with you. This is the time also along with earlier, but to really be instilling an understanding of anxiety, healthy anxiety, the anxiety we get before a test that helps us prepare and how that can help us plan and what that looks like, as well as when anxiety may be getting big and how to connect with important adults in their life around that. And I think this is really important because the tween age is when they still think you kind of know stuff you haven't you don't like, not know anything quite yet when they get to be teens that they really they're hearing these things. And so you can keep encouraging them to understand what's to come as they become teenagers. And so when I think about teenagers, we're really kind of passing that baton to them. In some ways they have increased autonomy. Teens are all about more risk-taking that they want to associate with their peers. And so we really want to be figuring out how can we create space for them to be accomplishing these tasks and to be demonstrating their abilities in these areas? And so this is really the time for kids to really have a firm understanding of what anxiety is and be able to understand how anxiety and anaphylaxis can overlap and how they can start to figure out the difference between when they're feeling anxious, when their brain is saying something's wrong, how they can scan for their environment and something wrong.

00:25:50

Fawn McNeil-Haber, PhD

Have I even been eating? Could I have been exposed to something? What's going on and how they can step by step go through that process? Because the more prepared they are, the more predictable their environment can be. And they know what's going to happen, the easier it is to encourage them to go through this process and to be brave in these ways. So when we think about kind of I'm going to move into some real-world scenarios, and so I know that a lot of families struggle around restaurants, so restaurants are a big thing. Some families go to restaurants, some families don't go to restaurants. This can depend on the variety of food allergies that your family may have and what you decide works for your family. But one of the things I always think about is you have the elementary school, your tweens, your teens and your young adults, and we're really preparing them. And if restaurants are going to be something that's going to be part of their circle as they get into teens and young adulthood, we need to think about, OK, how do we help them navigate that situation? And once again, I think about ways that they can speak out, ways that we can empower them.

00:27:08

Fawn McNeil-Haber, PhD

I really love food allergy cards. When we're feeling anxious, it's really hard to get the words out. It's hard to sometimes make things clear, and that's a nice way for kids to have something tangible that they can hold on to to pass along to someone in a restaurant. Um, also, once again, we think of preparedness and calling ahead, making sure that we're going to restaurants where we kind of know what our child can order, what they might want, how the restaurant needs to be able to deal with that sort of thing. And even if we're thinking about a kid who might be anxious about that sort of going out somewhere, how can we create small steps so they can get closer to that challenge? So even if they're going to restaurants, but they're bringing their own food, but they're able to be there and they're able to see how other people are navigating. Maybe they might see how you talk to the waitstaff about food allergies, even if they're just eating their own food and how they can slowly make steps in that direction and how you can be cheerleading and celebrating them all along the way, knowing that like you're going to get there, this is all about growing, maturing and conquering challenges and you've conquered other challenges and you can always pull out.

00:28:30

Fawn McNeil-Haber, PhD

That's that strength based, pulling out things that your child has already accomplished as proof that they're able to accomplish things. Other things that people sometimes bring up is going to supermarkets, there's food everywhere, and how does that look navigating that, especially if the child is nervous about being even near their allergen? And so one, of course, if you have airborne contact reactions, you want to be mindful, obviously medically of where you should be in relation to an allergen. But a supermarket can be a great place to see the peanut butter on the shelf or see the bread and see it and notice it there and you there, and that you're safe. We're fine. We're going down the aisle. We're shopping. Maybe we even talk to you, peanut butter. You don't get to come home with me. You just stay right over there and making it playful and making it fun for kids about how they can be empowered around their food allergies and see. But once again, I always like to talk to parents about how do we make small gradual steps if you have a child anxious about something big. How do you break it down into small steps so that they can engage with that sort that whatever it is? Um, the last thing that I'm going to talk about is the epinephrine auto injectors, and I think this is really important for us to be thinking about.

