On the labels of pretty much everything we eat, we see allergen information. Peanuts, tree nuts, wheat, soy — the list goes on. It’s far easier for parents to know what they’re giving their children, who have food allergies, when they’re giving their children these packaged foods. Going out for dinner, however, becomes a huge hassle. While it’s obvious that Thai peanut noodles have peanuts, it’s much more difficult to determine whether something was made with milk or eggs, and so many things are. Because of this, parents of kids with these allergies tend to be more anxious, a new study finds.

“It’s assumed peanut and tree allergies are the most severe, and therefore it may be presumed they would cause the most strain for caregivers,” said allergist Dr. Laura Howe, lead author of the study and a member of the American College of Allergy, Asthma & Immunology (ACAAI), in a press release. “But because eggs and milk are everywhere, and used to prepare so many dishes, caregivers with children allergic to those two ingredients feel more worried and anxious.”  

Indeed all of these allergies can cause some of the most severe reactions, including anaphylaxis, a rapid constriction of the airway. Peanut allergies may have more of a reputation simply because they’re more common than milk or egg allergies, which occur in an estimated 300,000 and 600,000 American kids, respectively, according to ACAAI, compared to about three million people with peanut and tree nut allergies. On top of that, egg and milk allergies tend to fade after age 16 in 70 to 80 percent of kids, while peanut allergies are lifelong.

All parents of kids with allergies need to be vigilant about the foods their children are eating, but for egg and milk allergies, the reaction-causing molecules can be found in the most obscure of things. For example, some canned tuna fish and other non-dairy products have casein, a milk protein. Whey, a popular component of energy and body-building drinks, is also a milk protein. Eggs can be an even worse offender, appearing in everything from cake to meatballs to salad dressing. With these allergens appearing in so many foods, giving a child something to eat becomes a question of “Will I need the epi-pen right now or not?”

The ACAAI researchers asked 305 caregivers of children allergic to tree nuts, peanuts, milk and eggs about their children’s most severe allergic reaction and their overall quality of life. They found that 64 percent of caregivers could accurately perceive the severity of the child’s reaction, and that these people were more likely to understand the offending foods, thus leading to less anxiety. The rest either overestimated or underestimated the severity of the child’s reaction. Many parents were also unsure of how exactly to respond if their child had a reaction, and felt that others who came in contact with their children didn’t understand the severity of allergies to these foods.

“It is important for those who care for food-allergic children to work with an allergist to determine exactly what foods their child is allergic to, and how to respond in an emergency situation,” said Dr. Michael Foggs, president of the ACAAI, in the release. “Parents need to have a clear plan of action in case their child eats a food they shouldn’t. Children with a history of severe allergic reactions, and their caregivers, need to know how to administer epinephrine. Having plans in place can ease a parent’s worries.”

Kids who are prescribed epinephrine auto-injectors, and whose parents carry at least one with them all the time, are most likely to survive a severe allergic reaction. They allow the person having an allergic reaction to quickly inject themselves with life-saving epinephrine. However, it’s only a temporary solution and medical help should be sought.

Source: Howe L, et al. Annals of Allergy, Asthma & Immunology. 2014.