Teen traveling with school team - Peanut Allergy Information

Teen traveling with school team

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My DD14 was diagnosed with a peanut allergy this past summer, she has also been advised to avoid tree nuts because when she tried cashew butter it gave her a stomach ache. She is traveling with school teams, cheer/volleyball last season and this season Speech and Drama. We live in Montana and so they travel at least 100 miles to each meet! Therefore, they spend the night often and they eat at restaurants. We do have a 504 plan in place but it doesn't cover restaurant eating, I'm under the impression now that her 504 is not adequate but I'm not really sure what needs to go into it yet. She has done okay so far until last Saturday, they stopped at Pizza Hut for dinner on the way home and when she got home she had hives from her chin to her chest, she did not have any other symptoms so I treated her with benadryl and she was fine. In emailing back and forth with the coach (who had seemed so far to be understanding and accommodating)she said they stop at Subway, Pizza Hut and McDonalds quite often. I've read quite a bit and my understanding is McD is safe except peanut/nut topping on ice cream, flurries and any salads that have a nut topping (which are usually in a sealed packet, so easily avoided.). Subway bakes their bread on the same pans as their peanut butter cookies and can't guarantee that they have been cleaned sufficiently. So Subway bread is out. Pizza Hut has many items that are cross contact with peanuts/tree nuts, so I would like to avoid but it may not be possible for her on the bus. Is there any items at Subway or Pizza Hut that are not at risk for cross contact?

By PeanutAllergy.com on Nov 26, 2014

Question of the Week: Answered!

Every week, PeanutAllergy.com answers one of the questions posted in our community.

Our Answer:

Trying to find safe, convenient places for your food-allergic child to eat can be difficult and frustrating, especially when you aren’t there to ensure the place is, in fact, safe, so thank you for reaching out to our community! Here is a forum topic where some community members have discussed fast food restaurants and their safety, and their tips may help you out.

Being able to discuss your child’s situation with the coach is very helpful. It’s also important to have a plan and discuss what to do if something does go wrong. Having a reminder of what allergic reactions look like and to share it with the coach can increase safety and awareness, as well. Here’s a treatment resource to share.

Some resources exist online to help you find allergy-friendly restaurants. Learn about AllergyEats here, and the coach may be appreciative if you share it with her as well. This resource can point out safe restaurants along the way, and the team could try those instead of Subway, Pizza Hut, or other chains.

If it’s possible to speak to the manager of a particular restaurant, that is the safest option. Possible contaminants can include peanut oil, peanut-crusted fish and chicken, and peanut toppings on desserts. Typically, local restaurants are more likely to be peanut-free than regional or national chains. Some of the chains that are known for accommodating those with food allergies, however, include Outback Steakhouse, Red Lobster and Red Robin, while some of the riskier restaurants include Chick-fil-A, Chili's and Dairy Queen. Read more about peanut-free restaurants here.

If this causes any stress or judgement from your daughter’s teammates, a fellow PA teen has some tips here.

We asked our Facebook community what they thought. You can read what their responses here.

We wish you the best and hope you can find some safe restaurants for your daughter!

By vinucube on Dec 4, 2014

My understanding is that intact peanut protein must come into contact with blood for the development of peanut allergy. Injection, vaccination are therefore possibilities. Stomach acid reduction can cause undigested peanut protein to be absorbed. Eczema can cause proteins to be absorbed through the skin. Hence my questions. Thanks for the answers!

So you may want to think of any mechanism by which this may have occurred. If you do, please let us know!

As for allergy testing, it may be best to avoid the skin prick test. As you may know, intradermal flu vaccines have about half the viral proteins as the intramuscular shot. That is because the immune response in the skin is much stronger. Likewise, it takes very little allergen introduced into the skin to develop a new allergy.

By Fuji Mama on Dec 2, 2014

Nope, no eczema! Some dry skin in the winter, nothing a little lotion won't cure! Other than a little hay-fever, she doesn't have other allergies either. We are going back for further testing on tree nuts in January, for some suspect nuts.

By vinucube on Nov 30, 2014

Does she have eczema?

Cocoa might help reduce food allergies: http://www.ncbi.nlm.nih.gov/pubmed/22342543

By Fuji Mama on Nov 30, 2014

Thank you for your reply! We don't know why she developed this allergy at 13 years old! One day she was eating peanuts and the next day it was causing an itchy throat! Took her to the allergist and they tested and confirmed a peanut allergy.

