Meet Dr. Sarah M. Boudreau-Romano
Food Allergy Action Hero
1/09/2013 - Our featured Food Allergy Action Hero is Dr. Sarah M. Boudreau-Romano. Many of you know her as ‘The Allergist Mom’. Sarah has confidently and poignantly written about her experiences with food allergies and how it has affected her family. Here is what Sarah had to say:
ALLERGY FREE TABLE: We have truly enjoyed reading your posts on The Allergist Mom blog about your personal experiences with food allergy. Tell our readers about your experience as a Mother of four, three of whom have life threatening food allergies.
DR. BOUDREAU-ROMANO: Being a mother of four is hectic and a blast but when you add food allergies into the mayhem, it becomes complex and oftentimes tricky. There is a delicate balancing act trying to meet everyone’s different food needs while still keeping our home a completely safe place to live and flourish. As hard as it can be at times, it is the life we have been given so we do our best to accept our lives the way they are and make them as fun and happy as possible.
ALLERGY FREE TABLE: You have two important jobs, Mother and Physician. Tell us how you balance work with managing your children’s food allergies. Please include how you handle child care.
DR. BOUDREAU-ROMANO: Actually, when I finished my Allergy/Immunology fellowship, I took some much-needed time away from the hospital. When the children were very young, there was just too much new food introduction and so many hives and so much vomiting that I didn’t feel comfortable leaving them in someone else’s care. As they grew, the reactions became less frequent but then I had 4 children under the age of 5 so working from home just made more sense to me. I knew that I wanted to still provide some level of care to the food allergy community and that is when I decided to start my own business and blog, The Allergist Mom, as a way to provide useful and compassionate expertise to food allergy families.
When I do leave my children in the care of others, I have the babysitter meet with the children first while we are all home mostly so that I know the children are comfortable talking to the babysitter especially if there was a reaction. I also meet with them separately in a non-rushed setting to discuss the emergency action plan, teach them the signs and symptoms of an allergic reaction, and teach them the importance of and how to use the antihistamine and more importantly, the Epipen. When they come to babysit, I put the Epipens and antihistamine in a place that is easily accessible to the sitter. Along with the medications, I put each of the child’s emergency plan out so if an emergency were to happen, they have one sheet of paper to refer to and they can just follow the arrows. I remind the children that they are to immediately tell the sitter if they feel they are having an allergic reaction.
ALLERGY FREE TABLE: The list of foods that your family needs to avoid is lengthy. Tell us what foods you currently avoid.
DR. BOUDREAU-ROMANO: We avoid milk, egg, wheat, oat, soy, corn, barley, quinoa, peas, beans, peanut, treenuts, mustard, sesame, banana, cantaloupe, orange, cranberry, red grape, fish, and shellfish. We avoid the majority of these foods based on a history of an allergic reaction and follow-up testing.
ALLERGY FREE TABLE: Because your children are allergic to different foods how do you manage meal time? Do you prepare foods everyone can enjoy? If so, would you share with us some of your family’s favorite meals?
DR. BOUDREAU-ROMANO: My children are each allergic to their own unique set of foods but we keep our home and our meals safe for everyone. We believe that our home should be the one place where, in general, you can be safe and grab food and not have to have as much food-related stress. The argument that this is not teaching them the real world doesn’t work for us. There is plenty of real world experience while they are at school and parties and restaurants. We feel that home shouldn’t have to be yet another real world experience for them but rather a little safe spot in the very real world.
I was not great at creating meals a few years ago (that’s being nice to myself... the meals were horrible!) but have since forced myself to get in the kitchen and feel comfortable and be creative. It has really paid off! Some of our favorite meals are homemade marinara sauce and rice pasta, kale spaghetti, meatballs, chicken tortas, chicken vegetable soup, stuffed green peppers and tomatoes, and mushroom/chicken risotto. The list goes on! But that is a good start for top 8 allergen-free meals!
