In case you haven't had a chance to read this initial post introducing The 6 Stages of Allergy Parenting, here's a quick overview of the key information before we jump into details from each stage:
The Six Stages of Allergy Parenting
Adapted from Ellen Galinsky's work, licensed family therapist and founder of this Food Allergy Counselor Directory and website, Tamara Hubbard developed the Six Stages of Allergy Parenting after recognizing that allergy parents could benefit from parenting guidance specific to allergy parenting that incorporated emotional benchmarks, too.
This primary purpose of this framework is to offer guidance related to the emotional and mindset aspects of allergy parenting, which is often overlooked in allergy parenting guidance.
The 6 Stages of Allergy Parenting essentially offers parents a framework to help them develop their mindset and parenting choices during each stage of parenting, which directly impacts their child's ability to learn how to live confidently with allergies. While overall allergy management skills and goals are noted for each phase, the guidance is heavily infused with information related to the emotional tasks, which are helpful for parents to be aware of and/or develop during each stage of allergy parenting. (For more information on what to teach your child at each stage of their development, check out this Allergic Living article).
Stage 1 - The Image-Making Stage
The Image-Making Stage is the period before the baby is born, and is similar for all parents, with the main goals focused on preparing for changes and parenthood. Where differences might occur is if you're already a parent of a child with food allergies and/or allergic conditions, in which case, you may already be nervous about the development of allergic conditions in subsequent children.
The most important parenting tasks in this stage are to be aware of these fears and concerns, and to discuss them with your healthcare team to be sure you're receiving the most accurate and up-to-date information.
Stage 2 - The Nurturing Stage
The Nurturing Stage covers infancy and ends at toddlerhood. The hallmark of this phase is developing your connection with your child.
If your child is diagnosed during this time period, the main focus for allergy parents is to adapt to life with the allergic diagnosis - which is usually a big adjustment! This adjustment includes the emotional work of processing so many thoughts and feelings, such as the loss, grief and sadness associated with a parenting journey that is different than the one you expected, and even anger, guilt, and trauma. (See image below for common post-diagnosis feelings and mindsets). It also includes working towards an acceptance of the diagnosis and learning to live with the uncertainty of allergic diseases. (Note: Acceptance doesn't mean you have to like something; it simply means you're willing to feel/connect with all the feelings that the unwanted situation brings).
Even though you may begin to process these thoughts and feelings, it doesn't mean they will go away - and that's one of the hardest parts about parenting a child with a medical diagnosis - the intensity of how we feel and what we think. They will likely resurface with varying intensity at later times, such as during major transitions (i.e. school transitions), and post-reaction. But, acknowledging them and noticing if/when they impact HOW you parent is a useful strategy to work towards your own well-being AND help you focus on that bigger parenting picture.
Given that safety is the parents main responsibility during this stage, it's common to feel overwhelmed and anxious. Adjusting to life with allergies and developing a new workable mindset takes time and practice, so be kind to yourself during this stage. You may find yourself spending late night researching allergies, telling yourself that you can't leave any stone of information unturned. While it's important to learn about allergies and adapt to life with them, it's equally important to aim to focus on what's most crucial to learn first so that you don't burn yourself out trying to learn everything at once. Focus on the current stage you're in, how to adapt daily life, and how to care for yourself during this major transition, too.
A heavy dose of self-compassion goes a long way during this process! And it's not uncommon for newly diagnoses parents to feel like they need extra support, whether through support groups, more experienced allergy parents, and even therapy, so don't be shy about asking for help!
Stage 3 - The Authority Stage
Next is The Authority Stage. Here come the tantrums and desire for more independence, as this stage covers the toddler and preschool years!
If a child is diagnosed during this stage, it's still important for parents to work through the parenting tasks in the previous stage, as truly processing and adjusting to the diagnosis are tasks that should be addressed no matter when the diagnosis occurs.
The main focuses during this stage are helping your child learn the basics of allergy safety and assessing if your allergy approach fits with your lifestyle. This includes learning/teaching these safety rules within the home, as well as outside of the home, as future stages will require the child to navigate their allergies in school and social settings. As mentioned in the initial 6 Stages of Allergy Parenting post, children often learn through scaffolding, or building upon prior knowledge and experiences. Therefore, it's important to lay a solid foundation of allergy skills in which to build upon. And while the skills they're learning are focused on a serious topic (safety with allergies), don't forget to get creative and make it fun the learning as fun and hands-on as possible so they're engaged! Red labels for "not safe" and green ones for "safe", playing with food items as a first step to introducing more foods (with your allergist's approval), and reading allergy-related books together can help.
