• Eliminate from the house all foods which are causing food allergies.  This is especially important if a young child has food allergies.   If your small child is allergic to peanuts, you should not have any products which contain peanuts or tree nuts at home.   
• Avoid peanut butter substitutes if you have a small child with peanut allergies.   While peanut butter substitutes do not have any peanuts in them, having them in the house may confuse your child who will think it is okay to eat it elsewhere.
• Request that food brought in the house (for example, friends bring a dish for a party) have ingredient labels.
• Make sure everyone knows where you keep the epinephrine auto-injector and that everyone knows how to use it, including the baby sitter.
• Look for foods manufactured from companies that specialize in food allergy avoidance - they can often be found in the "natural" sections of grocery stores and online such as  Peanut Free Planet, Enjoy Life Foods,
• Cherrybrook Kitchen,  Cookies for Me, and Allergyfreefoods.
• Get cooking!  Buy a food allergy cookbook, subscribe to the Living Without magazine, or check out this website for some free recipes to try out.

Avoidance can be easy in the comfort of one’s home, but it is much more difficult in other areas, such as friend’s houses, schools, restaurants, and other public places.    In fact, most fatal and near-fatal food allergic reactions occur
away from home.   These steps can help minimize the risks:

• Do not eat anything until you know exactly what is in the food.  I have heard too many horror stories about people with food allergies who ate something without first checking the ingredients and consequently died.  A minute of your time to check the ingredients can save your life.
• Do not assume that others know about your food allergy and what specific ingredients need to be avoided.  Educate family members, friends, teachers, and others about your food allergy.   Even if they tell you they know what to look for, tell them anyway.    
• Make a card that list ingredients that need to be avoided for family, friends, and teachers.
• If you have small children and visiting playmates, consider wiping their toys clean before letting your child play with them.
• In restaurants, be sure to stress the life threatening potential of your food allergy, and ask to speak to the cook if possible.   Give a list of ingredients to avoid, raise awareness of the risk of cross-contamination, and ask for
• clean utensils and cookware to be used for your dish.  Do not share utensils with others at your table.
• Ensure people wash their hands after meals.  Studies confirm that hand soaps, liquid soaps, and commercial wipes are effective in removing food allergens from the skin.   Note that alcohol-based hand sanitizers are not effective in removing food allergens from the skin.
• Wipe the restaurant table or the airplane fold down tray to eliminate any possible food particles left from a previous person.
• Bring your own food.  The school or airline cooking staff may be very good at dealing with food allergies, but mistakes do happen.   Bringing your own food is safest.
• Have your child bring lunch from home, instead of buying the school lunches - and don't let them trade their food!
• Give your child’s teacher an alternate snack for “surprise events”.  The teacher can give this to your child should other students bring a treat for a special event (birthdays)
• Before traveling, write down information about your food allergy in the language of the country you are visiting.   You can also download a free food allergy dictionary here - they have one for over 20 different languages, including Chinese, Polish, and Greek!
• Get a medic alert bracelet Have it inscribed with your food allergies and remember to always wear it!  You can get medic alert bracelets from various places including some local jewelry stores and internet vendors such as MedicAlert,  n-styleid, and American Medical ID.  
• Always bring your epinephrine auto-injector where ever you go.  If flying, keep you auto-injector in the original box that it came with, or bring a letter from your physician stating the need for you to bring it in the plane.
• Do not be afraid to use your epinephrine auto-injector.   Immediately use it if you are having an allergic reaction - do not wait, do not take benadryl first.   If in doubt, use it.   The longer you wait to use it, the less effective it will become.

Always carry your epinephrine auto-injector with you.  Because 1 dose may not be enough, it is recommended that you carry 2 doses with you (1 Twinject , 2 Auvi-Q, 2 adrenaclicks, or 2 Epipens) at all times.

Learn how to use your auto-injector before you have a reaction.  The time to learn is not when you are having symptom! 

• Instructions on how to use Epipen
• Instructions on how to use Adrenaclick
• Instructions on how to use Auvi-Q

Have a plan and teach your family, friends, and co-workers how to use the injectors in case you are not able to administer a dose yourself.

Don’t assume your friends, child’s teacher, sitter, or caregiver knows how to use an epinephrine auto-injector—go through all the steps with them.  If you have some expired epinephrine auto-injectors laying around, you can practice using them on an orange to get a feel of how they really work.

Do not delay in seeking help.   You should always seek emergency treatment (IE. Call 911) when you have an allergic reaction.

Get a medic alert (you can get medic alert bracelets from various places including medic alert or American Medical ID) and don't forget to wear it!  

It is an exciting time for the treatment of food allergies. The collected scientific evidence is strong enough now that I feel we can do food desensitization safely. Oral immunotherapy to food is no longer a wish, but a reality!  

Dr. Dauby is excited to offer food oral immunotherapy (OIT).  In a series of scheduled visits at our office, small incremental amounts of the particular food are given to the patient by mouth in a controlled setting to desensitize the person to their food allergy. This therapy does not involve shots or medications. 

After approximately 4-12 months of treatment, the majority of patients (well over 80%) can eat usual and customary amounts of the food without incident or reaction.  Only a small number of patients may not tolerate the therapy successfully. 

My protocol is similar to those used in numerous successful studies in the United States and published in respected and recognized medical journals to include:

1.     Successful oral desensitization for systemic peanut allergy. Ann Allergy Asthma Immunol 97. 266-267. 2006

2.     Oral peanut immunotherapy for peanut allergic patients. J Allergy Clin Immunol 119. 2007

3.     Oral Desensitization in Children with Cow’s Milk Allergy. Journal of Investigative Allergy and Clinical Immunology 2008; 18(5): 389-396.

4.     Specific oral tolerance induction in children with very severe cow’s milk-induced reactions. Journal of Allergy and Clinical Immunology 2008; 121: 343-7

5.     A protocol for oral desensitization in children with IgE mediated cow’s milk allergy. Allergy 2004; 59: 980-7

6.     Egg oral immunotherapy in non anaphylactic children with egg allergy. Journal of Allergy and Clinical Immunology 2007; 119: 119-205

7.     A randomized, double blind, placebo controlled study of milk oral immunotherapy for cow’s milk allergy. Journal of Allergy and Clinical Immunology 2008; 122: 1154-60.

Why are there not more allergists performing this procedure?