Ask the allergist – December 2022

Ask the allergist is a regular feature in our newsletters where Canadian allergists answer your questions!

Dr. Julia Upton is on staff at the Hospital for Sick Children in the Immunology and Allergy Department; and an Associate Professor in the Department of Paediatrics at the University of Toronto. She is the past Section Chair of the Anaphylaxis and Food Allergy Section of the Canadian Society of Allergy and Clinical Immunology. Dr. Upton is also a member of our Healthcare Advisory Board.

Please note: Dr. Upton is answering as an individual allergist and her answers do not constitute an official position of her affiliated organizations. Her responses are for informational purposes only and do not constitute specific medical advice, recommendations, diagnosis, or treatment. Please talk to your doctor about any concerns or questions you may have regarding your own health or the health of your child.

This month she answers a question about peanut allergy and potential risk with a dog that’s eaten peanut butter treats. 

My son has a peanut allergy. How careful does he need to be around our neighbor’s dog that loves peanut butter treats? 

Thanks for this question, it brings up a number of questions that can be discussed with your allergist. 

Firstly, a discussion of the severity of the allergy. While we are not as good at predicting the possibility of reactions as we may like, your allergist will advise more caution if you’ve experienced severe allergic reactions/anaphylaxis in the past. 

Secondly, ensuring these management areas are attended to: always carrying an epinephrine auto-injector, knowing how and when to use it, and ensuring any asthma is well treated and controlled.  

Thirdly, ingestion is typically required for food allergic reactions. Therefore, there is a risk if the dog just ate a peanut butter treat and the dog is allowed to lick faces. The risk would be lower if the dog’s ingestion is more remote, if the dog is not allowed to lick your son’s face, and if his hands are washed afterwards. 

And fourthly, a discussion about risk tolerance. There are very few experiences or activities which have no risk to anyone, food allergic or not.  

Overall, my advice would be to work with your doctor and child to understand which experiences are important and making those work by minimizing risks where you can through awareness, preparation, and overall best health, and being prepared for the very small chance of an allergic reaction in any situation. 

Do you have a food allergy-related question you’d like to ask an allergist in the months to come? If so, send it along to us at info@foodallergycanada.ca. Please note: The allergists in this series answer questions on general topics, please talk to your doctor if you have questions about your own health or the health of your child.