“Food Allergies,” Disability Services: Leaders (2020)
“Food Allergies,” Disability Services: Leaders
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Food Allergies
Food allergies and reactions to food can have a significant effect on a person’s physical and emotional health and ability to participate in Church meetings and activities.
What is a food allergy?
A food allergy is a condition in which exposure to a specific food causes the body to mistakenly treat the food as a harmful substance. This reaction may trigger anaphylaxis, a reaction that can result in death. Globally, 240–550 million people may suffer from allergies to some foods, but the most common allergies are to peanuts, tree nuts, fish, shellfish, milk, eggs, wheat, and soy.
At church, adults, youth, and children are often exposed to food allergens in these ways:
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Homemade food items served at Church functions
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Unlabeled food items, such as bakery items or home-baked goods
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Cross-contact with food containing allergens
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Preparing, passing, or partaking of sacrament bread that contains allergens or has had cross-contact with allergens
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Treats, candy, or other food items that contain allergens
How do I recognize a food allergy reaction and anaphylaxis?
Look for the following symptoms, which could be mild or severe:
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Shortness of breath, wheezing, or repetitive cough
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Pale or blue skin, fainting, weak pulse, or dizziness
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Tight throat, hoarseness, or trouble breathing or swallowing
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Significant swelling of the tongue or lips
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Hives over the body, widespread redness, or itching
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Repetitive vomiting or severe diarrhea
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Feeling that something bad is about to happen, anxiety, or confusion
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Drop in blood pressure
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Itchy or runny nose or sneezing
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Itchy mouth
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Mild nausea or discomfort
What is anaphylaxis?
Anaphylaxis is a sudden, severe, and potentially fatal allergic reaction. Symptoms can occur within minutes or hours after exposure or ingestion. Without early administration of emergency medication called epinephrine (also known as adrenaline) along with emergency care, the result can be fatal. Symptoms of anaphylaxis include:
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Airway constriction.
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Extremely low blood pressure.
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Shock (anaphylactic shock).
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Suffocation from swelling in the throat.
What is the best treatment for a reaction?
Epinephrine is the most commonly used medication to treat severe reactions and anaphylaxis. It is available by prescription as a self-injectable device (such as EpiPen, Auvi-Q, or Adrenaclick). Most individuals with food allergies carry one of these devices with them. If members have a food allergy, leaders and teachers should discuss possible treatment with them or their parents in anticipation of an allergic reaction.
How do I respond to an anaphylactic reaction?
If someone is experiencing anaphylaxis:
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Inject epinephrine immediately (if available).
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Call 911 and request an ambulance with epinephrine.
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Call parents of children and youth after steps 1 and 2.
If symptoms do not improve or if symptoms return, more doses of epinephrine can be given about five minutes after the previous dose. Transport the person to an emergency facility, and stay there at least four hours, because symptoms may return. Do not depend on antihistamines. They will help only with skin issues and may cover any anaphylactic reactions, causing a delay in the administration of epinephrine and possible irreversible effects, including death. If you are unsure what to do, give the person epinephrine and call 911. If someone with a food allergy feels ill, never leave him or her alone.
How do I help prevent food allergy exposures and anaphylaxis?
Following the guidelines below will help keep those with food allergies safe in a church setting:
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Take all food allergies seriously, because they can be fatal.
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If members have food allergies, communicate with them and with the parents of children and youth.
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Know what foods they must avoid, and determine if there are safe substitutes.
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Inform them when food will be present.
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Avoid serving home-baked or bakery goods. Such goods are usually at a higher risk of cross-contact and do not always have ingredients listed on the label.
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Label homemade food with ingredients.
How can those with food allergies safely partake of the sacrament?
Leaders and teachers should be sensitive to the physical and emotional impact food allergies have on an individual and should develop ways to safely include people in all activities and worship—including partaking of the sacrament. The guidelines below may help:
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Members with food allergies, such as gluten intolerance or other conditions, should inform a member of the bishopric and discuss with him what adaptations may be appropriate for the sacrament.
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Members may provide their own allergen-free bread or other broken bread-like substitute. Members may bring a pre-broken bread substitute in a sealed plastic bag and give it to a priesthood holder to place on a separate tray.
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During the sacrament, the priesthood holders break the regular bread but do not open the bags or touch the allergen-free bread substitute. The prayer to bless the bread is offered in the normal way.
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The bishopric ensures that the priesthood holders can identify members to whom the allergen-free item should be passed. Those who prepare, administer, and pass the sacrament should receive training on how to avoid cross contamination.
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Depending on the number of individuals involved or specific circumstances, the bishopric may modify the procedure.
How do I avoid cross contamination?
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Understand what cross-contact is and how to avoid it. Cross-contact happens when one food touches another food or surface. As a result, each food or surface then contains small amounts of the food allergen. These amounts are so small that they usually cannot be seen, but they can be transmitted onto food generally considered safe. Even very small amounts of food allergens have the potential to cause a life-threatening allergic reaction.
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During the sacrament, avoid cross contamination by following the guidelines below:
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Properly wash hands with soap and water before preparing the sacrament (hand sanitizer will not remove any food allergens).
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Allergen-free bread should be handled first before working with bread with allergens in it. If you have touched bread with allergens in it, be sure to wash your hands with soap and water before touching allergen-free items.
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All allergen-free items should be placed on a separate allergen-free tray.
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If a member brings a pre-broken allergen-free bread substitute in a sealed container, do not open the container; place it on the separate allergen-free tray.
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Additional Resources
For more information on food allergies, anaphylaxis, and how to recognize and respond to allergic reactions, see the following resources:
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Printable Posters and Signs
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Avoiding Cross-Contact with the Sacrament Sign (Portuguese)
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Lisa A. Thomson, “Managing Food Allergies at Church,” Ensign, June 2020, 40–45.
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World Allergy Organization White Book on Allergy: Update 2013 (World Health Organization, 2013), worldallergy.org.
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