00:29:56

Fawn McNeil-Haber, PhD

A recent study found that almost one third of caregivers did not give their child epinephrine in an emergency because they were scared or nervous. Now, parental anxiety has real dangers here because a lot of kids don't get the medicine they might need in an emergency. And so this is once again where preparedness and planning and understanding what to do in an emergency becomes really important. I've been talking about the brain and how when anxiety part of it is about pulling that alarm in the brain, that something is dangerous, there's a threat. The alarm is that fire alarm is going off on the brain and we are being flooded with those stress hormones that cortisol. And at that point, the brain is just trying to make survival decisions. This is like when someone pulls in front of you on the highway, you hit the brake, you move out of the way. All of this happens before you're even able to think about it. And so we want how we respond to an emergency to be just that quick that we know the food allergy plan. We know what we're supposed to do in the emergency. We know how to use the auto-injector. We are familiar with it. We know where it goes, we know where it's located and that our kids are familiar with it, that they've seen it before, that they've potentially been able to try out the trainers and use the trainers and practice before the emergency so that they are ready, that they know what's going to happen.

00:31:26

Fawn McNeil-Haber, PhD

So even if it's a little scary, everybody knows exactly what they need to do. And I think about this because sometimes parents get nervous about talking with their kids about epinephrine shots, and I think about my son had a recent reaction, kind of like Dr. Sweeney’s story about her child. He had a reaction to something that he had had before that we thought was safe and that we had encouraged him to eat. And he had a reaction to that and we gave him the epinephrine. All was well, and for several weeks after that, my son would come up to me and he would go. And at first I wasn't sure like, what's happening here? And he motioned towards the auto-injector. And so I'd go, I'd get the trainer. I went over and I'd use the trainer. It's not the real thing, the trainer and like, I'm all better. And so this would just keep happening and keep happening. And this is the thing about kids when they get anxious about a situation or nervous or something has happened. They're trying. Their world is play, and so they're trying to process things through play.

00:32:37

Fawn McNeil-Haber, PhD

So for the next four weeks, out of nowhere, I'd be in the middle of cooking and he grabbed his neck and my job was to run and get the trainer and use the trainer, and he'd be like, Oh, he's all better. And so one day I asked him, like, Are you feeling a little nervous about what had happened and that daddy and I are going to be able to do the right thing? And he's like, Yeah, yeah, I want to make sure you're on your toes and that you're ready, OK? And so he had us practicing until he felt better. And then it just it went away. He was done and he had moved on to the next thing so I use that just as a way that it can be very helpful for kids to practice and play. And I recently saw on Amazon that target, I forget which line it is, but there was a toy fanny pack and in the fanny pack came an allergy inhaler, play epinephrine and it just had all the accouterments that we are so familiar with. I think there was even a little bracelet to play with for a doll to get used to it. And so these are great things to do to help these things become a very familiar part of your kid's world to help reduce anxiety. So I'm going to pass the baton to you Liz.

00:34:04

Liz Voyles

Wonderful, thank you so much. You gave us so much to think about Dr. McNeil-Haber. So I just want to point out with that last point that there are free videos that are really fantastic within the free app, the Backstop app we have pediatrician Dr. Shelly Flais, who leads a little training series of just really quick, nice videos to help remind you caregivers, partners, teachers, how to use an epinephrine injector. It covers all of the brands so you can just select the video for your brand, and you can easily share it for free with the folks who are in your village, helping you take care of your child so you can download the free app and get Backstop events. And then once you're in there, you select allergy safety skills and you can check out those baseline training videos. Ok, we are going to start our Q&A. I just want to remind everyone to ask a question. You can use the Q&A box, which is just at the bottom of your screen. Don't use the chat. Use the Q&A box if you can. And then I'm going to read your question aloud, and our experts can answer your question so everyone can hear it again. You can upvote the question that you would like to be answered most. We've also got a live poll if you would like to hear out which topic. And then what are the best times for you? We really want to meet everyone where they are and prioritize the content that you want to see most. Ok, so first, I think as folks are typing in their questions, we're going to answer a question that was asked a lot before the webinar even began by folks who registered, which is consistently that children are really afraid to try new foods or are incredibly picky or disordered eaters. And what, as parents, we can do about that? So fun. Do you want to start us off on that one?

00:36:57

Fawn McNeil-Haber, PhD

Yes, and I always will, and I'll let Dr. Sweeney jump in if she has more to add on this, but I always like to encourage parents to make sure they're in conversation with their pediatrician around picky eating because sometimes we as parents think something's really picky and really want to encourage when our pediatrician or our allergist may feel like, you know what? They're doing pretty good, they're eating a good enough variety of foods. But for those kids that either are really kind of closing down the amount they're eating or seem really anxious about what they're eating. One, I always want to help kids understand what the signals their body is sending them. To understand the communication that's happening with their body. If they're getting nervous, having some sort of way to talk with your kids about how they're feeling. So not just that they're not eating and encouraging them to eat. This is really healthy, but getting a sense of whether helping them articulate how they're feeling around the food and whether they're feeling nervous and how they can go about establishing some safety. And so one meeting their needs, going about establishing some safety. But then when I get back to that strength-based noticing whenever they're willing to eat something and being sure to champion that because sometimes what happens is as parents, we can get so focused on what's not going well that we miss the times that something is going well and that we can really cheerlead and be proud.

