My heart sunk when I found out my eight-year-old has an almond allergy

"I feel like life will never be quite the same. Dramatic as it sounds, it’s true," writes Aussie mum Melissa.

Melissa Noble

4 min read

October 18, 2023 - 4:08PM

Primary School

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My heart sinks as the paediatric allergist delivers the news: our eight-year-old son has anaphylaxis, a severe, life-threatening allergy - to almonds.

I’m sort of momentarily stunned as I take in what she’s said. I don’t know anything about allergies. We’ve never had them on either side of the family. This can’t be happening.

I burst into tears, then try to get a grip as she walks me through how to use an EpiPen.

“Do you need to take a moment,” she asks, kindly. I shake my head and take a deep breath.

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Image: Supplied

"He complained his throat felt strange drinking a smoothie"

Three months earlier, my son and I had been having a sneaky smoothie together when he started to complain that his throat felt strange and like his tongue was getting bigger.

At first, I thought he was just having a moment, as kids do, but when we went outside, he had a red rash down his chin.

Our GP referred us to an allergy specialist and so began the long wait to find out what was going on.

Finally, the day has arrived and at the appointment, the paediatric allergist performs a skin prick test. For those who haven’t heard of it before, it’s where the patient is exposed to small amounts of allergy-causing substances (allergens) on their skin to see how their body reacts.

Pretty much as soon as the paediatric allergist applies almonds to my son’s back, he feels itchy and before long, a red bump appears.

Image: Supplied

My son's symptoms fall under the life-threatening banner

As a young child, my son had eczema. The doctor explains that food allergy is more common in infants with the skin condition – around 30% of infants with eczema develop food allergies, compared with 10% of the general population.

Interestingly, there is some evidence that managing eczema well during infancy may reduce the likelihood of a child developing a food allergy.

The specialist says anaphylaxis to almonds is relatively rare, but the fact that my son’s skin prick test was elevated, and he experienced throat tightness as a symptom suggests his allergy falls under the life-threatening banner.

Symptoms of anaphylaxis can include difficulty breathing, tongue or throat swelling, hoarse voice, cough, fainting, severe stomach pain and diarrhoea. Anaphylaxis usually happens within minutes of exposure, but sometimes it can occur one to two hours later.

And if it’s not treated immediately, anaphylaxis can be fatal. There are around 20 deaths in Australia each year due to anaphylaxis.

Most children outgrow food allergies to eggs, cow’s milk, wheat or soybeans by the time they reach high school, but allergies to peanuts, fish, shellfish and tree nuts (including almonds) are more likely to be lifelong.

"I feel like life will never be quite the same"

After teaching me how to administer the adrenalin injector and what to do in an emergency, the doctor gave me two copies of an ASCIA Anaphylaxis Action Plan.

My son is to avoid all almond-containing products until our follow-up appointment in 12 months, she says. As we walk out of the appointment, I feel like life will never be quite the same. Dramatic as it sounds, it’s true.

We will have to carry an adrenaline injector and antihistamines with us EVERY time we leave the house. We will need to get into the habit of reading EVERY food label on EVERY product our son eats.

EVERY meal or drink out will need to be screened. We’ll need to check the ingredients and whether there is any risk of cross-contamination. Even tiny amounts of the allergen can cause severe reactions.

EVERY parent or relative whose house our son goes to for playdates or sleepovers will need to learn how to use the EpiPen and what to do if our son accidentally ingests almonds.

One day in the near future our son will have to learn how to use the EpiPen himself in case we’re not around.

"I keep telling myself to just take it one day at a time"

Recent studies show that teens are the highest risk group for fatal food-triggered anaphylactic reactions, whether it’s because they are trying to fit in or not wanting to stand out from the crowd.

Sometimes I have nightmares about those impending teenage years when my son’s at a party drunk and eats something without thinking. Or when he’s a young man backpacking through Asia and eats a random meal that contains almonds on the side of the street. The prospect of something like that happening absolutely terrifies me.

But I keep telling myself just to take one day at a time. There’s no cure – it’s just something that we as a family will have to learn to live with.

Luckily, our friends and family have been incredibly supportive. Since the diagnosis, our son has attended several birthday parties where parents have ensured no almonds or almond meal is present in any of the food.

Some of our close friends have a daughter with anaphylaxis and they have been an invaluable source of information and emotional comfort.

Life throws us all curveballs – it’s how you cope with obstacles that matters. We just never expected our greatest challenge would come in the shape of a scruffy-looking nut about the size of my thumbnail.