Friendly Skies & Food Allergies
Karin Menard of Lunenburg, Massachusetts, is a very experienced allergy mom. With 9-year-old twin girls who have peanut and tree nut allergies, a 14-year-old son with shellfish allergies and a husband allergic to shellfish, peanuts, tree nuts, bananas and sesame, she is no stranger to adapting to new situations. Still, flying with her family has given her pause.
“The biggest challenge for me is dealing with the unknown,” Menard says. “It’s a mental thing where I worry about everything—from an earlier passenger in our seats with a peanut butter sandwich, to the response I’ll get from flight attendants, to making sure my concerns don’t make the kids anxious about flying.”
Menard hasn’t let her fears keep the family from traveling, however. She’s found ways to have a safe and happy flight for all. Safe travel by airplane is not only possible, it’s done by food-allergic passengers like the Menards every day. The secret is vigilant preparation.
Planning is Everything
In 2010, the U.S. Department of Transportation solicited public comments about the presence of peanuts on airplanes. Although the process heightened awareness and generated serious conversation, DOT concluded it didn’t have authority to create industry-wide policies. With no government regulations addressing their concerns, food-allergic travelers are on their own when it comes to flying.
It’s understandable to be worried about air travel, yet conquering the fear is worth it. It can, quite literally, make the whole world available. These steps can help you better plan your air travel for a safer trip.
Work with a doctor. Before locking down your itinerary, discuss safety strategies and potential travel risks with your allergist or qualified healthcare professional. A written emergency plan can provide additional reassurance, particularly if you’re traveling with a food-allergic child. This is also the time to update epinephrine prescriptions and other medications that might be needed.
Research online. “Before booking our flight, we did a lot of research online about the airlines that didn’t serve peanuts and those that would work with us to ensure a safe flight,” says Brenda LaPlante Gardner of Old Town, Maine, whose 8-year-old daughter is allergic to peanuts and hazelnuts. Many airlines explain their food-allergy and other diet-related policies and procedures on their websites, where they also provide details about on-board snacks and meal service. What’s posted (and what’s not) can give you a sense of how receptive an airline is to passengers with special dietary needs.
Understanding what food is served on a flight is important in order to assess potential danger spots. Some airlines regularly offer peanuts as snacks or sell peanut-containing foods, while others may serve them in first class only. Tree nuts are very common on flights, particularly in first class meals. Some airlines offer warmed tree nuts in first class and business class, a problem for anyone sensitive to aerosolized tree nut particles.
Use the phone. It’s generally best to book your flights over the phone, not online or through a travel agent. Talking directly with an airline rep gives you the opportunity to put your allergy or other special needs on record and to make specific requests.
“Contacting the airlines directly and informing them about my daughter’s allergy was helpful. Some were much more willing to help than others,” LaPlante says. Certain airlines are willing to establish a “buffer zone” of one to three rows in front and behind a peanut-allergic passenger’s seat where alternate snacks are served. Other airlines will honor requests to not serve peanuts at all when a peanut-allergic flyer is on board or they will make on-board announcements. Be sure to write down the airline agent’s name and telephone number in case you need clarification or confirmation of special arrangements.
Fly early. Whenever possible, book the first flight of the day. Planes are usually cleaned at night, so seats are generally safest first thing in the morning. Always opt for a direct flight when available. This limits the number of “surprise” situations that can arise when boarding a different plane and interacting with a new crew. It also lowers the risk of extended delays between flights in airports with limited food options.
Understand security. The Transportation Security Administration’s regulations cover carry-on medicine and food. According to TSA’s website (tsa.gov), over-the-counter medications, such as Benadryl, are not limited to 3.4 ounces but they must be declared and presented at security. (Large quantities will likely be questioned.) Epinephrine injectors are also permitted, along with all other prescription medications. TSA suggests that prescriptions be in their original packaging with the pharmacy label and that passengers carry a letter from their doctor, documenting the medical need. Security will require an explanation if the name on your medicine doesn’t match the name on your airline ticket.