00:38:37

Fawn McNeil-Haber, PhD

Another thing that I really like to encourage is for hard things to be paired with fun things. So an example of this may be my 10 year old really likes this particular YouTuber. And so we happen to try to push bell peppers today because I don't feel think they get enough vegetables. So I bought some bell peppers and I cut them up, and they both thought I was crazy because they didn't want bell peppers. But you know what? They got to sit and watch YouTube if they were willing to try the bell peppers. But in the end, they decided, OK, they wanted to watch their show. So thinking about, is there something that I can pair together with this to make it more fun for them so that they might be willing to give it a try?

00:39:27

Liz Voyles

The next question that we got from a few folks who are online right now and then many from who said this when they were registered is what do you do right after a reaction and in the kind of days and weeks or after a fear failed food challenge because there are a lot of kids who are showing intense fear after one of those sort of traumatic events occurs?

00:40:00

Julie Sweeney, MD

Um, so I think I'll start by just saying that when you're preparing for something like an oral food challenge, it's good to think about the possible outcomes with your child when you're going into it, of course. They are two, that's different than if they're eight. But, you know, saying you might have a reaction, but then we'll have a better idea of how much you can tolerate, like not really thinking of it as a failure, but almost like we're going to get more information about what's going on with your food allergy at this point and then trying to keep it positive as much as you can. I mean, obviously, it's scary if they have a reaction. It's scary if you are exposed to something and you have a reaction. But the way you talk to your child about that is so important. It may be fun if you can go from there and what things are great to say at that point.

00:40:58

Fawn McNeil-Haber, PhD

Absolutely how you plan ahead of time. I always like to start there, either with a reaction or when we're talking about an oral challenge that we you're there to see how it goes, but the doctors are prepared and that they wouldn't be encouraging us to do this if they weren't ready, if they didn't know how to handle the situation. The other thing is that many times kids will think, OK, a food allergy challenge or reaction. They think that the reaction, especially for a challenge, is going to be big when typically allergies are very mindful about when very early on when they decide that it's time to stop. So really preparing them for what's going to happen even with an anaphylactic reaction, once again practicing with the auto-injector. So one prepping going into it. But this happens and that afterwards your child is feeling really nervous, really anxious and maybe traumatized by the situation. And so one of the things that I think is really important is getting a narrative going, really talking about what happened and laying out there, especially if your child will let you talk. Sometimes kids get so nervous that they just want to avoid it altogether, which is really hard. But if your child will talk about it, you guys can talk about what happened and you can pull out the things you want them to remember.

00:42:26

Fawn McNeil-Haber, PhD

So allowing them to be scared at the park, they're scared. But also, oh my goodness, you are great when it came to the epinephrine shot. Look at what you did and we got to ride in an ambulance and it was scary. But we both had never ridden in an ambulance. So really kind of telling the story. Remember, kids want to talk about this over and over again because their brain is processing. And if you've ever been in some sort of car accident or something and you're telling your friend and then you're telling another friend, we're really kind of, our brain is processing it. So you want to let your kid talk about it, draw it. Maybe they're telling a friend what happened? Maybe they're telling this person what happened. Let them talk about it and also try to maneuver it to that strength-based in that way that you can empower them around what they accomplished and anticipate the fact that it's going to be hard. It's going to be an emotional roller coaster for you and them for a little while and then anticipate that they will move on and move through it.

00:43:29

Liz Voyles

You grow through what you go through, right? So we're getting a lot of questions about me just repeating where to go, to see those videos, to sign up for private sessions and to sign up for circles. I'll also put it up at the end in the last slide, but it's getbackstop.com/events. Ok, we are also getting some questions, a few of them of different age children, which is interesting. Some who are toddlers, some who are teenagers who are following the rules and avoiding all the foods that they need to avoid when they're with family at home. And then when they hang out with friends, it's another story. When they're in a social situation, it's another story. So how do you sort of bridge that gap?