No, she was not taking acid-reducing medications.

No, she had not received any injections or vaccination in the months prior to her diagnosis.

It's very strange but apparently it's becoming more common for teens and adults to develop this allergy.

By vinucube on Nov 30, 2014

Fuji Mama,

Sorry to hear your daughter's allergy diagnosis.

Since it is a recent diagnosis, you may be able provide information that might help determine the cause of the allergy. Was she taking acid-reducing medications before her diagnosis? Did she receive an injection or vaccination in the months prior to her diagnosis?

By Fuji Mama on Nov 30, 2014

Thank you for your reply! So I found the Pizza Hut allergen guide (http://www.pizzahut.com/assets/w/nutrition/PHWSAllergenMasterListfor2014.pdf) and I only see 2 sauces that have tree nuts and actually they said that most of their items are "may contain" due to being from a vendor. Can you tell me where you found that they have peanut oil in their sauce? And which sauce(s)? I'm still on the fence for this restaurant. However, I am not on the fence with Subway! I asked at the local store if they used separate/different pans for the cookies and the bread. I was told, "no, but we are supposed to wash them in between, but I can't guarantee that everyone does wash them." Ughh! No thank you! Yes, she carries a 2 pack of epi's on her person at all times and there is a second set in the office, which the coach takes when they go on the road. Yes, I do send a bunch of safe food with her, but she wants to eat with her friends and doesn't want to be singled out, she chooses safe foods and will text me if she doesn't know what is safe.

By cathlina on Nov 30, 2014

Pizza Hut buys its pizza sauce from a vendor. There is peanut oil in the sauce. I thought they were changing vendors. But who knows. Subway is not safe because they make peanut butter cookies in the same oven as the bread. Additionally, she may have touched something that someone else touched that had peanut residue on it. If it was my child, I would send their own food. Although, I know this can be uncomfortable for a teenager....her safety needs to be the first consideration. Does she or the coach carry an epi-pen for her? Also, Section 504 requires that 504 accommodations extend beyond the classroom to all activities including sports.

By Mrsdocrse on Nov 30, 2014

Hi We have never eaten at Pizza Hut since they state on the website that the sauce "may contain" peanuts. We don't eat at Subway just because I don't like it. Your daughter needs to try advocate for herself and speak to restaurant managers when you are not with her... I know this is hard.. My son doesn't typically do that for himself either... He just doesn't eat.

By MicheleB on Dec 6, 2014

Did she eat the breadsticks? I didn't know anything about the sauce. My son has eaten the pizza and been fine but we stay away from the breadsticks because of what I found on line. Look up Pizza Hut allergies & there is a list of allergens & their menu.

By smithdcrk on Dec 23, 2014

I, too, have a PA teen who travels with her team to meets that may be hours away. As recommended by this site, the Allergy Eats app can be invaluable when eating on the road. She does eats at McD's & Wendy's and avoids the desserts and salads - just in case. We had a near miss at Subway this summer and they are forever on the "banned" list. But Taco Bell, Schlotzky's and Chipotle's are okay. If the coach is willing to accomodate, I will do the research needed.

Most restaurants have websites with allergen lists, if they do not, we don't eat there unless we know the kitchen standards.

The overnights are the scariest. At one extreme, we once sent her with a mammoth wheeled cooler with every meal and snack needed for the three day retreat! They had a refrigerator and microwave, and we used lidded containers - lids stayed on! The best ever was Wright State University who has a separate kitchen for special diets and designated prep spaces. Her meals were identical if not better than the regular line and she even got a safe eclair!

The most common cross contact areas are baked goods, desserts and fry baths. Chocolate is often processed in multi-ingredient facilities. So even though the kitchen that made the cookie may be peanut free, you must ask about every ingredient. Papa Johns and Dominos are really good about letting you know that on their websites.

A good coach will support your daughter and the team attitude will reflect their coach - coaches sit at the top of the teen hierachy :-) My daughter's team has shifted restaurants to eat at places that are safe for her (cici's and dominos instead of pizza hut). If they stop at an area with multiple eateries, someone ALWAYS keeps her company if she can't eat at a favorite like Chick Fil A. As a last resort, we use google and yelp to see what is "on the way," if the options are ambiguous or poor, she carries the cooler.