Developing trust in others' ability to care for our child is another huge focus within this stage (if not already developed in the previous stage). As children continue growing, they will need to learn how to separate from parents, which means parents need to learn how to separate from their children, too. This can seem hard enough without allergic conditions, so recognize that this is supposed to feel hard and doesn't necessarily mean bad things will happen when you're not there. Focus on developing trusting relationships with a few key people in your life by educating them on allergies and your family's approaches to safety. Don't have someone you feel you can trust? Connect with other parents in a local allergy support group to see if they have babysitters they trust! Start slow and small - with someone there while you're present. And remind yourself that this is a crucial development for both you AND your child!
Additionally as important is monitoring your own mental health, anxiety and stress levels during these earlier stages in particular. It's very easy for excessive anxiety to throw parents off course because it feels safest to avoid doing new things that make us uncomfortable. But as this framework shows, it's important to remind ourselves of the bigger picture - the ultimate goal of raising a confident allergic kiddo, and that starts with us modeling the steps to our kids. So not only will you benefit from checking in on yourself, so will your child!
[Noticing picky eating habits or avoidance of foods? Episode 17 of the Exploring Food Allergy Families podcast may be helpful, as gastropsychologist Tiffany Taft, PsyD shares insights into the differences between developmental "picky eating" and Avoidant Restrictive Food Intake Disorder (ARFID)].
Stage 4 - The Interpretive Stage
The middle childhood years fall into The Interpretive Stage. Because of the increase in time spent outside of your care, it's important to focus on teaching your child basic self-advocacy skills and how to navigate various social situations. If your child was diagnosed as an infant or toddler, you may find yourself hitting cruise control during this stage - with things going more smoothly once they transition to elementary or primary school. But it's important to continue to practice and develop allergy skills. Remember, the skills learned in this stage will be built upon the allergy management skills you've taught them in the previous stages.
Role-playing and discussing hypothetical scenarios can help kids practice their allergy management and safety skills at home before ultimately trying them out at school or activities. They'll need guidance understanding and navigating social experiences, so it's a great stage to also build an emotional health toolkit that includes calming/coping strategies such as belly breathing and 5-4-3-2-1.
Parents may also notice their own increased anxiety during this stage, as they continue to shift their trust to others to care for their child's safety on a daily basis. Therefore, it's important to continue to monitor your own thoughts and feelings, especially during these transitions periods, as you continue to engage in new experiences that are likely outside of your comfort zone.
Stage 5 - The Interdependent Stage
The Interdependent Stage is the parenting stage that probably keeps most parents up at night! It's the one that newly-diagnosed parents find themselves worrying about even though their child is still an infant because it's a MUCH bigger step towards independence, with less time spent with family and more time spent with friends.
This is the stage that all the previous stages prepare us and our child for. It's not uncommon for parents and teens to find that there are knowledge gaps that need to be filled before both feel confident in the teen's ability to stay safe. Especially if you've avoided allergic reactions for years, the seriousness of the allergy may be lost, so it may be time to do a deep review of all things allergy. After all, you not only need to learn to trust your teen, but your teen also needs to work towards earning your trust by showing they can be responsible and trusted!
If you've noticed similar feelings to ones you experienced when your child was a toddler, don't be surprised, as the teen years can trigger intensity. Prepare for power struggles and not seeing eye-to-eye, which only increases parental anxiety and fear. But being willing to listen to their input and ideas will help immensely! Open and calm communication, shared decision-making, and a team approach to problem-solving are your greatest tools during this stage.
If you and your teen just can't get on the same page (or even in the same book) about allergy safety, consider getting your allergist involved. Parental emotions, as well-intentioned as they are, can complicate things, so take yourself out of the equation momentarily by setting up an appointment for your teen and their allergist. It may be helpful for them to have a candid talk where your allergist can share information that may help your teen change their perspective.
It's also helpful to take a step back in this stage and assess what other skills they may need to learn to help them bridge to the next stage: young adulthood as an allergic individual. Do they know their medical history? Have they learned how to speak up at doctor's appointments? Have they taught their closest friends how to use their epinephrine autoinjector in case of emergencies?
When our anxiety and worry spikes in this stage (as it likely will), ask yourself: WHAT DOES IT WANT ME TO KNOW? Sure, it may remind you about risks, but it may also be helping to guide you towards focusing on ways you can positively impact outcomes, such as identifying other helpful skills to teach your teen.
And just like with previous stages, monitoring your own anxiety levels and mental health is crucial. Without doing so, our ability to remember our bigger parenting goals decreases and the likelihood to get thrown off course grows.