00:44:31

Julie Sweeney, MD

Well, I'll start with the littles, just from a parenting perspective. I think that when they are little, you have better control as a parent over what's happening when they are on a play date or what's happening when they are at preschool or at school. And I know for me as a parent, I would always try and anticipate what foods were going to be in an activity, what things they might not be able to have. And I would say that a lot of the parents were so receptive and so happy that I helped them come up with things that would be safe, that all the kids could enjoy that. Oh, I didn't know that Ryan could have that. Yeah, let's have that. That would be great. And then he did feel like he was part of the experience. And then with preschool, if there was going to be a day that they were going to have a special celebration. We went to one preschool that just stopped having food altogether at celebrations, and they would do pencils or stickers or something fun. But when we did have that experience, then either I would just volunteer to make whatever it was and bring it in myself. If I was the only one who had an allergic child or I talked to another mom who had an allergic child. And we would work together to come up with something safe. But I think that in those situations, I really just tried to. You're the parent. You can advocate for your child. You can really just come up with ways to try and make it as safe as you can when they're little. And then do you want to go ahead and tackle the older kids?

00:46:20

Fawn McNeil-Haber, PhD

I think in some ways it's similar with the older kids in the sense that you can encourage. And if you help them talk to their friends and their friends know different things than their friends, parents are willing to have certain foods there that their friends like, especially if they have a nice circle of friends that tend to be the same kids. You can still exert some control by talking as parents. You know, we think of food. I like to encourage parents to think of food allergies as something special. But also, how is this the same as all the other things that we're doing? And when you have a teenager, the more that you can be connected with the other teens parents so that you can kind of know what's going on and lots of different ways. The easier it's going to be to hit lots of developmental challenges that come at that age. And so one, I'd be thinking of it from that perspective, too. How can I? Are there parents that I can work with that can help me make sure that my teen has something there? Can I help them bring stuff along? And then also, can I have conversations with them? Once again, this is an age of autonomy. And so how do they want to handle it? Maybe I saw one person throw up that their teen, when they go on social things, they don't want to eat. They just don't want to eat well, OK, are we talking about? They don't want to eat for a few hours.

00:47:44

Fawn McNeil-Haber, PhD

Ok, so they want to handle that and we can work. How long does that last? How long does that work? Are they going on an eight-hour social event and not eating over the course of eight hours? Because that looks kind of different. So how can we problem-solve around what could be helpful for you and how do you want to handle it? Because a lot of it is like hearing how your kid wants to handle it at that age and getting them to be thinking about creative ideas and getting them to be thinking about what are things that their friends like because they have ideas and their friends have ideas. But sometimes it takes an adult to help them talk through it and figure it out. So really working with teens around that. And also, I mentioned that teens are more likely to take risks making sure your teen has areas in their life where they can take risks. What does this look like? This may look like kids that are involved in sporting events. Sporting events are all about throwing yourself out there and doing the hard, hard thing, or OK, or me and my friends allowed to go to some particular concert. And it's just like us going. And it's all like, where can they do things that make them feel like they're taking risks so that in other areas, they can be more likely not to work out those pieces of being a teen?

00:49:06

Liz Voyles

That's fantastic advice, so we're getting a few different questions about kids either having panic attacks or kids perceiving that they are having a reaction to a food when they're actually not having a reaction to the food. So I sort of paired those two themes together. You could continue to pair them or take them apart, consciously uncoupled them. But what do you think? What do you think about those two kinds of phenomenons?

00:49:48

Fawn McNeil-Haber, PhD

So I think this is something that I see frequently, and I think it's really important for us to be learning about anxiety and learning about what panic is and to be teaching our kids those things so that they know what this is, that this isn't some foreign thing, that suddenly they're having all of this anxiety. So they know food allergies maybe started when they were very young. They know about food allergies, they know about food allergy reactions, and suddenly they're experiencing anxiety. They don't know what that is. And all of the information they have is to equate it with a reaction. And so I think it's really important early on to be talking with our kids about anxiety and how they're feeling and whether their body is sending the messages that they're nervous, not just in reference to food allergies. It really does need to be a reference to a test going to a friend's house for the first time, meeting someone new going to the pediatrician, and maybe they're going to get the flu shot, being able to connect what is anxiety so that you're not speaking a foreign language if they start, if the two start overlapping and they're unsure that way, you can communicate about, OK, let's slow down and start problem solving. Is this anxiety? Is this a reaction? Now you, as the parent, want to be careful, always jumping in and telling your kid what they're feeling, especially if you suspect that it's really a feeling and not a reaction you want to get them, OK? What have you eaten today? Let's start thinking about it.

