By Melanie Potock, MA, CCC-SLP
Despite being feeding specialists, few SLPs and OTs get training in how to protect children who are at risk for developing food allergies or are currently diagnosed with a food allergy. Here are three tips from the four-hour Masterclass, Food Allergies: Safe Introduction and Management in Feeding Therapy:
- Store allergen-safe toys in a separate, sealed storage cabinet that is clearly labeled just for this purpose. This includes toys that have been washed thoroughly to protect clients from contact with an allergen and would not include items such as Play-Doh™, which contains wheat, or crayons which often contain soy. An optional pile of clean smocks or washable “gowns” stored on the shelf are convenient if there are any concerns about minute traces of allergens being present on the clinician’s scrubs from a previous client.
- Don’t rely on milder hand wipes to clean tables, such as the Wet Ones™ brand. Allergens that may be on a table from a previous client’s session are only removed with thorough cleaning with soap and water or all-purpose cleaning agents that meet state and local food safety regulations and then scrubbing in succession with at least two alcohol wipes if possible. The first alcohol wipe removes the residue, the second picks up any remaining particles to ensure there is no cross-contact with toys, feeding tools or food. However, if the table was not cleaned immediately after the previous client, the residue from the food may require more effort and additional alcohol wipes. Swipe over the surface with pressure for at least 10 seconds with each sequential wipe. Textured surfaces may require scraping and more pressure and time to thoroughly clean the surface.
- Before introducing new solid foods or treating a baby with an increased risk for food allergies, get permission from their caregivers to take a photo (front and back) of baby in their diaper. This provides a baseline record for their medical chart should baby begin to show signs of an allergic reaction in one of the future treatment sessions. Babies don’t typically present with difficulty breathing (although it’s possible) and are more likely to present with hives, redness of the skin or vomiting. Even a subtle change in skin color or texture is notable, but may have been caused by a pre-existing heat rash, irritation from contact with scratchy clothes, etc. It’s helpful to have that photo to refer back to – babies have so many variations in skin tone and can appear “blotchy” simply due to changes in skin temperature. The photo also provides a record of any trace of atopic dermatitis, a leading risk factor for developing food allergies in childhood. To be clear, atopic dermatitis may predispose a child to developing a food allergy, but food allergies do not predispose a child to develop atopic dermatitis. Atopic dermatitis may be triggered by food intolerances or food sensitivities, but not by a food allergen. Up to 20% of children will present with atopic dermatitis and the pre-photo in the child’s chart can be an important safety precaution to monitor skin over time.
About the author: Melanie Potock, MA, CCC-SLP teaches 4-Hour Masterclasses on Allergies, Tube Weaning and ARFID. Course locations are listed on her website at MelaniePotock.com. Follow her on Instagram for daily tips!
Resources:
Binaifer Bedford, Girvin Liggans, Laurie Williams, Lauren Jackson, Allergen Removal and Transfer with Wiping and Cleaning Methods Used in Retail and Food Service Establishments, Journal of Food Protection, Volume 83, Issue 7,2020.
Papapostolou N, Xepapadaki P, Gregoriou S, Makris M. Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn. J Clin Med. 2022 Jul 21;11(14):4232. doi: 10.3390/jcm11144232. PMID: 35887996; PMCID: PMC9317394.
Please check out Melanie’s website for course dates at MelaniePotock.com. For my local friends, she is coming to Raleigh on April 6 . The Super Early Bird pricing ends January 31st (only $100 per class!)
Food Allergies: Safe Introduction &Management in Feeding Therapy- AM
Appetite: How to Foster Hunger & Wean Kids from Tube Feedings-PM
Date: Saturday April 6, 2024 Location: Wakemed Andrews Center
William F Andrews Conference Center 3024 New Bern Ave Raleigh, NC 27619
Thank you to both Krisi and Melanie for this! Great information to have when you have different children coming into your space!
Thank you both for all that you do!
Hi!
I so appreciate the info shared, the care and dedication shines through in all of your articles. My 6 yo daughter has Trisomy 21 and Dysphagia and her tell tale sign is redness of the cheeks or forehead and when it’s more extreme her tongue will begin itching. She will constantly wipe her tongue with her hand and even with her foot! Recently she was showing signs of irritation & I didn’t know what was happening because there were no foods at the time, well I had a slight case of atopic dermatitis on my hand and while cutting some baked butternut squash to serve her finger foods my hand begin slightly burning. I realized it was the squash that may be the problem, I usually would put it in a blend for her so I’m not really handling it. It may have been rancid , although I had cooked it fresh that day. So I immediately removed it and by the next day she was better ( I also flush her with a lite lemon water and tongue brushing). I am learning Applied Kinesiology to help us navigate the food allergens, I realize something that may have been OK last week, she may be bothered by weeks later. Maybe I feed her the item Too Much because it’s something she will finally show favor of and that may over due it. So much to understand on this Journey. Again, Your Service is appreciated
Micheline Latise
Chicago