Family Feeding

Family-style Meals with Food Allergies: Part 2

To the many families living with food allergies, this post is for you.  I want to discuss different ways to address serving dinner in a family-style way when you have food allergies to deal with.  I understand that there are so many different situations out there and many ways that people deal with them.  What works for one family will not for another.  This is why I want to give several options.

First a talk on family-style meals.  What does it mean and why do I recommend it?  A family-style meal is when you serve food on the table.  Each person selects what they want and how much they want on their own.  Everyone serves themselves.  This is an important activity.  It teaches children table skills and manners.  It also presents food in a non-pressure environment.  Nobody has to take something they do not want to.  I know all you vegetable pushers are freaking out here, but listen.  Over time, this method is much more successful in developing healthy, diverse eaters, than forcing children to eat specific foods.  Do not be confused though.  I am not suggesting you cater to your children and serve them whatever they want- no, no, no!  You decide on the meal and serve it.  They decide how much they want to eat and what they want from what you offered.  This may mean they eat only pasta one night and hamburger the next.  It’s ok.  This is how they learn to try foods and listen to their hunger signals.  As long as you are providing healthy meals in a non-pressure setting, you have done your job.

As far as food allergy families go, family style eating can be more tricky.  I will first touch on the safest route. This means you avoid all allergens of anyone in your house.  If there are peanuts, fish and egg allergies, there are none of those items in your home.  Nobody consumes these.  Your home is a “safe” place for everyone.  This is especially ideal when young children are in the home and you are concerned about accidental exposure. In this instance, serving a family style meal should be straightforward.  Since all the foods are safe for everyone, any person can choose what they like from what is offered.

Another option is to allow foods that some family members are allergic to on your table.  This will likely result in having 5-7 food options at every meal to accommodate everyone.  This may not be appropriate if you have severe allergies and/or small children who can accidentally take an allergenic food.  I would recommend this for families who have a variety of food allergies that become overly restrictive when you remove all the foods that everyone is allergic to and also for those who are comfortable keeping food allergen foods in their home.  This is not for everyone.  This is also an opportunity for older children to interact with their allergic foods as they will have to do this outside of the home.  It is good for them to learn to identify their allergens and avoid them.

The third option is a bit of a hybrid between the two listed above.  This would mean permanently excluding certain foods (severe allergens) but allowing others.  I will give an example from my own house.  Our allergens include peanuts, tree-nuts, shrimp, pork, turkey, eggs, chicken as well as a dairy intolerance.  We never buy peanuts or shrimp.  While the kids have never had an anaphylactic reaction to either, they did react enough that we think they have no place in our home.  At dinner, we do eat chicken about 6 times a month.  The child who is allergic to chicken either eats multiple side dishes or a protein he can tolerate.   He knows he can’t eat it and has no desire to even touch it.  This works for us but it is a family by family decision.  I am very comfortable with my kids’ knowledge of their allergies and how to treat others with allergies different than their own (hand and face washing after eating, etc.)

I want to stress that all of these options are ok.  Every family has to decide what works for them.  Read this information from FARE regarding this here.  If having allergens in the house makes you a nervous wreck, do not do it!  If there have been severe reactions in the past, I also do not recommend keeping allergens in the home.  Unfortunately, past reactions do not necessarily predict future reactions.  Mild reactions in the past may still become anaphylactic in the future.  Again, if you do not feel comfortable, do not do it, it’s not worth it.  Always consult with your allergist and hopefully a registered dietitian nutritionist, who can help you navigate your specific food allergy situation.

Rachael Costello, RDN, LDN, is a registered dietitian. The materials and content contained on this site ( are for general educational purposes only and are not intended to be a substitute for professional medical advice, diagnosis or treatment. Persons with serious medical conditions should consult a physician before beginning or modifying any diet, exercise or lifestyle program. The use of any information provided on this site is solely at your own risk.

Food Allergy Basics

If you or a loved one does not live with food allergies, you may not be aware of how involved  or serious they truly are.  Before our oldest son was diagnosed, I had no idea how much this would change our life, and I am a registered dietitian!  There is no cure for food allergies, total avoidance of the offending food is the only treatment.

There are a wide variety of reactions possible.  Hives, itching, swelling of the lips, throat, or tongue, dizziness, vomiting, diarrhea, and difficulty breathing are symptoms of a food allergy reaction. This is not an exhaustive list. There is always a chance of anaphylaxis, whether previous reactions have been mild or severe. It is very unpredictable and the treatment for anaphylaxis is epinephrine.  Benadryl will not stop an anaphylactic reaction.

Living with food allergies requires constant vigilance- always reading labels, always asking questions, always carrying epinephrine and always educating others.

There are eight foods which cause the vast majority of allergies.  These are egg, milk, peanuts, tree nuts, soy, wheat, fish and shellfish. In 2006, the Food Allergen Labeling Consumer Protection Act (FALCPA) went into effect.  This law made food labels much clearer to read in regards to these top 8 allergens.  The common name of the allergen is required to be listed on the label now.  This has made it easier to determine what foods are safe.  However this is not fool-proof.  Foods may be processed in a facility that processes an allergen, and this is NOT required to be listed.  More companies are voluntarily listing these warnings but this is not a law.  Another concern is that people are allergic to foods that are not in the top 8 allergens.  What about them?  It becomes more difficult to deal with a food outside of the top 8.

Unfortunately we often cannot rely on food labels due to the above reasons.  This means actually calling the company and asking specific questions to determine if the food is safe.  Imagine having to do this on a regular basis, just to stay safe.  This is a reality for many families dealing with food allergies.  And just because you call a company once and hear that it is safe does not mean it will always be safe.  Companies change their operation from time to time, so there is constant re-checking involved.

We also have to consider cross-contamination.  When cooking and preparing food, it is so important to wash surfaces and utensils that came in contact with the allergen very well before using those again for the safe foods.  This includes hand-washing and possibly brushing teeth.  If I were to eat peanuts, I would wash my hands and brush my teeth before giving my son a hug and a kiss. This may seem over the top, but we would much rather prevent a reaction and spend a few minutes cleaning up than end up in the ER.

Since 1 in 13 kids have a food allergy, this is real life for someone you know.  When we ask how food was prepared, when we ask to see a food package to read the label, when we ask you to wash your hands, I hope you will understand that we are not be being helicopter parents.  We don’t want to have to ask these questions.  We don’t want to constantly be on guard. It’s exhausting. We are trying to prevent a serious reaction.  We want our kids to live normal lives and not feel excluded, so we do it.  We do it because we have to.

We have amazing family and friends.  They have been so willing to learn our allergies and prepare food that everyone can eat.  They ask me questions, text me pictures of food labels, and always include our children.  I hope that all families dealing with food allergies have such an amazing support network.  We love you guys!!!