Food Allergies and Anxiety

Food Allergies and Anxiety

By Patience Domowski, LCSW



More and more children seem to be developing food allergies these days. Kids with severe reactions often are very anxious about their allergies because they don’t want the consequences of a reaction (such as trouble breathing), and can be worried that other people won’t be understanding of their allergy. For example a child who had to be hospitalized for going into anaphylactic shock from peanut butter on someone’s fingers at a birthday party  is naturally going to be little more wary and even nervous to attend another birthday party. They don’t want to end up in the hospital again! Or another child who tells their friend’s mom they can’t have seafood and the mom serves shrimp for dinner anyway might be concerned that people don’t understand them or care. Sometimes kids even get teased about their allergies or told they aren’t real. This is very upsetting for the allergic child and can make them quite frightened as some kids’ allergic reactions are life -threatening.


Ways to help your food-allergic child feel less anxious:

-Teach them nice ways to explain to others about their allergies, maybe even give them little business cards with information on it to pass out to friends and friend’s parents so they understand a little better.

-Teach them how to check food labels so they can be confident what they eat won’t make them react, and ask grown-ups present to help them double-check as well

-Remind them that just because they had an allergic reaction in a certain situation before (like at a party, or school), doesn't mean it will happen again- child and family will be more careful next time

-Remind them of the protocol of what to do if they think they are having an allergic reaction and who to ask for help, carry epi-pen if needed or other medications

-Teach some coping strategies for anxiety such as deep breathing, thinking happy/calm thoughts, and making a plan to handle problems that arise

-Joining a food allergy support group can be helpful for parents and children

-If they continue to show excessive anxiety, have them see a child behavioral therapist


Ways to help others understand your child’s allergies:

-Provide some basic education, nicely, to other parents, friends, teachers, etc on how the food allergy affects your child and what they need to avoid and how (can they just not ingest a food, or not even be near it?)

-Remind friend’s parents before a playdate or party and also pack safe foods for your child so the other parent doesn't have to worry about what to feed your child at their house

-Even if your child has a 504 for allergies at school, inform any new teachers or lunch aides about the allergies, and ask teachers to tell other parents coming into the classroom with food for parties about the concerns. Suggest other options that won’t affect your child like toys, stickers, or other foods that are safe and yummy to bring in to the class, or say you will provide all treats for your child at these events.

-If your child is being teased or bullied about allergies, provide some education to the other person about the seriousness of the reaction and why its not cool to be mean about it. Report the bullying incidents to the authorities such as school staff or adults in charge at the event.

-Tell teachers and other adults involved with your child some ways you are working on teaching coping strategies to your child to handle their anxieties like ‘remind them to take deep breaths’ or ‘please tell my child I packed his lunch so he doesn't need to worry’, etc.

-Give everyone written and verbal information on how to handle allergic reactions, symptoms and how to dispense medication in case something does happen. For example while the school nurse is trained to use an epi-pen, the chaperone on a field trip might not be trained, so they would need that information in advance

Other tips:

Connect with other parents dealing with same situation for more ideas and supports. Make sure your child is getting support as well if they are emotionally affected by their allergies.

Feeding problems

Eating/Feeding concerns and how to address them (Picky Eaters)

This is for picky eaters, kids with autism, sensory food avoidance, etc...

This is an idea of how to introduce new foods that I have come up with based on observing different interventions teachers, OTs, therapists, parents, etc have used with kids. I cannot and will not guarantee this will work, but its just a suggestion to try.
The basic idea is to offer/present or insist on trying the new food BEFORE they get the food they want. Do not even show them their preferred food when presenting the new food. New foods must be offered SEVERAL times on different occasions for kids to try to see if they will like it/eat it. Don't give up after just one attempt!!  
Also often children will eat more/different foods at school, or with peers/siblings/friends/cousins/etc MORE OFTEN than just with mom/dad at home, so try sending in different food options to school, invite kids over at home to all eat foods, etc. 
When I talk about "New or Different" foods I mean normal kid food that the child refuses, nothing that is usually an acquired taste like some different cultural or "ethnic" foods, sushi for example if family is not Asian, certain vegetables like Asparagus most kids don't prefer for example. Ask/observe other kids to find out what is "normal" kid foods in your area/culture. 

Using a "First/Then" chart card may be helpful for visual learners (most autistic kids).




Feeding Behavior Protocol

Present new food daily, or at least several times/week. Child must do Step (below) first, then receive preferred foods.  Once the Step (that you are on) has been successful for 5 consecutive days, move on to next step in sequence. If unsuccessful, go back to previous successful step. Don’t pressure child or make it feel like a punishment. Make it relaxed. Model eating different foods for child, offer child to eat off parents plates, have peers/siblings model eating the new food as well (if possible). Keep trying new and different foods. Research shows child may need to be presented with new foods 20 times before will eat/try it. Skip Steps below if your child is already past that stage (don’t go backwards if unnecessary)

(** Note - most kids will be at step # 3, 4, or 5 to start. Some kids may need pre step or steps 1-2 to start)

Pre-steps: (Use if child is avoidant of touching certain textures like pudding for example)

– Have child first touch food with one finger (or touch food with a plastic glove on, or in a plastic bag)

-Have child put hands in food, then wash off /remove quickly

-Move to step 1:


  • Step 1: Touch food to mouth
  • Step 2: Lick food
  • Step 3: Take a tiny bite “mouse bite”
  • Step 4: Take a larger bite “elephant bite”
  • Step 5: Eat new food (1)
  • Step 6: Eat full serving of new food
  • Step 7: Try another new food!! Repeat Steps 1-7 as needed