In discussion with Dr. Melissa Lieberman and Kellie Welch
By Anne King
I recently visited with Dr. Melissa Lieberman, a psychologist at the Eating Disorders Program at Toronto’s SickKids, and Kellie Welch, a clinical dietitian. We discussed the challenges facing parents and the issues that can arise as children grow up and attain independence.
Q If allergens are a problem, how can parents empower very young children so they can be safe but not afraid?
ML: Young children will feel less anxious if they know that the adults in their lives can manage their allergies and keep them safe. Parents should speak about allergies in a calm way, using developmentally appropriate language to reassure their child that, yes, they have an allergy and it can be dangerous, but if they are prepared (e.g., by carrying their auto-injector) then they will be okay.
Q How do you respond to allergy anxiety?
ML: Anxious kids with food allergies tend to narrow their food choices to the extreme, leading to weight loss and other issues. Avoidant/restrictive food intake disorder (ARFID), a newly introduced eating disorder, requires cognitive behaviour therapy for the parents and the child. Support groups are a great resource, too.
Q After a reaction, how can families get over the experience?
ML: Parents should model positive coping, be empathetic listeners, and provide reliable and unconditional support. Sometimes, though, parents feel anxiety, guilt and self-blame. Remember that mistakes can happen. It can be helpful to share stories with other parents who have children with similar allergies.
Q What if a child is a picky eater as well as having allergies?
KW: Keep mealtimes pleasant and stress-free. Try to avoid pressure, praise, rewards, tricks or punishment. Parents should work closely with their allergist and dietitian. Once you have met with those professionals, don’t be afraid to experiment with new foods.
Q Where can we find more information?
KW: Find a dietitian at dietitians.ca for children, and specialtyfoodshop.ca serves the needs of a variety of patients: those with celiac disease, dysphagia, energy-boosting needs, metabolic disorders, cystic fibrosis and assistive feeding devices.
Anne King is a mom and writer who lives in Toronto. Reprinted with permission from Food Allergy Canada. For more information about managing food allergies, please visit foodallergycanada.ca.