Fare Warning

updated 11/19/2001 AT 01:00 AM EST

originally published 11/19/2001 AT 01:00 AM EST

On a February afternoon in 1995, Marianne Barber's 14-month-old son Lucas bit into his first peanut-butter-and-jelly sandwich—and nearly died. "He got hives all over his face and chest," says Barber, 44, "and began to cough and wheeze."

By the time Barber, an advertising copywriter, and her husband, David, 40, a software engineer, got Lucas to an emergency room a half hour later, he couldn't breathe. Fortunately, as soon as he was injected with epinephrine, a form of adrenaline, the symptoms subsided. Lucas, it turned out, is allergic to peanuts and several other staples, making him one of about 7 million Americans—14 percent of them kids under 5—with severe food allergies.

To help other parents cope, Barber, with pediatric allergist Dr. Maryanne Bartoszek Scott and psychologist Elinor Greenberg, has written The Parent's Guide to Food Allergies. Barber, who lives in Weston, Conn., with David, Lucas, now 7, and their older son Dylan, 11, spoke to PEOPLE contributor Jennifer Frey about keeping allergic children safe.

What are the most common food allergies?

There are eight: peanuts, milk, eggs, wheat, soy, tree nuts, fish and shellfish. They're high in protein. If you're going to have a reaction, it will be to a protein in that food.

Is there one that causes the most problems?

Peanuts. Five percent of U.S. kids are allergic. And 63 percent of the 200 or so food-allergy-related deaths annually are from peanuts. They can contaminate other foods during the packaging process. It takes only 1/100 of a peanut—a speck—to cause a life-threatening reaction in a severely allergic child.

What are the signs of an allergic reaction?

Symptoms can include swelling of the lips and throat, hives, vomiting, wheezing and fainting. The most severe reaction is called anaphylaxis. It's defined either as one life-threatening condition—difficulty breathing, for instance—or as a combination of symptoms, like hives and abdominal pain, that together indicate that the body is about to go into shock. Only an injection of epinephrine can reverse it. Untreated, anaphylaxis can cause a child to die.

Do more children suffer from food allergies today than in the past?

We've seen a sharp increase, particularly in industrialized countries. We keep our homes very clean; as a result the immune system doesn't have much to fight, so it begins attacking substances it ought not to.

Is there a way to test children for allergies?

There are blood and skin tests. But unless there are reasons to believe a child might develop food allergies—such as parents or siblings having them—it's expensive, invasive and time-consuming. When there is a family history, use caution introducing the foods at issue. Infants' intestinal cells are more permeable than adults', making them more vulnerable. Wait until a child is at least 1 before introducing eggs, and at least 3 before trying peanuts.

Once it is determined that a child has a food allergy, what comes next?

Always have epinephrine and Benadryl handy. Keep no dangerous foods in the house. Give teachers and caregivers the child's emergency medical kit.

Is there a cure for food allergies?

The only cure is to completely avoid allergenic foods. Unfortunately, food products aren't always clearly labeled. Milk can be labeled casein, whey or lactose. The Food Allergy and Anaphylaxis Network (800-929-4040) offers "How to Read a Label" cards.

How do parents protect their children without making them neurotic?

It's a balancing act. If your child is a worrier, give a lot of reassurance; I let Lucas see me read labels. It makes him confident I'm keeping him safe.

Can food-allergic kids lead normal lives?

Yes. Lucas goes to day camp, after-school activities, sleepovers. I prepare the adults involved so Lucas can move safely through the world.

Do you encounter resentment from parents?

Every year a few don't understand why Lucas's classmates can't have peanut butter just because he is allergic. I try to educate them. Most parents are wonderful; they bring in treats for Lucas.

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