Food Allergy Mom

“Dear cross-contact, I hate your stinking guts. You make me vomit. You’re scum between my toes!” Those infamous words of the Little Rascals echo through my head every time I deal with possible cross-contact of food. If cross-contact had an actual face, I’d probably punch it. For reals. 

All humor (and aggressiveness) aside, perhaps you are just now hearing the term “cross-contact” and would like to know exactly what it means. I have been there. In fact, my allergist didn’t go over this concept with me during my child’s initial diagnosis appointment. 

A Definition

I ended up finding out about it in my research at home. My husband and I had to circle back to the allergist for medical advice. Here is a very clear definition of cross-contact from Food Allergy Amulet:

Cross-contact “occurs when a food allergen in one food (let’s say milk protein in cheese) touches another food (let’s say a hamburger), and their proteins mix, transferring the allergen from one food to another. These amounts are often so small that they can’t be seen!”

Food Allergy Amulet.

I love that definition because it is so easy to understand. Another good one is FARE. FARE is the trusted source of information about food allergies and they have a clear definition of cross-contact that you can read here.

Cross-contact means that even microscopic proteins can accidentally make their way into other presumably safe foods. 

I wish I had a dollar for every time someone told me to pick my child’s allergen out of their food (like peanuts out of trail-mix) and still feed it to her. I would be at least a few hundred dollars richer! Even if I did pick out the peanuts, the peanut protein would still be present in the remaining food.

Clearly, it just isn’t as simple as “not feeding” my child that particular allergen.  

Cross-Contact vs. Cross-Contamination

As you read in the above definition, some people in the allergy world also refer to cross-contact as “cross-contamination.” You might see this a lot in food allergy parent groups. I also used the term for many years until I gained more knowledge concerning this subject. 

Cross-contamination refers to food bacteria or food-borne illnesses being transferred to the food rather than an allergen.

Cross-contact is a phrase strictly used to discuss the possibility of foods touching each other during food prep. It is also important to note that cooking foods at a high temperature does not necessarily “kill off” the allergen proteins if cross-contact occurred.

So, what does this mean for you and your child? 

If cross-contact is a very serious concern for your child, then first let me say that I know how debilitating this information feels. I am so sorry.  Before diving in further, remember that it is okay to take breaks while reading about or researching this topic. 

We sometimes need to absorb the information, or even cry for a little while. It’s okay, momma. We’ll still be here.

Now, if you’re ready, let’s chat about all things cross-contact.  

There are two ways for cross-contact to happen; directly and indirectly. 

Direct Contact

When we say “direct contact,” that means that the allergen was put into food and then later removed. For instance, let’s say that Great Grandma made a crab salad in her kitchen for a family gathering. She actively mixed the crab into the salad bowl, but later removed the crab pieces one-by-one after she found out someone was allergic. 

That is considered direct contact even though the allergen in question was removed. The entire salad has crab allergen protein present throughout.  

Indirect Contact

Now, when Great Grandma was prepping away in the kitchen, she used a wooden spoon to mix the crab into the salad. She used a dish towel to wipe off the spoon before turning her attention to the potato casserole she was also preparing. 

Using the same wooden spoon, she then mixed the ingredients for the potato casserole. That is indirect contact. Though the potato casserole did not have crab in the ingredients, it was still introduced to the crab allergen protein because the wooden spoon was not properly cleaned.

FARE is the trusted source of information about food allergies and you can check out their poster that really gets into the specifics of sources of cross-contact and how to prevent it.

Cross-Contact in Manufacturing

Indirect cross-contact can happen in manufacturing. Say that peanut butter cookies were run through a production line first thing every day. At noon, they stop and switch over to making a raisin cookie. 

Before switching out those 2 products, the manufacturing staff run acid washes on the production lines. Their protocols are pretty effective at clearing out the allergen. Furthermore, the staff performs swab tests on the lines to see if the allergen protein is still present after washing. 

For some people, based on their sensitivity level, this is enough reassurance that the raisin cookie will be free from the peanut proteins. However, for some individuals, their reactions to the proteins are extremely sensitive. For Lauren and me, this is the case for two of our kiddos. This can apply no matter what the allergen is.

For example, it is possible for a person to react to 0.052 milligrams of peanut protein (Source 3 & 4).  That means that the peanut protein weighs about what 1 grain of salt would weigh. 

My family finds that realization to be terrifying. Based on my child’s needs, I personally cannot trust that an acid wash didn’t miss a “grain of salt” size protein and it didn’t somehow wind up in one of those raisin cookie boxed products. 

Thirty of those boxes might be safe, but what if I buy the one box that has that single allergen protein? To me, it feels like I’d be playing Russian roulette with my child’s life.

Cross-Contact at Restaurants

Your everyday habits around food suddenly get a lot more complicated when dealing with cross-contact in different settings. Restaurants, for instance. Your biggest dining out problem (pre-food allergy) was most likely just narrowing down what cuisine you were in the mood for the most.

I believe that most restaurant personnel are well trained in cross-contamination of food bacteria. However, it is difficult to find restaurants that train their staff well concerning food allergies and limiting cross-contact between foods.