00:51:24

Fawn McNeil-Haber, PhD

Ok? Is this you're feeling like your heart's racing a little bit and your palms are getting sweaty? Ok? All right. And kind of walking them through. But OK, you don't have any hives or your stomach's not hurting and usually so helping them kind of work through like, what is this that I'm experiencing and how can I try to calm myself down? Because, you know, taking certain things you can do to help calm anxiety, you can take slow, deep breaths. You can inhale. You know, I like to teach kids that they can inhale like they're breathing in a flower and their stomach starts getting bigger like a balloon. So you inhale. Let your stomach get bigger to the counter four. You exhale and your exhale should be slower than your inhale. That balloon gets really small. All the air blows out, like you're blowing out birthday candles and you take a few of those breaths and you can start to see whether does some of this start to calm down because we're not going to breathe through a reaction. But if we're dealing with the anxiety, the breath, because once again, that lower brain is very connected with our whole system, that breath can start the sound. We can start to think about how can I talk myself through it many times? If the kid is feeling anxious, they start to work themselves up.

00:52:44

Fawn McNeil-Haber, PhD

Ok, how? How am I doing? All right? I'm OK. I'm going to talk with mom about this. I haven't had any food. How can making and start doing that self-talk affirm themself as opposed to really working themselves up? So teaching different kind of skills to help them calm themselves down and help them problem solve about, OK, what is this? Is this anxiety? Is this a reaction? One of the things someone mentioned is the panic piece and that it can go into panic. And if your child's had a panic attack before, it can be a little easier talking about what a panic attack is than necessarily in the midst of having one for the first time. But a panic attack is when it swells and the anxiety just gets so big and comes back down. And so there are a number of things that you can do, even in relation that are similar to anxiety to help calm panic. But one of the things you also know is panic goes up and panic comes back down, and eventually they come back down. So establishing a way to talk about it and finding ways for them to calm their body is definitely one of the biggest things that I like to encourage parents to do, because then you and your kid can really kind of talk through it and understand what's happening, that, oh, this is just something the body does.

00:54:07
Liz Voyles

Ok, our next question is about adult anxiety, so we're getting these questions from some adults who have food allergies themselves and then some adults who are basically wondering if there's such a thing as addressing their child's anxiety without addressing their own anxiety. So talk to us about how important it is for adults to address their own anxiety. And then if they're interested in doing that, how do we put one foot in front of the other?

00:54:43

Fawn McNeil-Haber, PhD

Yeah, so once again, I think it's really hard for parents to be experiencing extreme levels of anxiety or I saw PTSD pop up, I didn't get to read the question or PTSD and not address those and have their kid not feel it. It can be. It's really hard because many of the things that we want to do, we want to be modeling, first of all, for our kids, we want them to see us talking through a situation because we get anxious about doing different things. And so we want them to be able to see us talk through those situations in a calm manner in order for them to talk through themselves. We want them to see us be able to breathe through something they're constantly, you know, watching us. And so the other piece is, if you're experiencing really extreme anxiety, it's easy to get triggered. And when I say triggered, I mean that different things are happening in the environment that flood the system with all of that anxious energy. And suddenly something happens, you're triggered and it becomes once again we talk about the brain is pulling the alarm. It makes it very hard to think. It makes it very hard to respond in ways that might make you feel like you're kind of being the best model and doing it and having the best reaction for your kid.

00:56:19

Fawn McNeil-Haber, PhD

So I would really encourage parents who are experiencing anxiety or PTSD to figure out ways to work with that. And when I think about adults that are experiencing anxiety in relation to food allergies, a lot of the things that happen, you know, with adults, we adults tend to put off kind of the things that we really need to do to help ourselves feel better and take care of ourselves, that it doesn't quite always rise to the level of, OK, I'm going to do this in specific ways. And so what I mean by that is sometimes I'll talk to someone who is experiencing a lot of anxiety and say, OK, we've been talking about a variety of different things. We can talk about it, but it seems like we're getting to the point where we have to start really integrating things into your daily life to bring that anxiety down. And so what are we talking about? We might be talking about things like mindfulness. They have apps now that help with mindfulness and that help calm. But really, how do I calm that part of the brain? How do I do the breathing on a regular basis to calm that part of the brain? How do I notice when I'm becoming anxious? What are my anxious signs that my body is becoming anxious and I need to calm my body physically? So this could be maybe for some people it's taking a bath or a warm shower.

