Argelia Salgado UWP1 Theresa Walsh 11/27/13 A New “Normal” for Children with Food Allergies Introduction Nicole’s first allergic reaction to peanuts happened when she was just a year old. A small taste of peanut butter caused her then tiny body to break out in hives and for her whole life to change. Eating became a task filled with fear and stress for her and her family. At the age of twelve she experienced her first anaphylaxis reaction and unable to breathe she was rushed to the emergency room. After coming so close to death she realized just how dangerous her allergy was. A few years later upon entering her biology class her first day of freshmen year in high school, she was once again faced with threat. Students were making peanut butter sandwiches as part of an experiment and when she had to tell her teacher in front of the whole class about her life-threatening allergy she felt humiliated. She was also completely embarrassed by the first impression she had just given her new peers. (FARE) Today three in ten families will have a child diagnosed with a chronic condition. (R1) With one out of every ten children having a chronic condition so severe that they require special supervision and care. (R1) Food allergies are just one of many chronic conditions. Six to eight percent of all children suffer from food allergies. (R2) And 150 people die each year in the U.S after experiencing severe reactions to foods. (R2) Understanding the psychological effects of chronic conditions, such as food allergies, in children in the U.S is one of the most important steps in helping them attain a better quality of life. The focus of this paper will be to describe the psychological effects of chronic conditions in young children. In order to narrow the data, my discussion will be limited to the psychological effects of food allergies in children. I will describe how anxiety, uncertainty, defining a new “normal,” and bullying contribute as negative factors in the psychological well-being of a child living with food allergies. Through my description of these factors, I will demonstrate the importance of emotional support for a child living with food allergies. What are chronic conditions? A chronic condition is defined as one that lasts longer than three months. (R1) The diagnosis of a chronic condition is the initial and most difficult time in the child’s new life. After diagnosis children are faced with new limitations, over protecting parents, and the need to re-establish their lives. The child’s life must now be lived on a day-to-day basis, as a tomorrow is not always guaranteed. Food Allergies as a Chronic Condition Children living with food allergies as a chronic condition have one of the best understandings of what it means to live on a day-to-day basis. Food allergies consist of the failure of the immune system to develop tolerance or maintain tolerance to the proteins of certain foods. (WebMD)Food intolerances are often confused with food allergies but unlike actual allergies they are not all involved with the immune system. (WebMD) An individual can be may be unable to digest certain foods but it does not mean he or she is allergic to the food. Fish, peanut, egg, soy, wheat, shellfish, tree nut, and cow’s milk have been identified as the eight most common food allergens in individuals.(R2) The most important threat to individuals with food allergies is the risk of experiencing an anaphylaxis reaction. Anaphylaxis is a sudden, dangerous, and potentially fatal reaction that involves the skin as well as several major systems including the gastrointestinal system, respiratory system, and the cardiovascular system. It results in difficulty breathing, a drop in blood pressure, and when proper care is not given immediately it can result in death. (R5) Feelings of Anger and of Loss When faced with the possibility of death and various other restrictions it should come as no surprise that children experience an initial feeling of anger and loss with their diagnosis. Food allergies as any other chronic condition changes the definition of “childhood” for a child. Due to the danger of exposure to the allergen and the extreme care they require, they are often restricted from attending parties, sleep overs, going on vacations, and sometimes even simply having dinner at restaurants. Young children are aware of the restrictions their parents place on them and realize for their safety but seeing other children is a constant reminder of what they have lost. Feelings of loss and grief come as a result of losing control over their emotions, relationships with friends, their bodies, the allergy, but most importantly over their life. Even though children are young they are not blind to the world, if anything a child with an allergy is more aware of the world around them because their life depends on it. A Life Filled with Uncertainty For many children living with food allergies it often feels as if no matter how vigilant they are of the world around them it is never enough. Allergic reactions can occur at any time and in any place, even when the child and their family have ensured that the environment is “safe.” Uncertainty always remains present in the mind of a child with a food allergy who can never be guaranteed with full certainty that what he puts it in his mouth, the things and people he interacts with, or the places he visits wont result in a deadly reaction. A small error on a product’s food label, cross-contamination, or even shaking someone’s hand that came in contact with the allergen is enough to elicit a reaction. (R4)It is to no surprise that, “Living with uncertainty affects a child’s sense of control, beliefs about risk, level of vigilance, and confidence in safety.”