We suggest always calling a restaurant ahead of time to inquire about their practices and food allergy awareness. I usually always ask a manager to explain to me what their kitchen procedures are so I can get an idea of how seriously the establishment takes food allergies.

Seeing as how you will not be present when the chef is preparing your child’s meal, try to get as much information as you can upfront. Your comfort level will determine whether or not you want to dine there.

Believe me, I know it can feel like a real leap of faith to allow someone else to cook for your kiddo.

Cross-Contact at Other People’s Homes

Again, it can be very stressful for some parents to trust others when preparing food for their children. There will be times you are invited to have dinner at your friend or family’s home. Decide beforehand how you want to handle the food situation. 

Response-wise, Lauren and I have both encountered people that are either indifferent or display actual anger at having to discuss our child’s allergen. If they are indifferent, I tend to just handle the food myself so I know it is safe. Problem solved. 

Then there are those that show irritation over having to answer questions about food prep. Honestly, if someone has to have it their way, or they are clearly irritated, I choose to tap out of those situations.

I NEVER order someone to accommodate our food allergies. I try to always approach the subject by asking respectful questions and clarifying their comfort levels. If someone chooses to respond to me in anger or sarcastic put-downs, then I don’t really want to share a meal with them anyway. 

In spite of those few turd balls that ruin social gatherings, there are SO MANY MORE people that will show up for you with a giving heart. The majority of individuals will gladly work with you in order to keep your children safe. 

Here are a few ideas to discuss with your host:

• ask them if they would mind providing you labels of ingredients ahead of time so you can call companies about cross-contact (including cooking spray and even spices)
• see if you can bring your own cookware to cook the food in (that way you know the pots/pans are safe)
• gently ask that plates/silverware/table cloths all be disposable to cut down on cross-contact possibilities (I usually offer to bring these so the host has less to do. And a bonus, clean up is easy!)
• try ordering food from a safe restaurant on your list and split the cost (places like Chipotle have great allergen statements and are safe from a few top 8 allergies)
• or bring your child their own food that is similar to what is being served

Owning to the fact that I have high anxiety around allowing other people to cook for my kids, I do tend to bring our own food. For those people that demonstrate a willingness to go above the call of duty, I do take the time to plan a dinner date with that family. 

Dealing with Cross-Contact in Your Home

Now, how do you handle cross-contact in your own home? First, the question often comes up about whether or not to keep your child’s allergen in the house. Different allergy families will need to make different decisions on this issue. And that’s ok!

As you decide your answer to this question, here are a few things to consider.

Are my kids:

• at an age of crawling all over the floors?
• putting objects and hands into their mouths often due to their developmental stage?
• unable to communicate their feelings (emotionally and physically) when something is wrong?
• responding to some allergens with tolerance? (For example: tolerating baked milk or baked egg.)
• able to understand what is safe to eat and what is not safe to eat?

I don’t know about you, but when my kids were infants (and even toddlers) they were constantly grabbing objects that had fallen on the floor. It would go straight into their mouths. Embarrassingly, I’ve even caught them licking my grey laminate flooring like it was Gordon Ramsay’s most delectable dish.

Due to my child’s young age, developmental stage, and her risk of anaphylaxis, it was just easiest for us to eliminate peanuts and sesame completely from the home. We didn’t have to worry about constantly cleaning up the nut and seed messes. (Because allergen maintenance is no joke.)

However, in some cases, it can be good for the allergen to remain in the home. The allergist advised Lauren to keep dairy in her house and around her kiddo, but remove the peanuts. The allergist’s suggestion was based on the knowledge of her child’s medical history and the fact that he could handle dairy in baked goods.

If you have more than one child, here are some more thoughts to mull over:

• Do you have multiple allergies to manage?
• Do the siblings have different nutritional needs?

Depending on the situation, your family might need to decide if they are all willing to go “allergen” free. This decision is usually based on how severe your child’s reactions are or how difficult it is to avoid their allergen.

On the other hand, due to the needs of other children in your home, your family might have no choice but to keep the allergen present. Pretend there are 2 children in a home. One child had a milk allergy, but the other sibling had a poultry allergy. Each one of those allergens would probably have to remain in both children’s environments in order to meet their individual nutritional needs.

Some other things to consider if you decide to keep the allergen in your home:

• Do you have a safe spot to store the allergen?
• Do you have a designated spot in the home to eat the allergen? 
• Can the family agree to allergen consumption safety rules? (Such as not using a utensil to touch one allergen and then reuse it on different food without throughly washing it.)
• Is there a designated set of utensils or dishes used only for that allergen?
• Conversely, are there separate dishes to safely prep/cook/store your child’s allergen free food? 

Last Note on Cross-Contact

As always, please consult your allergist or your doctor about your child’s allergies. Every child and every allergy is different. Don’t panic over how seriously to take cross-contact until you’ve asked for medical advice.

Food allergies are hard, friend. You are doing your best and you will continue to move forward successfully! We are rooting for you!

– Katie

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