[If your teen is doing oral immunotherapy (OIT) during this stage, you may find Exploring Food Allergy Families podcast episode 8 helpful, as two allergy-informed therapists explore power struggles and decision-making with OIT].
Stage 6 - The Departure Stage
The Departure Stage is the final stage of our allergy parenting journey, as this is when our young adult child fully transitions out on their own. This stage IS the bigger picture we've been working so hard to reach, and our hope is that we've taught our child the skills and provided them the tools necessary to live confidently with their allergic condition!
Our parenting job doesn't end here, but the level of our involvement in their allergy management changes. Therefore, this is your time to reflect and process the parenting journey, which may not have been the journey you envisioned while back in stage 1, but hopefully is still one you feel proud and honored to have traveled.
And there's always a new generation of allergy parents welcoming your guidance!
My hope is that The 6 Stages of Parenting framework helps guide allergy parents through each stage of their child's development, but with guidance to enable them to keep the bigger picture/bigger parenting goals in mind. By doing so, it becomes an anchor to help parents assess their progress, their pace, and their own anxiety, overwhelm, and stress levels.
It may also feel reassuring to know that so many allergy parents have stated that they feel that their ability to develop allergy confidence has been hindered by the pandemic. Those that were newly diagnosed during or just before the start of the pandemic haven't been able to practice allergy skills as freely, and therefore, may be addressing these tasks in different stages than initially expected! This is also true of allergy parents and allergic individuals in other stages, especially in the preteen/teen years. All of this delay does have an impact on how we feel about navigating life with allergies. So make note of this as you continue to try new experiences now - and remind yourself that the more we practice safely being outside of our comfort zone, the more confidence we can build!
Remember, support is out there if you need it! Don't forget to check out the Food Allergy Counselor Directory, the Exploring Food Allergy Families podcast, the Food Allergy Behavioral Health Resource section, and the allergy-specific therapeutic worksheets. And if you're an allergy-informed therapy provider, then visit the Provider page!
----> And don't forget to sign up to receive helpful allergy psychosocial tips and updates via email! Subscribers also get the free "Allergy Anxiety and Overwhelm Mini Guide".
I look forward to hearing your thoughts on the 6 Stages of Allergy Parenting!
*This post is one of the 2022 "Pre-Food Allergy Awareness Week" posts. Stay tuned for more this week, including another allergy life skill and an in-depth look at "The 6 Stages of Allergy Parenting" framework.
Follow the FAC on Instagram (@FoodAllergyCounselor), Facebook (www.Facebook.com/FoodAllergyCounselor) and Twitter (@FACounselor) for more valuable information and posts!
Living with allergies means experiencing emotional discomfort, since uncomfortable feelings such as anxiety, worry, sadness, anger, and overwhelm can pop up at any time.
But our mind doesn't like discomfort or anything that creates it, such as unpredictability, uncertainty, anything that isn't very clear cut, and sensations that mimic allergic reactions. It feels icky, hard and sometimes even impossible to get through these discomforts. And since our mind wants predictability and certainty to help it feel calmer and safer, it encourages us to make choices that lead us towards that calm - which typically means our mind pushes us to avoid the situation that created the uncomfortable feelings.
While it may seem easier (and safer) to always avoid situations that make us feel this way, if we do, then we limit our ability to develop confidence while living with allergies.
So then, this next statement may stir up those uncomfortable feelings for you:
UNFORTUNATELY, WE HAVE TO STEP OUTSIDE OF OUR COMFORT ZONE TO GROW OUR ALLERGY CONFIDENCE.
Simply put, if we avoid every opportunity to practice allergy management skills because it's outside of our comfort zone, then it limits our ability to expand that comfort zone and eventually learn how to live confidently with allergies.
Sure, you still have the choice to avoid uncomfortable scenarios, BUT, if that is the main tool you use to get through the discomfort, then you're limiting your ability to live a fully engaged life even WITH allergies.
So then, how do we learn to step outside of our comfort zone when so many situations feel so unsafe when managing allergies?
We need to identify strategies and tool that help us work through the uncomfortable feelings and sensations we experience in order to get to the other side - confidently living with our allergy. (Stay tuned for another skill coming this week to help when we do decide to step outside of this comfort zone).
The list of strategies and tools that will help us work THROUGH the discomfort (rather than letting it STOP us) may include:
And here's a NEW tool to put in your toolkit!
The G-R-O-W Technique is a mindfulness-based skill to help you notice the discomfort, understand it, and move forward even with it being there. (It can be adapted and taught to kids, too!)