(R5 pg 3) It is frustrating and upsetting for a child when they adhere to strict restrictions, always carry with them a sense of fear, and still experience a reaction. It becomes a roller coaster of emotions for the child when their only sources of protection are restrictions from the world around them and a painful epipen injection in case a reaction could not be prevented. Experience of Anxiety Relying on so little for safety and being afraid of so much can lead children to experience severe levels of anxiety. An important influencing factor in the child’s anxiety is the parent’s reaction and attitude towards the allergy. Parents who remain calm and maintain a positive outlook have been found to help children experience lower levels of anxiety and to take a proactive approach in protecting their health. However, parents who demonstrated high levels of anxiety through over protective behaviors, raised children with higher levels of anxiety and placed them at risk for developing mental health problems. (R4) Children with chronic conditions have been found twice as much at risk for developing mental health problems than healthy children. (R5) Despite the negative consequences that anxiety may have, experts believe that small levels of anxiety can actually be beneficial to the child. (R4) Maintaining small levels of anxiety reminds the child the severity of their allergy and that they must protect themselves as best as they can. Establishing a New “Normal” Adapting to the anxiety, the restrictions, the uncertainty, and the allergy as a whole, requires children and their families to create a new “normal.” Children are no longer able to play, interact with others, or experience life as they go without worrying about a reaction. “If kids are normal, not sick, they like to be treated special. But if kids have a disease, they want to be treated normal. (11-year-old girl”(R-5) Living with a chronic condition such as a food allergy changes the world for a child as Nicole described in her story. Children must now live on a day-to-day basis with no guarantee that there will indeed be a tomorrow. Every child develops his own definition of a new “normal” differently. Some children define a new normal in terms of safety and acceptance and understanding from their loved ones. For other children, a new “normal” consists of being able to freely interact within the real world and to be seen as normal. The last group consists of children trying to find a balance between the previous two. (R1) No matter what the new “normal” becomes it is a crucial step in subsiding some of the negative psychological effects of food allergies. During this transition the child learns to find an appropriate balance between experiencing a close to a “normal” childhood as possible and taking the necessary the precautions to avoid a reaction. Since developing a new “normal” is a process that requires the involvement of the whole family, it is also a time when children realize they are cared for and loved by others. Importance of Emotional Support Very often parents, ‘“parents underestimate the negative impact food allergy has on the quality of life of their child. It was found that parents reported significantly less impact of food allergy on the quality of life of their child than the children themselves.”(R5) This demonstrates that parents are not aware of the severe effect food allergies have on the psychological well-being of children. In order for parents and families to be able to provide adequate support to the child, they must first have a good understanding of what the child is feeling. Often parents become so focused on preventing a reaction that they fail to recognize that the emotional well-being of the child is just as important as the physical. Conclusion If a child is mentally and emotionally strong they are better able to endure the negative changes associated with having a food allergy. An increase in understanding of the psychological effects of chronic conditions such as food allergies would result in a better lifestyle for these children. This newly found understanding must be used to provide children the necessary support that addresses the multiple psychological effects of living with a food allergy. Anger, loss, uncertainty, anxiety and the need to develop a new “normal” can be managed by helping the child see that they are not alone and that their allergy does not define every aspect of who they are. Education in regards to food allergies and their psychological effects should not be limited to the family members of the children. At one point or another in our lives we may have to interact or take care of a child with food allergies and thus we must be prepared to help them prevent more than just a allergic reaction. References 1. Food Allergy Research & Education. (n.d.). Food Allergy Research & Education. Retrieved November 27, 2013, from http://www.foodallergy.org/truestories/nicole 2. Food Allergy and Food Intolerance -- Allergic Reactions, Symptoms, Treatments. (2012, March 16). WebMD. 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