The Emotional Benefits of Oral Immunotherapy on the Whole Family
A mother recently came to our practice with a toddler who had a suspected peanut and cashew allergy. While this is a cause for uncertainty and fear for a lot of families, this mother was particularly anxious about the impact of the diagnosis on her child’s future. She did not have any food allergies herself, but her (now adult) brother did. She had lived through years of trauma, growing up with the fear of something happening to her brother. That trauma was now spilling over into the next generation, and she was determined to find a solution that would prevent such an outcome for her own child.
When we explore the option of oral immunotherapy (OIT) together with a family, it’s important to understand the full picture of the impact of food allergies on that specific family —as well as the benefits that proactive treatment with OIT can provide.
Food Allergies and Quality of Life
Research supports our anecdotal observations from our patients — food allergies significantly impact the quality of life of patients and their families. For example, The Peanut Allergy Burden Study showed that peanut allergies reduce the “psychosocial, emotional, and social functioning” for patients and their caregivers. Furthermore, a 2016 study found that for those with food allergies, “constant threat of exposure, need for vigilance and expectation of outcome can have a tremendous impact on quality of life.”
Increased anxiety and stress in people with food allergies occur for several reasons:
- Feeling different from their peers
- Worrying about food and possible exposure
- Effect on social activities
- Higher rates of bullying
However, research also shows that treatment with oral immunotherapy can make a measurable difference. This is true for both the patient and their caregivers.
How Oral Immunotherapy (OIT) Provides Support to Families
OIT can result in an increased sense of empowerment and confidence for the whole family due to anxiety reduction and a greater availability of food and social options in daily life. The following sections detail the areas in which we have seen noteworthy impact on the patients and families we treat.
Siblings of Those with Food Allergies
Food allergies impact siblings in different ways than the child with the allergy. They may deal with feeling less important than the allergic child. Some siblings, especially older siblings like the mother in our clinic, may take on the emotional stress of keeping their sibling safe. In other cases, they may be resentful that family decisions have to be made based around the allergic child’s needs.
After reaching maintenance in OIT, a lot of things become easier for the family, including:
- Increased safety during traveling with less pre-planning needed
- Family decisions don’t have to be based solely on the fear of cross-contamination
- Reduced risk of severe reaction due to accidental exposure in any environment
OIT can empower families to experience new things together. For one recent patient who reached OIT maintenance, his family was able to enjoy attending a professional baseball game together for the first time — no longer afraid of a reaction due to accidental exposure to peanuts at the ballpark. Travel choices for families can also broaden when families are less concerned with cooking facilities or access to special foods. Parties and events can become more enjoyable for the whole family because fear of cross-contamination is collectively reduced and food choices for the allergic family member are increased.
Choosing a College for a Student with Food Allergies
College decisions are complicated enough without a medical issue. Young adults with food allergies and their families evaluating post-high school options often prioritize factors related to caring for their food allergies such as:
- Proximity to home
- Safety of the dorms
- Cafeteria options or access to a kitchen
- Paying extra for accommodations or services
Young adults who have reached OIT maintenance can instead focus on variables like academic and extracurricular options. They, along with their families, have more confidence in choosing a college based on the school as a whole, rather than focusing only on the concerns of safety with their food allergy.
Financial Decisions When Your Child has Food Allergies
Many parents of young children with multiple food allergies make career choices with their child’s safety in mind. It is not uncommon for a food allergy parent to choose to stay home full-time with their child — sometimes driven by the anxiety of putting the child in someone else’s care or the overwhelming logistics of preparing safe foods. OIT gives parents a greater sense of ease about sending a child to daycare or on a playdate. Eventually, parents may feel more comfortable working outside of the home due to decreased anaphylactic risk.
Foods specifically manufactured to be safer for individuals with food allergies can be comforting for families. However, access to these products is often limited by high costs and limited storefront availability. When no longer concerned with cross-contamination reactions , their food options at the grocery store and restaurants significantly expand and their financial burden is reduced.
Overcoming Fear at the Dinner Table
For many families, meals are a time for bonding, discussion, and fun. However, in families affected by food allergies, mealtimes are challenging. Often everyone at the table is adopting a sense of hyper vigilance — especially when there have been past reactions at mealtimes. This is especially true when eating outside the home. OIT decreases the anxiety around family meal choices and food interactions.
Confidence for the Whole Family — Setting up Patients for Success
OIT can improve the quality of life for the entire family, but it is important to ensure that the benefits of the treatment outweigh the burden for prospective families. These factors can help families to maximize the positive for the whole family:
- Minimize travel for treatment
- Consider treatment costs from start to finish
- Seek an experienced clinician with a team who can also provide structure and emotional support through the process
- Insist on relevant and evidence-based testing to ensure that proactive treatment is only for their personalized allergens
Latitude Food Allergy Care provides comprehensive food allergy testing and treatment in the San Francisco Bay Area and New York City. Our expert team, led by board certified allergists, provides oral immunotherapy for single and multiple food allergies.
Dr. Joanne Moreau is a board certified allergist and immunologist. She leads Latitude’s food allergy clinic on the Upper East Side in New York City. Throughout her career, she has worked with many children and adults with food allergies, and has gained a unique appreciation for the difficulties they encounter. She is committed to changing the lives of food-allergic people by using evidence-based treatments to allow them to eat foods that were previously harmful, and to help free them from the constant worry of their food allergies.
Tina L.R. Dominguez, PA-C has devoted her career to food allergy research and food allergy care. She provides care for Latitude patients in the San Francisco Bay Area, and leads the Latitude food allergy clinic in San Ramon, California. As one of the founding clinicians of the Sean N. Parker Center for Allergy & Asthma Research at Stanford University, Tina worked closely with patients undergoing OIT, trained allergists on OIT protocols, participated in clinical trial design, and conducted several OIT clinical trials. She serves as a consultant for Aimmune Therapeutics, developing training protocols and patient and clinical staff education materials for physicians around the country who are offering Palforzia.