It’s hardly a scene that conveys fun and frivolity: a parent squinting under the dim glow of a streetlight trying to make out the ingredients in a small piece of candy, trying to determine if the treat will harm their child. And yet for the moms and dads of kids with food allergies, it can be an unsettling ritual that repeats itself every Halloween night.
For peanut sufferers, the danger lurks in everything from Snickers to Reese’s Pieces. For those allergic to tree nuts, Heath bar and Almond Joy are among the no-gos. Milk allergies can place almost anything containing chocolate off-limits. Even Twizzlers aren’t gluten-free, posing a concern to those with Celiac disease. And adding to the degree of difficulty, many miniature Halloween candies don’t show ingredients on their packaging — only on the larger bag they came out of.
“Can you imagine, trying to read a label under a street light, in the middle of the evening, with that small writing? If there’s even a label at all? It can be challenging to begin with, and then you throw in a little bit of peer pressure and excitement, and kids throwing caution to the wind,” says Dr. Thomas Murphy of Charleston ENT & Allergy. “And who knows how these things are handled? You may be reaching into a bowl that’s been cross-contaminated by something else.”
Safe Halloween treats
It’s hardly a recipe for an enjoyable Halloween night. Of the eight major food allergens, peanuts, tree nuts, milk, eggs and wheat can often be found in Halloween candy. Dr. Murphy knows the risk personally — he’s allergic to tree nuts, and recalls carefully combing through his Halloween loot to weed out anything that might make him sick. Now an allergy specialist, he knows there are ways that parents and neighbors can make Halloween a little safer.
It begins, of course, with candy. Dr. Murphy says there are several types of Halloween treats that are considered allergen-free, a list that includes Dum-Dums, Ring Pops, Smarties, Swedish Fish, Jelly Belly jelly beans, Skittles and Starburst. But parents and caretakers must remain vigilant — kids with food allergies can get caught up in the excitement of Halloween or want to eat what their friends are eating, tempting them to try something even if they know they’re allergic to it.
That’s why Dr. Murphy advises taking injectable epinephrine trick-or-treating with you. “It’s fraught with challenges, for sure,” he says of Halloween. “Avoidance is the cornerstone, but this would be a night where caretakers and parents of food allergy kids need to be particularly thoughtful about bringing their injectable epinephrine just in case.”
Allergic reactions brought on by food can run the gamut, from hives and tingling around the mouth to lightheadedness and dizziness. In some people, food allergies can bring on a potentially deadly condition known as anaphylaxis, which can include a severe drop in blood pressure and a tightening of the airways. In such instances, use of injectable epinephrine is the first line of treatment.
“The range is wide, and there’s no predicting whether it will be more of a mild or a severe reaction,” Dr. Murphy says. “When kids are running around and it’s dark outside and they're covered in a costume, some of those early signs may be missed. It might be thoughtful for parents to pack treats they know their kids can tolerate if they want something while trick or treating. And then when they get home, turn on the light, and when the excitement’s kind of come down, decide what’s important to avoid.”
Teal Pumpkin Project
In lieu of trick-or-treating, the Centers for Disease Control suggests hosting a Halloween party, where parents can hand out fruits and vegetables in addition to treats they know are safe for their children or others who deal with food allergies. For those determined to go door to door, there’s another alternative: the Teal Pumpkin Project, which promotes awareness of food allergies and similar conditions.
The program, started by Food Allergy Research and Education, involves placing a teal-painted pumpkin on the doorstep to convey the message that non-food treats — such as small toys or glow sticks — are available. Those taking part can register at FARE’s website, FoodAllergy.org, so parents can plan which houses to stop at. The project helps kids with food allergies feel more included in Halloween, and helps relieve some of the stress felt by their parents.
“It’s a shared responsibility,” Dr. Murphy says. “It’s about the community being sensitive about all kids during this time, whether it’s food allergies or Celiac disease or diabetes. Maybe offer a treat substitute the child can enjoy while out and about, so there’s no label-reading in the dark of night. This isn’t a night off from chronic illness, but they can still have fun while continuing to be responsible.”
Have a question about food allergies? Call Charleston ENT & Allergy at (843) 766-7103, fill out their online form to request an appointment, or visit their website at CharlestonENT.com for further information.