ALLERGY FREE TABLE: What have you learned along the way that you wish you would have known immediately after your second child was diagnosed with food allergies?
DR. BOUDREAU-ROMANO: That each age has its own challenges and that things will get better. More than anything, I needed hope that we will make it through this and that we will adjust and learn how to create a beautiful life... even without cheese.
ALLERGY FREE TABLE: Your blog mentions that your daughter is anaphylactic to cow’s milk. How do you help her stay allergen safe in our dairy coated world?
DR. BOUDREAU-ROMANO: My daughter had anaphylaxis to cow’s milk at 4 months of age to her first sip of cow’s milk-based infant formula. She actually has been able to eat cow’s milk since she was 2. (See, there is some hope!) One of my sons also has a history of a severe allergic reaction to cow’s milk as well and we haven’t been so lucky with him
Let’s face it, milk is everywhere. Yogurt, mac and cheese, candy bars, flavored chips... it goes on and on. In public, I carry baby wipes and lots of them. I wipe off any surfaces where we will be spending time. Especially when they were young and put their hands in their mouth regularly, I would frequently wipe their hands with wipes after getting them out of the swing at the park or looking at books at the bookstore. When they were still crawling around on the ground and picking up things to put in their mouth, I preferred to keep them closer to home. If we did go to a friend or family member’s house, we asked them to run the vacuum and we would often bring a blanket or sheet from home and lay it out for the kids to play on. We also asked people to take their shoes off in our house when the children were babies. One time a friend of ours was sitting on the couch and my son crawled up and put my friend’s shoe in his mouth. Our friend had just been to The Pancake House and when I looked, he actually had embedded pancake (egg, milk) in his shoe. Luckily my son must’ve missed the pancake but at that point, we felt taking off shoes was a good idea especially when the kids are still very young.
And then there is the obvious, we always carry our Epipen with us wherever we go. Always.
ALLERGY FREE TABLE: Many holidays are upon us. How do you manage food allergies during holidays and celebrations?
DR. BOUDREAU-ROMANO: I mostly manage this by hosting, luckily it’s not all on me though! My mom is a huge help. When we go to my gramma’s for Christmas Eve however, it is no doubt difficult. I always bring our own food for the kids. Asking my gramma to whip up a dinner without milk, eggs and wheat etc. is just too much to ask. Plus, the idea of cross-contamination in someone else’s kitchen makes me nervous and the last thing I want to feel on a holiday is anxious.
I have created a plan with my gramma that after dinner, we clean up all the food. I am in charge of making all of the desserts and so when dinner has been cleared, only my desserts come out. This way when the kids are opening their presents and snacking on sweets, I know the sweets have all been made in my kitchen. It makes everyone feel better. We live an hour away and leave a bit earlier than everyone else so when we leave, the pecan pie can make its appearance.
I have always made it clear that my children have to ask me every time they eat something so it would be better if the adults didn’t offer food to my kids, any of them. This way others are not left to distinguish who has food allergies and who doesn’t and to what.
Again, I bring wipes for the all-too-occasional sloppy kisses and to help wipe down the other little kids hands after dinner. If you give people the tools, they are more willing to help make it safer.
You always have to deal with the new-comer or the old-timer who doesn’t get it, but the more you can plan ahead, the better.
Creating safe, fun and new holiday traditions can be tough and honestly, it can feel like a loss, but once you get past that, the new traditions can often be better than the old!
ALLERGY FREE TABLE: If you want to read Sarah’s thoughtful, compassionate, and informative articles, check out her blog, The Allergist Mom. We learned many interesting things about food allergy management from reading Sarah’s posts and we hope you will too.
Please remember that this interview is of a general nature only and is not medical advice. While Sarah Boudreau-Romano is a doctor, she is not your doctor. You should consult your own physician or health care provider for any medical advice you seek with regard to food allergies and any other medical conditions. Also, please do not imply that any food, ingredients, products, medications, or treatments that she discusses are safe for you or your family. You need to consult with your physician, and always remember to check labels and contents.