00:57:53

Fawn McNeil-Haber, PhD

For some people, it might be how to breathe. For some people, it might be music. How do I start intentionally calming the anxiety? How do I start calming that part of me? Because once I can calm my body, I can start thinking about, OK, what? What things might I need to do to challenge myself to move more into the world if I feel like I've kind of closed my world off quite a bit because I'm avoiding all of these different things, but until I'm able to move my anxiety and calm it down, it's going to be really hard for me to challenge myself to be like, OK, I'm going to go to part of this party. I'm going to be there for a little while and then I'm going to leave. And that's enough. That's enough food exposure for me. But if I don't know how to come, if I can't get in the car, I'd be like, OK, just breathe. You're OK. You did a great job. If I can't cheerlead myself and it's going to be really hard for me to challenge myself to move into those situations where I can, I can succeed and feel brave.

00:58:58

Liz Voyles

Fantastic. Ok, we're getting a few different questions about children who perceive that an allergen is there when it's not. So we have one parent who's describing thinking that every little piece of dirt on the floor is a possible wheat crumb. We have other parents who are talking about kids who wash their hands too much. We have other ones who talk about sanitizing every surface, all the time and just generally being afraid of leaving home. So can you speak a little bit to kind of what it's like when we get so cautious that it starts to really limit ourselves.

00:59:56

Fawn McNeil-Haber, PhD

Yeah. So. I think that is one the reason why I started off talking about that safe piece is when is that the important piece that we know something safe and we're avoiding it anyway, which really shuts down life. Suddenly you're avoiding all of these different things. And so there are two pieces that I'm going to talk to a little bit about what we can be able to do as parents and a little bit about, OK, sometimes we do need to get professionals involved and really connect with someone who can help us help our kids or ourselves through that piece. So when I think about what parents can do or what adults can do when it gets that level is establishing some sort of communication around what's going on and that they think that that's there, that there are ways that we can check to see if things are really safe ways that we can look into it. But once we've established that, OK, yes, this is a safe place. It seems like you're not able to take part in this particular thing because we really want to connect both as adults and as kids with something that we want because if the kid isn't interested in this at all, it's going to be really hard to motivate them to challenge themselves to be brave in a particular situation. Also, I think that's true for adults, too. It makes it what is it that we want to accomplish, succeed at and do? And so OK, so we're not able to go.

01:01:37

Fawn McNeil-Haber, PhD

Maybe we're not able to go to birthday parties because every little thing we think is a week from or is something so OK. So how do we if you can get the child to say that they want to go to this place, then suddenly we can start challenging them to get closer and closer and celebrating those things where they're OK. So we know that say, if I'm going to have you touch that now you as the parent needs it. Once again, we're our own anxiety. Make sure you're not getting in your own head about, Oh, is it really safe? But OK, see if you can do that and how you're going to celebrate, what are you going to do? What's going to be the celebration? Or are we going to play a game or are we going to do this? Are there ways that you can inch your child more and more into that space and challenge themselves when you find that no matter what you do, you can't get your child to try to move forward. You're seeing no movement. That's when I start getting into OK, you may need someone else to help a little bit more. There are different things when we're feeling really worried, when we're feeling really scared of different things that are happening, we go for control. We want lots of control. And one of the ways to get that control is by not interacting with different things, and we may have thoughts coming into our head.

01:02:51

Fawn McNeil-Haber, PhD

These obsessive thoughts coming into our head that everything is dangerous and it can be really helpful to have someone sort out and figure out, OK, is this anxiety? Are these obsessive thoughts coming in that the child is kind of clinging to? And how do we help them realize that, huh? These thoughts may not be as true as you think they are, and we can see this with adults, too. We can see some obsessive behaviors coming in where rationally, you know, something is safe, but there's something in your mind telling you. But maybe not. Maybe that's dangerous. And how do you disconnect from those thoughts? Because we think of thoughts as part of us, if we think it, it's true. And that's not the case. We can think lots of things. We can think I'm a pink elephant. I'm a pink elephant, but I'm not a pink elephant. So not all thoughts are true. So how can we disconnect and identify the fact that this is a thought? I'm having a thought that this is dangerous. I think that this is dangerous, but I can also figure out whether it actually is dangerous and challenge myself to take that step. And sometimes it's hard to do that alone, and that's when we get into do we need someone to help us? Could be a therapist to be someone else, but do we need someone to help us get through that?

