Living in fear of your child's food allergy

This eight-year-old carries several EpiPens, two different inhalers and methylprednisolone steroids with her in case she accidentally consumes peanuts, which she is severely allergic to, and goes into anaphylactic shock. — TNS filepic

Between six and eight percent of children suffer a food allergy, with eggs, milk and peanuts being the most common causes.

They can cause vomiting, cramps, hives, swelling, eczema, breathing problems, and in severe cases, anaphylactic shock, which can lead to hospitalisation or death.

A new study, published on March 11 (2021) in the Journal of Pediatric Psychology, finds that more than 80% of parents face “significant worry” about their child’s food allergy.

Forty-two percent met the clinical cut-off for post-traumatic stress symptoms (PTSS) and 39% reported moderate to extremely severe anxiety.

Parents whose children have had to have an adrenaline auto-injector (e.g. an Epipen) administered were seven times more likely to experience PTSS.

Dr Judith Young, from the University of East Anglia’s (UEA) Norwich Medical School and Addenbrooke’s Hospital in the United Kingdom, noticed in her work as an honorary consultant clinical psychologist that parents were describing psychological distress related to their child’s allergy, but that there was little research into this.

Dr Kate Roberts carried out the study as part of her doctoral thesis at UEA, in collaboration with Dr Young, Dr Alex Brightwell from the Norfolk and Norwich University Hospitals NHS Foundation Trust, and Prof Richard Meiser-Stedman, from the Norwich Medical School.

Dr Roberts said: “Caring for a child with a food allergy can be really challenging, not least because they can be exposed to the foods they are allergic to, even with very careful management.

“We wanted to see how the parents of children with food allergies were affected by anxiety, worry and PTSS.

“And we also evaluated whether the level of anxiety and stress experienced was linked to factors such as the severity of the child’s allergy.”

A total of 105 parents of children with medically-diagnosed food allergies completed online questionnaires about their experiences.

Around half of the children had been rushed to hospital at least once because of an allergic reaction.

As well as considering the level of the child’s allergy, the team also looked at the parents’ intolerance of uncertainty, i.e. how they manage unforeseen events, like the fact that they cannot completely control their child’s exposure to food they’re allergic to.

They also assessed the parents’ “self efficacy”, i.e. their confidence in allergy management.

Dr Roberts, who now works at Cambridgeshire Community Services NHS Trust and the Queen Elizabeth Hospital King’s Lynn, said: “We found that a large proportion of the parents – 81% – reported clinically significant worry and 42% reported significant trauma symptoms related to their child’s food allergy.

“Parents who reported their child to have had an adrenaline auto-injector administered, were around seven times more likely to report clinically significant PTSS.

“Greater intolerance of uncertainty and lower food allergy self-efficacy were associated with poorer psychological outcomes.

“But we found mixed results for the relationship between allergy severity and parent mental health, with PTSS observed in parents of children with both life-threatening and milder allergies.

“This really highlights the need for greater awareness about the mental health problems that parents of children with food allergies may be experiencing.

“Knowing which factors could predict different psychological outcomes is important because it could help identify those parents who may be struggling with their mental health and help them overcome some of the problems they may be experiencing.”