I didn’t want him to be the ‘peanut-allergy kid’: What it’s like to have a child with severe food allergies.

But Betsy and Hansen have been doing it for years now, learning along the way. They realized their son Haskell had severe food allergies when he was just 10 months old. Peanuts, pecans, walnuts. He reacted to all of them. Two years later, they had a daughter, Sage, who is also allergic to peanuts.

The kids are now 6 and 4, and the parents have been managing the allergies with a new form of immune therapy called SLIT, or sublingual immunotherapy. The treatment involves placing liquid drops with small doses of a particular allergen under the tongue, holding it for two minutes, then swallowing the drops.

The goal is to attempt to retrain the immune system to be less reactive to an allergen, without also taking on significant risk from the treatment itself.

Researchers still haven’t found a cure for allergies, but some treatment strategies can improve chronic symptoms, safety, and quality of life for those who suffer from them.

Betsy and Hansen don’t have food allergies, but Betsy now uses SLIT to treat seasonal allergies.

Here are seven things Betsy wishes she’d known six years ago when she first became the parent of a child with a severe food allergy.

(Note: Dr. Nikhila Schroeder at Allergenuity Health Associates reviewed this article to ensure medical accuracy.)

(1) Your child won’t have to be socially isolated.

When Haskell went to school, Betsy worried about the social implications of his allergies.

“My big source of anxiety was he’d be bullied or isolated at a nut-free table,” she says. “I didn’t want it to define him. I didn’t want him to be the ‘peanut-allergy kid.'”

She said you’ll occasionally hear stories of middle-schoolers putting a nut in the drink of a student with a food allergies, creating a very serious medical situation out of what they imagined was a harmless prank.

The possibilities still alarm her, but for the most part she’s found the people her son interacts with are kind and empathetic.

To her surprise, five of Haskell’s 22 classmates also have food allergies.

The issue, she said, is so prevalent that many of Haskell’s friends are aware of their classmates’ allergies, and they notify parents about what their friends can and can’t have during playdates.

(2) Reactions to allergens vary depending on what’s going on with your child’s immune system.

Betsy said Haskell’s tolerance levels vary significantly depending on how he is feeling and what type of environment he’s in — and parents need to be aware that these factors play a role in successfully managing allergies.

“If you have pneumonia, you’re much more susceptible to having a severe reaction than if you’re healthy and strong,” Betsy said. “If there’s high pollution in the air, you’re more vulnerable. Your body can only fight so much. Some people say, ‘I have an allergy, but it’s not severe,’ when actually it’s, ‘You haven’t had a severe reaction yet, but that doesn’t mean you can’t.'”

(3) What works for your kid may not work for others.

It took four years for Betsy and Hansen to fully understand the treatment options that were most effective for Haskell.

“For some kids avoiding (the allergen) and carrying an Epipen is a good fit. For others you might want to try one of these emerging treatments.”

(4) You’ll get skilled at navigating meals outside of your home.

When they learned about Haskell’s diagnosis, Betsy and Hansen were wary of eating at restaurants.

They avoided Asian restaurants and ice cream shops, due to high risk of cross-contamination and the prevalence of peanuts in menu items.

However, as Haskell continues to receive SLIT treatment and the family continues to learn more about life with severe food allergies, they’ve gotten more comfortable dining out. Betsy says she uses the Parents of Allergic Kids Facebook group for guidance on places that are particularly allergy-friendly.

Some spots that she’s found to be accommodating include Burtons and P.F. Chang’s. Jeni’s Splendid Ice Creams is another family favorite, because they use sterilized scoops and brand-new bins for serving those with allergies.

Anxiety around mealtime can become a serious issue, so Betsy’s family is trying to walk the line between ensuring their son takes his health situation seriously and not making him afraid to enjoy food.

“There’s always that continuum of social and safety and you don’t want them to be afraid to eat. We’re trying to empower him with information and tools,” she said.

(5) Halloween and birthday parties can prove challenging.

A few years ago, at a birthday party, Haskell burst into tears when he had to sit to the side and watch his friends eat cake. Betsy always comes prepared with an alternative treat option, but this time he was adamant: he wanted that cake.

Now, though, Betsy says her son is old enough where they can have a back-and-forth about the situation.

“I can say, ‘It’s not fair, but it’s your responsibility to keep yourself safe. I promise you we’ll always come up with a substitute. But you’re responsible to not do something dangerous just because it’s tempting.'”

Halloween can be another difficult night. Betsy suggests letting kids with allergies trick-or-treat with their friends, then taking the goodies home later to sort and see what they’re able to eat.

The family has also come up with a clever concept called “The Switch Witch.” Haskell and Sage put the candy they can’t eat into a basket, which they place outside their door. The “Switch Witch” comes and replaces the candy with treats that are safe for them, as well as a small toy.

They also set out teal pumpkins to raise awareness for food allergies, and pass out only non-food items at their home, like glow sticks and slap bracelets.

(6) Make sure you have a clear diagnosis from a medical professional

Today, nearly everyone knows someone who avoids gluten, dairy, or other foods, and some may define their avoidance as an allergy, when in reality it’s an intolerance issue.

While any allergy or intolerance can be debilitating, Betsy urges parents to be certain they have total clarity on the health situation they’re facing in order to tackle it most effectively.

She encourages families to get a proper allergy diagnosis from a board-certified allergist.

(7) The knowledge about preventing allergies has shifted significantly in a short time span

Betsy explains that the knowledge base about food allergies and how to better attempt to prevent them has grown tremendously over the past decade, even starting to change in the time between the births of Haskell and Sage.

Some important study results over the past several years have prompted a notable shift in medical guidelines regarding possible food allergy prevention strategies in Europe and the US.

The change involved moving further away from the previous recommendation of avoiding the introduction of commonly allergenic foods during a high-risk child’s early months or years, and instead shifting towards the opposite philosophy: early introduction of peanut or other commonly allergenic foods, with the possible need to continue these exposures consistently for months to years during a child’s early stages of development.

The science and research in this area is not complete by any means, and still continues to evolve quickly, which is also important for families to understand.

Unfortunately, there is no perfect strategy to prevent food allergies. But the newer research has helped improve the knowledge about approaches for families to consider during their child’s early months and years.