4 tenets of living with a toddler's dairy allergy

A few people at work with kids recently diagnosed with a milk allergy asked me how we deal with it, so I figured it would make a good blog post. 

BabyT, right around the time we discovered her dairy allergy

The simple summary, to borrow a phrase from Mad-Eye Moody in the Harry Potter series, is "constant vigilance".  There is food everywhere and we need to be extremely careful about reading labels and asking questions.  Here's the basic outline of what we do regularly:

1.  Pay attention.  Just yesterday we went to a new Spanish class, and the teacher tried to hand BabyT some cheese-flavored goldfish crackers, which we intercepted.   This has happened more than once at the playground, too - well-meaning parents offer cookies or goldfish crackers (what is it with the fish?) without asking first.  Good thing I was paying attention and not far away.  At 2, T is old enough to *say* she's allergic to dairy, but doesn't realize that means she needs to check the things she's given to eat.  This means I can't zone out and check my email, or get lost in conversation with other parents.  Food is everywhere.  On the bright side, most organized classes are good about asking and tracking food allergies, so if there is a regular snack, there's nearly always something for her to eat.

2.  Evangelize and speak up.  Food allergies are a lot more common now than when I was a kid but folks not living with one don't think about it.  I'm an introvert and it sucks for me to always have to speak up, but I think of it as developing my mama-bear skills.  At restaurants, we ask about *every dish* even when it seems like things shouldn't have dairy in them.  For example, sweet potato fries are sometimes covered in a batter containing milk.  An aioli sauce, which seems like it should be just mayo, actually had yogurt in it.  Even the pretzel-flavor goldfish crackers have dairy in them.  I also have to ask how things are prepared - do they add butter to the grill?  It takes us twice as long to order food, but I'd rather have that than hives and puking afterwards. 

This is especially true for daycare, where we're leaving our kid in the care of others all day.  Ours is a large corporate daycare so they have specific procedures and paperwork for allergies - they have Benadryl and epi-Pens on hand, detailed instructions from T's allergist, and a list of food allergies in the kitchen.  They have a lot of kids with different allergies, and they do a great job of feeding everyone.  But even with these precautions, we still need to be proactive.  Everytime T gets a new teacher, we make it a point of telling them directly about her dairy allergy.  We try to do the same thing with the "floater" teachers who come through the rooms to relieve the main teachers.  The daycare has lists in each classroom, with photos, but we want to make sure they understand what her allergy is and what it looks like when she has a reaction.

We've had two minor slip-ups at daycare - once where T grabbed food from another kid, and once where we think she was served cheese, but it was at the end of the day when her regular teachers had gone home and the "floaters" claimed they didn't know about her allergies, and weren't sure what she had eaten (yikes!).  In both cases we had a discussion with her teachers and the daycare director, and put plans in place so that T would eat at a table next to a teacher (to prevent grabbing) and reconfirmed that allergy lists and photos were in each classroom and re-reviewed with all the teachers.  I hated being confrontational about it, but if I was going to continue to leave my child there, I needed to be sure they had a plan in place for how to prevent these things in the future.  (And they did, so all is well.)

The same is true for going to others' houses for playdates.  I always ask to read the packaging for any snacks, and if they don't have it, I just don't feed her.  I'd rather be safe than sorry.  Which brings me to my next point.

3.  Always carry "safe" snacks.  I don't need to feed my child all day long.  We have a "no food in the car" rule.  I'm more a fan of 3 meals and 1-2 snacks and T is growing well, so I don't have to stress about "getting food into her".  But if we're at someone's house or at a class and a snack is served, I make sure I have alternate options for T in case there isn't a non-dairy choice.  Our diaper bag is always stocked with Trader Joe's fruit leather, Larabars, and granola bars.

Something else I plan to do once T starts getting invited to birthday parties, is bringing our own dairy-free cupcakes so she doesn't feel deprived.  Her new preschool alerts parents to the next months' birthdays so we can bring in alternate treats in case the one being served is not okay.

4.  Educate yourself about ingredients.  Especially for dairy, milk-based ingredients come with a variety of names.  Luckily, many American packaged foods have an "allergy statement" under the ingredient list that says something like "Contains: Milk, Soy, Wheat, etc..."  This makes it really easy for me to *discard* a food if it states milk, but isn't quite good enough for me to automatically include it if it doesn't mention milk.  Here's a list of ingredients I look for to disqualify an item:

milk, cream, butter, cheese, yogurt, lactose, lactate, casein, lactase, milk protein, nonfat dry milk, whey, dairy solids

Since T's reaction was not life-threatening (at least not the few times she's been exposed to milk), we were ok feeding her things that stated "Made in a facility with" or "Made on shared equipment" that also processes dairy.  Factories are required to follow Good Manufacturing Practices (GMP) that state they need to wash all equipment between runs.  And to be honest, we don't buy a ton of processed food anyway.  But for a life-threatening reaction, those would be ones to avoid as well, just to be safe.

And it's not just food that I need to look out for - it's also health and beauty items like soap, shampoo, and lotions.  A lot of them incorporate milk proteins, which irritate BabyT's sensitive skin.  I've bought a few baby lotions that I had to keep for myself because they contained milk.

It gets easier over time.  As a family, we eventually gave up dairy at home, so nearly everything we buy and cook is ok for BabyT to eat (but not quite, so I always check before feeding her something.)  Asking questions at restaurants got easier, and we found a few that we can rely on to have good choices for her and us.

As I mentioned earlier, we received the good news that T is now cleared to have milk in baked goods, so some storebought breads and cookies might be fine if I can confirm they were baked at least at 350 degrees for 30 min or more.  But we are still vigilant about dairy ingredients, especially when I'm not sure how the food was prepared.  In this case, it's actually easier for me to bake stuff like this at home.

Are you living with a kid's food allergies and have other tips to share?