01:04:09

Liz Voyles

Ok, I know we're over time, folks, so I think we'll do probably two more questions. These questions are fabulous and I just want to thank everyone for being so engaged. So we're getting a few questions about siblings how to handle anxiety in siblings who are not kind of the center of attention, maybe when it comes to the allergy, but who nonetheless, as Dr. Sweeney described at the beginning of the webinar, are very much part of the picture and may not quite know how to handle the nervousness and sometimes the trauma of these reactions.

01:05:02

Fawn McNeil-Haber, PhD

Yeah. Ok. I am very much a proponent of being very intentional about family members, and we can start off with siblings, but being very intentional about how they are included in what's going on from the beginning, how you plan to maneuver different things to make sure that they are being thought about and that they are included in the process, that they are being given an opportunity to tell their story of what happened. Their story of how there was a reaction. The ambulance came. Everybody left and maybe I was home with a relative or with the other parent and didn't know what was happening all that time that they get to process all of those feelings. But even things like whether they end up avoiding certain allergens because they're not in the house or being just very intentional about how we include siblings.I have one child with food allergies, I have another child that doesn't have food allergies and we would sneak out and have pizza. And that was like our thing. And I, you know, my husband knew that we were sneaking out.

01:06:19

Fawn McNeil-Haber, PhD

The little one didn't know, but like, it was a thing on purpose that we were sneaking out. We were going to go sneak out. We were going to have pizza and we weren't going to tell anybody. And it was an intentional thing because I wanted him to have opportunities to have these things happen without so that when he couldn't, he didn't necessarily feel like he was just being neglected and being forced to do this, even though he didn't have a problem. So really being intentional about how am I including these siblings in what's happening? Are they learning to read labels? Are they being recognized as food allergy champions when they remember, Oh, you didn't get your EpiPen? Are you like? Yep, very cute. That was a great job. How are you bringing them in so that you're acknowledging everything they're doing, as well as any fears or worries that they have, or if they start taking care of their siblings more than it seems a little more than necessary. That makes you start to wonder, are they? Are they overly worried and are they trying to make up, create some control because they're feeling out of control because of the food allergies?

01:07:28

Julie Sweeney, MD

Yeah, I love all of that. I think that was so important when that happened last year just to, I think for my youngest to know that I was caring as much about him being anxious as I do the other kids, making sure to ask the right questions like, what is it that's worrying you about going to school and eating foods at school? And that's when he said, I'm nervous that you not there. And if something happened that the teachers wouldn't realize that they would need to give me an EpiPen. So, you know, and getting past that so that then we could then role-play, what might happen? I could say, you know what? I talked to your teacher about it. She knows what happened. I talked to the school psychologist about it. She knows what happened. She pulled him into the office. They went over some strategies that he could use for breathing strategies and things like that. And it was great. And I love your idea of having that special time when your other child, because I can't tell you how many times Ben has said, I can't wait for Ryan and Liam to go to college so I can eat nuts in the house. I'm like, It's just so funny the things that they think about.

01:08:46

Liz Voyles

The things that they think about that is right. So we have one last kind of theme of questions that a few people have asked about, and then I think we'll probably end it so we can all put our kids to bed. But there are pretty consistent questions about parents feeling frustrated. That they're asking schools, daycares, camps for what their child needs and not getting it or also feeling anxiety about the asking. In general. So give us some tips, because something that we all have to do all the time, really. Give us some tips on how we can be direct seriously without kind of being over.