G: GIVE the feeling or sensation a name. You can simply name the emotion, or get more creative, giving it an actual name like "Mr. Worry". This allows you some distance between you and the feeling and/or sensation. This is what helps us pause so we can CHOOSE our actions and don't have to automatically do what the feeling or sensations says you should do.
R: REVIEW why the feeling or sensation might be there. Get really curious - what does this feeling want you to know? Are you trying something new? Do you need more information on a topic? Are you doing something important, but scary? We typically jump to assumptions and worst-case-scenarios conclusions. We may assume something is too risky based on our feeling, so it’s important to identify other reasons something may feel uncomfortable to do.
O: OBSERVE how it feels in your mind and body. Get to know how your mind and body reacts to this feeling or sensation. Does your stomach feel upset? Is your mind racing? Become familiar with how it feels when this emotion is present so you can tell the difference between anxiety and reaction sensations, and how it feels when you're doing something new versus doing something unsafe.
W: WAYS to move forward with discomfort. This means mapping out workable solutions. What do you need to help you try this new situation or move forward rather than automatically avoid it?
I'll leave you with this last piece of encouragement:
Make the commitment to yourself that learning how to grow through discomfort and get off the allergy anxiety/overwhelm autopilot mode is important enough for you to do, even when it feels incredibly hard to. Sometimes that all you need to do to get yourself on that journey, and it's a great place to start!
Yes, it takes time and practice, but you WILL learn how strong you are...even if you don't always feel that strength.
Food Allergy Awareness Week (FAAW) 2021 may be over, but the education and advocacy efforts won't stop! Together, we will continue to educate the general public and work to make a difference in the lives of those managing food allergies and allergic conditions.
As part of this community, here is my ongoing commitment to this effort:
I commit to continuing to be a change maker regarding food allergy mental health - having the conversations, building the relationships, identifying the gaps and then helping to fill them!
In the meantime, if you've missed any of the 2021 FAAW tips offered this week, you can review them all below, including the additional guidance offered for each one.
DAY 1 - Sunday, May 9th, 2021:
In honor of all of you amazing allergy moms, and the first day of Food Allergy Awareness Week (FAAW), here are the results from the 1st question on the "2020 Food Allergy Mom Experience Survey". What do you think of these results? Why do you think 57% of moms surveyed felt allergy moms don't speak up about their experiences enough? (Full anonymous survey answers will be shared in an upcoming blog post).
Check out Exploring Food Allergy Families podcast episode 15 for full results from the moms' survey. Find it on the Podcast page or on any podcast app - Apple Podcast, Spotify, iHeartRadio, etc
DAY 2 - Monday, May 10th, 2021:
Today's FAAW tip is focused on reframing anxious allergy thoughts. Let's start with some helpful reminders about anxiety:
You can find the following worksheets (and more) to help manage allergy anxiety and worry in the "Worksheets" section:
DAY 3 - Tuesday, May 11th, 2021:
Today's FAAW tip is all about the urge to control when we feel overwhelmed, anxious or fearful of allergies. This is usually triggered by the unpredictability and uncertainty that comes along with food allergy life.
Wouldn't it be ideal if we could always control every risk possible? Unfortunately, that's not a realistic goal, nor is it actually helpful! While trying to control things may decrease the discomfort you feel from the worry, it's a temporary relief which usually leads to increased and growing anxiety over time. More and more energy goes into trying to stay ahead of everything, and when that gets too hard, avoiding people, places and things will start happening. Trying to control also robs you of opportunities to learn and grow - to focus on figuring out what you need to confidently get through tough situations (or thoughts/feelings).
Rather than AIMING TO CONTROL, think about HAVING INFLUENCE OR IMPACT on situations, especially daunting ones.
COMMUNITY CHALLENGE: The image below is just an example to help you process your own list for yourself, or if you're a parent, for your child. Grab a sheet of paper, draw the image below, and have fun exploring just how much impact you have on your ability to decrease anxiety and increase confidence!
COMMUNITY INPUT: What else would you add to this list, in either section?
FAAW BONUS - New "Urge to Control" worksheet, which can be found in the Worksheets section on this website:
DAY 4 - Wednesday, May 12th, 2021:
Wednesday's FAAW tip focuses on your food allergy mindset, because it matters!
Ask yourself these questions to help assess your allergy mindset:
These questions relate to your mindset, or whether you believe the qualities you possess make you capable of handling situations. People can have a "fixed" or "growth" mindset. Think of these as the type of glasses you're wearing - the lenses with which you see things. When wearing "fixed mindset" glasses, you're more likely to believe that you're not able to deal with whatever you're being faced with. With "growth mindset" glasses on, you're better able to envision yourself getting through roadblocks that are standing in your way.
