Tania Zulkoskey
Raising twins, one with food allergies.
Tania Zulkoskey learned of her seven-year-old son’s food allergies just days after Halloween two years ago. His twin sister does not appear to have food allergies. Here is Tania’s story of coming to terms with food allergies, and managing them with twins.
Families have all kinds of strategies to deal with the excessive treats that come from trick-or-treating. Last year, my partner and I just decided to let our twins eat a handful at a time, rather than just one piece at meal times. Just get through it, I thought.
Then suddenly, the day after Halloween, my son complained of a burning mouth just as we started to eat dinner. Thinking it was caused by uncooked garlic in the meal, we gave him milk to sooth his mouth. The burn continued so then we gave him a crushed almond ice cream bar that he’d received as a Halloween treat. His mouth began to look a little red and soon enough we started to think he might be having an allergic reaction.
By the time we arrived at the emergency department, our son had thrown up and was a splotchy red colour. We were brought into the treatment room immediately for assessment. What did he eat? He had one bite of the fish dinner, but earlier he had handfuls of chocolate bars —some with peanut and nuts— which was nothing new, except maybe the quantity, and some candy and chips. Our son was administered epinephrine. It took several of us to hold him down. As a trauma therapist, it gutted me immediately.
I was also acutely aware of what his twin sister was witnessing. Throughout the assessment she was navigating around his stretcher, trying to be close to him, to us, to also be included in the attention. After, she climbed onto his bed and snuggled in close to him. And there, in front of us, was a pure example of the bond that they have and of the twin dynamics at play. She wanted to comfort him, to be beside him, and at the same time not be left out. Of course, I said that he would be okay, and that she could still stay with him on the bed. Truth be told, I wanted to climb right in beside him too.
(This isn’t the first time we witnessed such strong twin reactions. When one of them has accidentally hurt the other, and is crying, the other one will often burst into tears too. On more than one occasion I have juggled two crying kids on my lap, one with an injured finger and the other an injured heart. It is in these moments that “I am sorry” and “I forgive you” are enacted so loudly they do not even need to be spoken.)
We made the decision that I would take our daughter home while our son remained in the observation unit for another 4-5 hours with my partner, his other mom. No sooner had I got my daughter home sleeping, I was called back to the hospital to help with an adverse reaction to the medicine. I had a neighbour come over, grabbed his blanket and made a beeline back to the hospital. In my mom brain, I knew exactly what I would do when I got there. I looked at my partner’s pleading and anxious eyes. She had been supporting him throughout, even while I was at home. I crawled into bed with my son, scooped him up and held him until he fell asleep.
When we got home, we found ourselves caring and tending to one twin while the other sought reassurance and comfort as much —if not more at times— than the other one.
Months later it was confirmed our son has a fish allergy. His twin sister does not.
There is a lot of stress on the importance of raising multiples as separate individuals. While in theory, it is completely possible in the future that we would allow his sister to order fish at a restaurant, at this age we would likely feel the risk of cross-contamination too high and request that she doesn’t. Yes, her choices are limited because he has the allergy, but as a family we can make decisions that are in the best interest of everyone.
When we ordered him a medical identification bracelet, she got a charm bracelet. The same — but different. As a therapist, I have heard stories from adults that witnessed their sibling being the centre of attention for various reasons, and how it can affect their relationships. If we can be mindful of the impact of each event on both twins, we are in a better position to defuse the dynamics that can develop. It removes the belief that [when something happens to one child], the family revolves around them. Instead, it allows space for everyone, competing feelings and all.
Food Allergy Myths and Facts: How young is too young?
Information for this article was provided by Dr. Zainab Abdurrahman, MD, MMath, FRCPC, an allergist at Kindercare Pediatrics Clinic in Toronto and at McMaster Childrens’ Hospital in Hamilton. Thank you, Dr. Abdurrahman!
Myth 1
“Our 15-month-old daughter had an allergic reaction to a food last month, but our pediatrician said we don’t need to do tests or see an allergist because she is still ‘too young’ for testing”.
Fact: Allergy testing can happen at any age. If a child has an allergic reaction after the child has eaten a food, a child can have an allergy assessment. There is no limit for the age for allergy consultation and possible skin testing. If a child has a severe reaction or anaphylaxis, sometimes testing can be falsely negative within 6 weeks. Hence, if there was a severe reaction, a delay for 6 weeks prior to skin testing may be warranted. (This is different from some seasonal environmental allergy skin testing that is not warranted for children less than 2 years of age.)
Myth 2
“Our son is only 2 years old, so if he has a severe reaction we will just drive him to the hospital because he is too young for epinephrine.”
Fact: A child of any age can safely receive life-saving epinephrine. A recent statement from the Canadian Society of Allergy and Clinical Immunology (CSACI) states: “The potential consequences of not administering epinephrine to a child with anaphylaxis outweigh the potential consequences of administering higher than recommended doses of epinephrine. Given the lack of suitable alternatives, the CSACI suggests that an epinephrine autoinjector of 0.15 mg be prescribed for children weighing less than 15 kg (including less than 10 kg).” To read the whole statement please go to this site.
Check out foodallergycanada.ca for more myths and facts on our blog.