Happy Birthday! (Hold the Cake…)
A highlight of a child’s birthday is bringing treats to school. The interruption of the school routine for personal attention, a “Happy Birthday” serenade complete with “Cha-cha-cha’s” and a decadent treat to eat drive my kids to plan this particular event not days, but months in advance. Despite their intense pre-planning (motivation I wish would spill over to doing homework, cleaning their rooms….) the request from mom’s kitchen is predictable: cupcakes with sprinkles or fancy toothpicks, please. However this year my daughter threw a sweet curveball. As some of her friends are on a gluten-free diet, she wanted gluten-free brownies to take to her class. With her name “written” in M and M’s, please. I love her unprovoked thoughtfulness on a day when most young kids develop an unsurpassed narcissism and was more than willing to indulge her request. Plus these brownies are literally to die for. No one misses the gluten-y goodness.
When I brought the treats to my daughter’s second grade class, two children rushed up to ask what was in the brownies. A third child informed me he was wheat- and dairy-free. Yet another announced he “couldn’t have M and M’s.” In all, four kids could not partake of birthday treats. That’s 20 percent of the class. That surprising number made me think back to when I was my daughter’s age and the number of students who missed out on celebratory treats was…zero. Rare was the allergic child and no one had ever heard of being “gluten-free.” Sometimes nuts made their way into brownies, and no one batted an eyelash.
But times have changed. There is published evidence to support the limiting of sugar (obviously), wheat and even dairy in our diets. Unfortunately there seem to be more nut allergies and the idea of walnut brownies must be oh-so carefully considered. Despite modern diet considerations, even a birthday treat sans nuts and gluten prevented several kids from participating in the centerpiece of a school birthday celebration. I felt sad for them but also proud of these children (seven and eight years old!) who were so fully aware of their dietary restrictions they honored them under the temptation of a chocolatey sugar rush. And it was impressive to see so many families embrace a contemporary dietary consciousness. But I kept thinking about the little boy who said he “couldn’t have M and M’s.” I wonder if what he really meant was “shouldn’t.”
When I worked in healthcare an important, routine question I asked all my patients was “Are you allergic to anything?” The answers were many, varied and sometimes puzzling. For example, the mother of a pediatric patient mentioned her son was allergic to a particular brand of jarred spaghetti sauce. Which makes absolutely no medical sense. But no matter, as the follow up question to a stated allergy is “What happens when you eat/are exposed to (fill-in-the-blank)?” And in the case of my avoider of pasta sauce, the answer was “He throws up.”
Ok. No wonder he steered clear. Food aversions are strong and lasting (eggs still kinda gross me out, after my mom fed me one as a toddler and I, that’s right, threw up.) But this boy doesn’t have an allergy. Plus kids who don’t like certain foods often state matter-of-factly, “I’m allergic to cheese, brussel sprouts, water….” The list could go on. But they aren’t faced with a life-threatening condition if exposed. They are describing dislikes or even intolerances. Not allergies. And the line between the last two gets blurred all the time, so that many of us think they are one and the same. So to clear the air (Sorry, no pun intended. Really.) here’s the difference between a food intolerance and a food allergy:
According to the American Academy of Allergy, Asthma and Immunology website, a food intolerance (also known as a sensitivity):
“…occurs when a person has difficulty digesting a particular food. This can lead to symptoms such as intestinal gas, abdominal pain or diarrhea. A food intolerance is sometimes confused with or mislabeled as a food allergy. Food intolerances involve the digestive system.”
And a food allergy affects:
“…the immune system. With a food allergy, even a microscopic amount of the food has the potential to lead to a serious or life-threatening reaction called anaphylaxis.”
Anaphylaxis is a fancy term for symptoms that include, but are not limited to, difficulty breathing, difficulty swallowing, hives and swelling. People who develop these potentially life-threatening symptoms following an exposure to a food item (like nuts) or an environmental insult (bee sting) carry injectable epinephrine, which stalls the symptoms until they obtain further medical treatment (which they should seek immediately).
Just to be sure, I don’t bring this up to advocate for eating of junk-food or to dismiss dietary choices…far from it. What’s important is to make sure a child’s food avoidances are classified in the right way. Parents should discuss concerns with their child’s pediatrician, obtain a correct diagnosis (intolerance vs. allergy) and relay the appropriate information to school. The school must obviously know about a true anaphylactic reaction (allergy), with doses of epinephrine provided and readily available should a child have an exposure. However, an intolerance or preference is a gray area and can cause an undue ruse if mistakenly referred to as an “allergy.” If your child has a special diet, clarify any restrictions with your child’s teacher and indicate how the teacher should handle the parade of birthday and party treats that inevitably pass through the classroom doors. Then provide the teacher with an appropriate stash of snacks for your child, so at the very least your little one won’t be left out and can eat something with their classmates. Because, as in the case of the disappointed little boy who “couldn’t have M and M’s” the teacher was scrambling for an alternative snack for him, and the best she could do was a rather tired-looking peach.
Above all, keep an open dialogue with your child’s pediatrician. Ask questions about any and all reactions your child has to food and anything else in his/her environment. And as for all the “free” diets out there…some make sense, others do not. And some may or may not be appropriate for a growing and developing weed like your child. Before trying out a diet that limits or emphasizes any food group, ask your doctor and/or a registered dietician.
Eat smart, eat well, eat healthy. But don’t forget to indulge once in awhile, it’s good for the soul.