Our mindset may change depending on situations we're in or experiences we've previously had. You may feel confident navigating some parts of life with food allergies, while feeling incapable of managing the aspects that you're most fearful of. But by subscribing to a growth mindset, you're allowing yourself the ability to grow confidence, manage anxiety, and essentially handle even the hardest of situations.
Community Challenge: Pick one allergy-related thought to try and reframe into a growth mindset-focused thought. If you're a parent, help your child use growth-mindset language - "I'm not comfortable with this, YET!" or "I'm still learning by practicing with my epi!"
To help practice this concept, you can download the "FA Mindset Matters" worksheet from the Worksheets section. To read more about growth mindset, look up Carol Dweck and her books.
DAY 5 - Thursday, May 13th, 2021:
Thursday's FAAW tip offers a problem-solving method that's helpful for when the fear and anxiety feel overwhelming.
When you need to make a decision but your emotions are taking over, having a problem-solving tool to help navigate the scenario can be beneficial. That's where the I.D.E.A.L. Method comes in! This technique helps define the main problem in a situation, and guides you through creating and evaluating solutions. Essentially, it helps you look at things more objectively.
Benefits of the I.D.E.A.L. Method:
Community Challenge: Choose something you feel stuck navigating lately and use the I.D.E.A.L Method steps to help you feel less stuck and better able to consider potential solutions.
The "I.D.E.A.L. Method " worksheet can be downloaded from the Worksheets section.
DAY 6 - Friday, May 14th, 2021:
Friday's FAAW tip has to do with processing the emotions associated with yours or your child's food allergy diagnosis. Avoiding allergens is helpful, but avoiding emotions isn't!
Of course you can recall the feelings you felt the day you learned about the food allergy, but have you connected with the stories that came out of it? When we experience something as emotional as a life-changing diagnosis, there's often a narrative that our mind attaches to - sometimes so quickly that we don't even notice it. It just sort of sneaks in and we don't take time to acknowledge it, let alone process it.
In the case of food allergies, we immediately jump into action - doing, learning, avoiding, protecting. We may process the surface thoughts and feelings, but the deeper emotions and stories likely stay put because there's no time or energy for that work. But what happens when we don't make the time to process them? They find ways to come back up, especially when we feel vulnerable, such as after another reaction or during a life transition that leads to increased emotions again. And those stories we told ourselves about the early experiences with food allergies have the ability to impact our allergy mindset - changing how we manage it all in the future.
Yes, it's uncomfortable to revisit that time in our minds, but it can help unhook you from unhelpful narratives that may keep you from moving forward in the way you want to on this allergy journey, especially if those narratives are focused on blame, guilt, and self-judgement. This image shows some of the emotions and diagnosis narratives that may be experienced. This isn't an exhaustive list, so use it as a starting point to help you identify your own. Use self-compassion and kindness with yourself as you process these, just as you'd offer a friend. Notice if you're still holding onto anything internally that's keeping you stuck, pushing you around or derailing you from being the allergic person or parent you want to be.
If you feel you need the support of processing this with a licensed therapist, you can find an allergy-informed one via the Food Allergy Counselor Directory.
DAY 7 - Saturday, May 15th, 2021:
Saturday's FAAW tip offers a post-reaction compass to help rebuild confidence and decrease anxiety after anaphylaxis through the T.R.A.C.E. approach.
It's very common to feel like a reaction, anaphylactic or not, has set you back emotionally and decreased willingness to live fully due to fear of another reaction. This is a normal response to a traumatic situation, so allowing yourself to honor those thoughts and feelings is a part of the healing process. But once the initial overwhelm from the reaction settles a bit, it's important to create your game plan to build your confidence again. Without this step, you risk staying stuck, hooked by fear and catastrophizing thoughts that keep you unable to truly move forward in a way that benefits yourself and/or your child.
T.R.A.C.E. is an easy way to remember the key components of this rebuilding process. It takes time to rebuild trust, getting back to a routine, reviewing with your allergist, practicing tons of compassion, and educating yourself on anxiety and to fill the knowledge gaps.
Community Conversation - what has helped you and/or your child move forward after a reaction?
You can find a free downloadable worksheet version of T.R.A.C.E. in the Worksheets section.
I hope you were able to share or learn new things this Food Allergy Awareness Week. I'd love to hear from you - what were some of the best tips
you learned or share this week?
Follow FAC on Twitter or Instagram, or on Facebook on the Food Allergy Counselor Directory page to get updates on the FAC Directory, blog or resources. And connect with FAC creator Tamara on Twitter or Instagram!
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