Check over TSA’s rules governing gels and liquids. Soups, salad dressings, gelatins and puddings are not allowed through security if they exceed 3.4 ounces. If you’re carrying on sandwiches, crackers, fruit or vegetables, they must be wrapped in a container that can go through the x-ray machines.
Sippy cups filled with liquid are not allowed; however, liquids such as “water, juice or liquid nutrition or gels for passengers with a disability or medical condition” may be permitted, according to TSA’s website. Baby formula and breast milk are also allowed. Some parents have noted that they were permitted to carry on single-serve containers of soy milk and rice milk by supplying a doctor’s note. Again, these items must be declared at security. Gel-filled ice packs may be problematic with security, so leave those at home. For more information, visit tsa.gov or call 866-289-9673.
Pack provisions. Although some airlines offer special meals, it’s never advisable for anyone with severe food allergies to eat snacks or meals provided by an airline. Play it safe and bring your own food. Pack extra in case your flight is delayed.
“We had a trip we’ve taken a dozen times and I packed enough food for the 3½-hour flight,” says Eliza Choe of Hong Kong, mother of three. Her 2½-year-old son is allergic to all nuts, seafood and eggs and he also has a dairy intolerance. “The airport was shut down for 8½ hours and the plane only had nut-based snacks and sandwiches with mayonnaise. My son cried for the last two hours. I was horrified!” Lesson learned. Choe now packs enough food, snacks and Neocate for all three children to last a full 24 hours. She and her family have since completed a safe and successful 15-hour trip from Hong Kong to Chicago.
Keep in mind that there may be a situation where security deems your food items a risk. Try not to let it ruin your trip. Pack a variety so that the loss of a few items won’t leave you hungry. Changing planes in another country can introduce additional challenges. It’s likely that customs won’t allow any meat, produce or milk products so opt for items like packaged gluten-free or allergy-friendly bars or crackers, which generally are permitted.
Time to Fly
At the airport, notify your airline’s check-in agent and the gate staff of the allergies. Request pre-boarding to give you a few minutes to get onto the plane before other passengers.
Make it safe. Once on board, alert the flight attendants to the medical condition. Before settling into your seat, wipe down the armrests and tray tables. Double-check seat back pockets. A fitted sheet is a handy thing to pack—it can be wrapped over the seat for added coverage.Store epinephrine injectors under your seat, not in the overhead bin. Easy access is critical in an emergency. Tell your traveling companions where the EpiPens are and make sure they know how to work them.
Traveling alone? Wear a medic alert bracelet. Consider notifying your seatmates of the allergy; this may gain their cooperation in not consuming allergens nearby.
Parent tips. Additional precautions are useful when traveling with food-allergic children. Place the child in the middle seat, to better protect him or her from exposure from food carts and plane walls. Don’t allow your child to explore the seat pockets; people often put trash there. Also, don’t let children stick their hands between the seats or retrieve toys from under the seats; both areas tend to accumulate dropped food.
React quickly. At the first sign of an allergic reaction, don’t hesitate to use emergency medication and to ask for help. Symptoms can develop quickly and it’s important that everyone is ready to respond.
Got a complaint? If your trip doesn’t go as planned and you have concerns about inappropriate treatment en route, you can file a complaint with your particular airlines and with the Aviation Consumer Protection Division, the federal agency that tracks air traveler feedback. Log on to airconsumer.ost.dot.gov. You can go through the Food Allergy & Anaphylaxis Network to get to the online complaint form. “We provide a link to the Aviation Consumer Protection Division complaint site at foodallergy.org/page/filing-a-complaint1,” says Chris Weiss, FAAN’s vice president of advocacy and government relations.
Flying with food allergies and sensitivities is challenging but with proper planning, it can be done successfully. “Even with all our food allergies, we continue to travel quite a bit,” says Menard. “The bottom line is to do your research so you’re comfortable. And then don’t hesitate to speak up. Airlines can’t do anything about it if they don’t know a passenger is on board with a life-threatening allergy.”
Katrina Ávila Munichiello lives in the Boston area with her husband and three children.