How to Travel Confidently When Your Child Has a Peanut Allergy

When your child has a peanut allergy, you‘re used to being diligent around grocery shopping, keeping medications handy, and having their health provider‘s number available — but what about when you‘re traveling?

The level of uncertainty about potential exposure can be stressful for parents, says Rebecca Fisk, MD, a pediatric hospitalist at Northwell Health’s Lenox Hill Hospital in New York City. However, taking some steps ahead of the trip can often help alleviate stress.

“Traveling with a child who has a peanut allergy requires significant planning,” she says. “Knowing what to expect in terms of flying, restaurant menus, what to pack, and other factors can help make a trip more successful.”

With that in mind, here are some top tips to consider.

Having a travel kit available as a carry-on, or in a handy place when traveling by car, train, or bus, is crucial, so you have easy access in case an allergic reaction occurs, says Dr. Fisk. She recommends items such as:

• Two epinephrine auto-injectors (EpiPen, Auvi-Q) or nasal spray (Neffy)
• An antihistamine such as cetirizine (Zyrtec) or diphenhydramine (Benadryl), and note the dose for your child before traveling
• The food allergy and anaphylaxis emergency care plan that your pediatrician or allergist has provided for your child
• Allergen-free snacks that are easy to eat on the go, such as applesauce pouches, plain pretzels, bananas, crackers, and dehydrated fruit
• Translation cards (such as those from stores like Equal Eats), which can list allergies in other languages, and can be handed to a server in a restaurant

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• Liquid soap, bar soap, or wet wipes (versus hand sanitizer, which research shows doesn’t necessarily remove food proteins that trigger allergic reactions)

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“Epinephrine auto-injectors can go through TSA [Transportation Security Administration] machines, but it’s helpful to tell them about the medications before putting your carry-on bag through the X-ray machine, since they may want [a] visual inspection,” says Fisk. ”For extra security, I‘d advise having a doctor‘s note explaining the child‘s diagnosis and medications used for [an] emergency.”

There‘s a common perception that peanut particles can be transmitted through a plane’s ventilation system, meaning that someone in any row could be spreading peanut residue throughout an aircraft.

Ask to pre-board so you have more time to wipe down all areas in and around your child‘s seat, Fisk says. And remember to carry wipes when using bathrooms on the plane, to reduce any exposure from those surfaces as well, she adds. Another tip: Consider flying early in the morning, since the first flight of the day will have the cleanest planes, says Fisk.

It’s never pleasant to visualize worst-case scenarios, but doing that can help you understand how you would manage an emergency in an unfamiliar location, particularly internationally, says Anna Nowak-Wegrzyn, MD, PhD, director of the division of pediatric allergy and immunology at Hassenfeld Children‘s Hospital at NYU Langone in New York City.

In addition to packing emergency medications like epinephrine and oral antihistamines, a bronchodilator medication, like those used as asthma inhalers, may be helpful if your child has breathing issues with peanut exposure, says Dr. Nowak-Wegrzyn.

”Also, if your child has a common comorbidity like asthma, allergic rhinitis, or eczema, make sure to take medications for these conditions, because traveling increases the likelihood of these conditions worsening, due to changes in humidity, different climates, and other factors,” she says. Whether your child has a co-occurring condition or not, having a discussion with their doctor about best traveling strategies can help you plan more thoroughly.

”People with food allergies can safely travel and enjoy exploring new destinations,” says Nowak-Wegrzyn. ”It just takes preparation and being aware of the potential risks.”