Label Reading Rules

When my older son was first diagnosed with anaphylactic food allergies in 2005, it was the experience and encouragement of other parents that helped me through the process of purging my pantry and restocking it with safe foods.  I again relied on other parents when both of my boys were diagnosed with eosinophilic esophagitis (EoE) in 2008.  I still look to other parents when we are able to add a new food, or when we must give up yet another.  They are a source of information when I don’t have the ability or energy to find it for myself.  My hope is that consolidating some of what I have learned can ease the transition for other families.  Please bear in mind that I have no medical training.  It is important that you consult with your (child’s) medical team for guidance that is tailored to your specific needs.

When a doctor tells you to exclude certain foods from your diet, the concept seems pretty simple.  You just need to get rid of foods containing those foods that must be avoided (allergens or potential allergens) and replace them with safe foods.  But then you start reading the food labels and realize that the process is not so simple.  Ingredient lists can be confusing.  You can’t even pronounce these words, so how can you possibly know if they are safe or not?!  The task can be daunting, but it is not impossible.  Below are a few rules that I follow to minimize accidental exposures that could have been avoided with careful label reading.

1. Check every label, every time.  Manufacturers can change ingredients without any change to their packaging.  The only thing they must change is the list of ingredients.  Sometimes the ingredients used to manufacture an item in one plant will vary from the ingredients used to manufacture the same product in another facility.  It is easy to become complacent and grab a “safe” item from the shelf without remembering to check the label.  Therefore, I read labels at the grocery store and also when I pull an item out of my pantry to use it.  It would be an embarrassment to divulge how often that one last peek at the label saves me!
   
2. Assume nothing!  Allergens turn up in unlikely places.  For example, I have seen chili recipes that call for peanut butter and turkey bacon that contains pork fat hidden as “natural flavor.”  If you cannot examine the ingredients of a prepared food, or if the food may have been cross-contaminated by shared utensils, skip it.  You do not want to explain to your allergist how you earned an ambulance ride because you decided that homemade cookie should be safe based on appearance.  Trust me on this!
   
3. Use your resources. If you don’t know what something means on a label, then take the time to find out.   Current labeling laws require that any foods containing milk, soy, wheat, egg, peanuts, tree nuts, fish or shellfish must use plain English to identify those foods.  (This is not the case for foods bearing the USDA logo, medications or cosmetics.)  Any other ingredients can be listed ambiguously, or hidden under terms such as “flavoring” or “natural flavoring.”  Resources can be “been there done that” parents, informational websites and your (child’s) medical professionals.  You can also call the manufacturer to ask for more information about their product.
   
4. When in doubt, put it back on the shelf.After all of the time you spent trying to identify the cause of your (child’s) symptoms and banish them, why would you knowingly chance the ingestion of a food that could include an allergen?  Look for a safe alternative or make it yourself instead.  If the item in question is a medication, consult with the prescribing physician to determine the best course of action.