Food allergies in NRI children

The word 'allergy' for a lot of Indians is something we associate with a skin rash, runny nose or watering eyes. So when hears of an allergy to food, it is not taken seriously. When an NRI child with a food allergy visits India, relatives and friends tend to dismiss 'food allergy' as just another NRI fad and a fuss over nothing. They could not be further from the truth.
Allergy to food or anything else like medicines, pollen or dust can range from mild to severe and even a life threatening condition called anaphylaxis. It is very important for us Indians in particular, to be aware of this condition as food allergies are on the rise in general and coming to light more so among Indian children living outside India. Research is still ongoing to find the cause of this condition and why children including Indian-origin ones, born in Western, developed countries are more likely to suffer.
Children and adults can be allergic to any food, but the top 8 food allergens are: peanuts, tree nuts [cashewnuts, pistachios, walnuts and many others], sesame [til], dairy [milk, butter, cheese, ghee], egg, fish, shellfish, soy and wheat. Indian-origin children tend to be allergic to chickpeas [chole] and therefore the related besan [gram flour] and chana dal. Fruit like strawberries and kiwi are known allergens too. Allergies are discovered early in childhood, but may develop at any age including in adult life.
Eating an allergenic food or contact with skin or mucous membrane [as in rubbing eyes] can cause an allergic reaction that may be a skin rash, hives, itching, runny nose, watering of the eyes, swelling of the lips, face or eyes, stomach ache, vomiting, diarrhea, feeling faint or even wheezing, a feeling of tightness and closure of the throat, inability to breathe and unconsciousness. If untreated, it can lead to loss of life very quickly, in a matter of minutes. Therefore, it is vital to know what to do if such a situation arises.
Obviously, prevention is better than cure.
If one invites a food allergic child over for a meal, it is good to check with the parent about what exactly they can eat and what they definitely cannot. Check the labels of foods to check what they contain, to avoid the allergen. This includes the oil used for cooking. Wash hands thoroughly before touching food made for the child. Do not mix spoons and plates during cooking or serving. If in any doubt or if this is overwhelming, it's best to ask the child's parent to bring their own food along which is safe for them. No, they will not mind at all and everyone can have a fun time without worries.
If serving finger food at a party, put out foods that are safe for the allergic child. People, especially other children will eat with their hands, disperse crumbs on the floor and contaminate door handles, toys, shared items like whistles, flutes, party horns etc. If it's a nut allergy, avoid obvious stuff like fried/masala nuts, chivda, sev mix and so on. If it's a besan allergy avoid chaklis, sev, pakoras and other such items. Mithai and a lot of Indian desserts will usually contain milk, nuts and besan. But several desserts can be made using substitutes or by avoiding nuts. Keeping wet wipes handy will help.
For birthday parties, often, an allergic child will be unable to have the cake as it contains several allergens. Also, several chocolates contain nuts or traces of nuts, soya and milk. Please do not force the child to try a bite of it or feel insulted if they do not eat it. If anything, you can buy or make a safe food treat that can be given as an alternative to cake. But leave it to the parent to decide if the child can eat it or not. At pujas, the 'Prasad' may contain nuts, milk or besan. It is a very sensitive issue for a child to decline it because of an allergy. Understanding this and not feeling offended goes a long way.
When having a food allergic child over for a play date without the parent being present, it's good to know what food to give them, who to contact in case of an emergency and to have their allergy medicine with you. Usually, an antihistamine syrup or tablet is given for mild reactions, but for a severe reaction, an intramuscular injection of adrenaline [Epipen/ Anapen] is required. A parent, carer or the child, usually carries this if he/ she is old enough. If taking on responsibility for a child with food allergies, one must know the exact dose of the antihistamine and how to administer the Epipen injection. It may seem daunting, but it is simple to learn and it could save a life. So, if grandparents visit from India and look after the child, they should certainly be informed of this and also the emergency number for the hospital. If in India, it may be hard to get prompt medical help, therefore extra precautions are required. Kind, well-meaning neighbours, friends, maids do offer biscuits and chocolates as a treat, but they will need to be gently, but firmly told that the child cannot accept this unless checked by the parent. Genuine well-wishers will understand and gift the child with a non-food item that is equally appreciated.
Children with allergies are like other children in every other way: Intelligent, physically active, fun loving, emotional and above all normal. They need to be cared for differently but have to be understood, accepted and not judged for why they wash their hands too many times or why they avoid doing certain things.
It's time we Indians took a moment to educate ourselves about food allergies. After all, it could be your grandchild, niece, nephew, your child's best friend, your own child or even you who is at risk.