01:09:46

Fawn McNeil-Haber, PhD

So if I heard you correctly, I know you kind of cut out a little bit there, but it sounds like how to talk to the school, talk to camps, talk to different people about food allergies and being assertive, and that can be hard at times. Yeah. And so I think one, it can be helpful to equip yourself with knowledge about what your school has to offer and what schools in general are supposed to offer. And so having that knowledge about what you can have, and so I saw something pop up in the chat about 504 plans and understanding what role this school has to play can really help us feel a little bit better when we're approaching them because we have that knowledge being able, especially for those of us that aren't typically you get thrown into the food allergy world. Maybe you were an introvert and you're like, I wasn't always speaking up. And now suddenly I'm in this position where I have to speak up to everyone and it can be really hard. And I think that's where the anxiety can come in, because once again, we talk that brain does not know the difference between the bear coming at us and a social threat. And so it starts pulling that alarm and being able to manage that anxiety within ourselves so that we can speak out. And this is what my kid needs. And being able to talk to the teacher and going to the principal and finding who is the right person to talk to, who's hearing me? Who do I feel most comfortable talking to? Also writing out what you want to say can be really helpful so that you're not trying to once again being prepared, not trying to do all of that rational thinking when all of that anxious energy is coming in, writing down the points that you want to make and that you're hoping to get through to the teacher about what you need and really trying to think about ways that you can work together and anticipate different problems that could come up because maybe you have a solution and you can share that with the school even before they're trying to figure it out that they may not know what to do and that you may have alike.

01:12:02

Fawn McNeil-Haber, PhD

Here's the issue. I think that this might help, or I think that maybe we can do this. And so really finding your voice and working with your partner, so if you have a co-parent, sometimes you do have to tag team, sometimes one of us has a better skill, is better at a particular thing than the other one, and you may have to pass along to the other parent or to a different relative to kind of help come in with you to have that conversation ahead of time. But it's so important to find the important person to talk, to establish that relationship with them, that ongoing communication that you can have, whether it's the nurse, the counselor and the teacher or the principal and figuring out, OK, how do I keep that, that conversation going? How do I check in? How do I keep that relationship alive?

01:12:53

Julie Sweeney, MD

Yeah, I've had a couple of conversations with parents where we've even just gone over what they can put in the 504 plan at their school or they're in preschool and they don't do 504 that their private preschool. But we put together like an allergy action plan, talked about what the school would need to do to keep them safe. And you're right, it's almost knowing what the schools have to do to help your child stay safe and having that confidence that you can ask for those things and it does get hard in social situations, then because then you don't have that as far as what’s allowed and what's not allowed, but really what you feel comfortable with and maybe you don't feel comfortable sending your child or to a birthday party where the mom's not paying attention to what you're saying about the safety of that event. But you hear a mom who says, Oh my gosh, I would love to know how to use the EpiPen. Let me know what I can serve. Then that's the birthday party that you're going to let your child go to. So there's a lot to that question, Liz, but you know, obviously we're here to help to. Intact.

01:14:08

Liz Voyles

Ok, I think we will wrap it there. We want to thank all of you so much for giving us a piece of your Sunday night. And we want to thank our partners at Red Sneakers for Oakley from the bottom of our hearts, for all the work that they do with us and for doing this event with us here today and everything they do to keep our kids safe. We also want to thank Dr. Fawn McNeil-Haber and Julie Sweeney for their fantastic presentation. Today's session gave us all, I think, a lot to think about. I know it gave me a lot to think about. If you want to create a personalized plan for your child or if you just want to keep in touch with us, go to getbackstop.com/events. You can also download the app there. You can chat with us on the app. You can access those videos that we talked about earlier. And you can also be the first to find out about upcoming events and webinars with our wonderful experts. We also have private sessions that you can sign up for right now today. And then we're going to be launching small circles about behavioral health really soon. We're going to have some really exciting stuff coming up in the new year. So if any of your New Year's resolutions have anything to do with managing your children's food allergies better and feeling braver in the new year, we are here. We're here for you to help you make those hopes and dreams come true in 2022. So thanks again, so much for joining us today and whatever and whenever you celebrate, we hope you have a wonderful and safe holiday season. Thanks again. Bye bye.

Up next

How to Find Your Footing: Reducing Anxiety as a Food Allergy Parent

Course Lessons

Food Allergy Anxiety in Kids: What Parents Can Do to Address It
Food Allergy Anxiety in Kids: What Parents Can Do to Address It
How to Find Your Footing: Reducing Anxiety as a Food Allergy Parent
How to Find Your Footing: Reducing Anxiety as a Food Allergy Parent
Navigating Anxiety in Food Allergy Parenting Today
Navigating Anxiety in Food Allergy Parenting Today
Growth Mindset: Moving Forward After an Allergic Reaction
Growth Mindset: Moving Forward After an Allergic Reaction
Food Allergies at School: What Your Pediatrician Wants You to Know
Food Allergies at School: What Your Pediatrician Wants You to Know