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Q&A: A Doctor's Perspective on Allergies and Halloween Treats

Medical professionals encourage parents to be aware when it comes to the candies children consume this Halloween.

Don’t worry about the Halloween ghouls, but parents beware: Be on alert for allergies from treats.

Dr. Kenneth Lien, chief of the Department of Allergy for Kaiser Permanente in Hayward talks with Patch about the dangers of food allergies in connection with Halloween candies.

Q: How can parents be assured candies are free of substances that a child might be allergic to?

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A: It is important to review the ingredients listed before any candies are eaten, especially if the child may have peanut or tree nut allergies. If the ingredients are not listed on the individual items, parents need to look up the ingredients on the product’s website. I recently saw a child with anaphylaxis — a serious allergic reaction — to a brand of toffee. The toffee contained cashews, and not almonds, which many parents may not be aware of.

Q: What are the best ways parents can determine whether a candy has allergens if the label does not list the candy's contents?

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A: Review the product’s website.

What are the most common allergies of children?

A: Milk, egg, wheat, soy, peanut, cashew, fish, shellfish, sesame seed.

Q: What are the most common nut allergies of children?

A: Peanuts and tree nuts (such as cashew, walnut, pistachio, pecan).

Q: What are the most common candies kids eat that unexpectedly have nuts in them?

A: Candies made in bakeries may be at risk for cross-contamination with nuts, so it is best to avoid these unlabeled candies (that is, if the ingredients are not labelled). Most bakeries use nuts in many cookies and brownies. The big manufacturers will have the ingredients on their websites. The Food Allergy & Anaphylaxis Foodallergy.org has an excellent website. They have great reference material, “How to Read a Label for a Peanut-Free Diet.”  It labels which foods to avoid if one has a peanut allergy and mentions how peanuts are sometimes included in chocolates.

What are some signs of an allergic reaction to food?

The symptoms may vary from mild to severe.

Some examples of severe symptoms include shortness of breath, wheezing, dizziness, troubled breathing, obstructive swelling of tongue and/or the lips, vomiting, cramps.

Some mild symptoms could include itchy mouth, a few hives around the face or face, mild itching, mild nausea.

Q: What should a parent do if a child has an allergic reaction?

A: If you suspect a severe, life-threatening reaction, call 911. For milder symptoms, consult your child’s doctor.

Q: How can parents learn what their children are allergic to?

A: Ask for a referral for a board-certified allergist.

Dr. Lien graduated from Yale University in 1993 and completed medical school at the University of Chicago in 1998. He returned to the Bay Area for his internship and residency training in internal medicine at Kaiser Permanente Oakland Medical Center. He then completed fellowship training in Allergy and Immunology at University of Medicine and Dentistry of New Jersey in Newark, NJ, in 2005. After fellowship training in allergy, he rejoined Kaiser as an allergist in 2007.


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