​As a licensed professional counselor trained in family therapy, I am always curious about how various factors impact family systems. The family is like a mobile in which everyone plays a role in its stability. So it's no surprise that the balance can be thrown off by even the simplest of changes.

The addition of a food allergy into a family system often results in major changes that affect most members of the unit. There have been studies done about the impacts on quality of life for parents/caregivers who care for a child with a food allergy, such as SOAAR's research studies on these and related topics. However, I was curious specifically how non-food allergic siblings felt about having a sibling with food allergies.

​In order to gain some insight on this topic, I created an informal and anonymous survey* with these seven questions (listed with results below), which was completed by 25 participants: ​
(Parents were allowed to complete the survey on behalf of those too young to complete it themselves)

Conclusions and Thoughts....
Food allergies, as well as any chronic illnesses, are a family disease - it impacts each member of the family in different ways, both positively and negatively. Some sibling impacts were highlighted by this brief, informal survey.

• Emotions: Based on these survey results, showing 92% of the non-food allergy sibling participants worried for their allergic sibling, it's clear that non-allergic siblings have a variety of feelings about food allergies being part of their families, with worry being a primary one. It may not always be obvious how the non-allergic sibling feels, or perhaps they may not be able to verbally express their feelings. Therefore, it's important for parents to routinely check-in with the non-allergic sibling to assess their feelings and perceptions about food allergies and its impacts on the family. Normalizing these emotions (particularly the ones perceived as "negative"), such as sadness, worry, or even frustration, can be reassuring and help them understand that it's okay to feel that way -- that they're entitled to their personal feelings and it doesn't mean they don't care for their sibling when they feel that way. Siblings may need guidance on understanding how their role can be a positive, empowering one, especially if they're feeling worried or upset. Reminding them that they're an important part of the team and not just on the sidelines of the illness may provide a new outlook that helps them reframe some of these feelings.
• Attention: I was particularly curious whether non-allergic siblings perceived that they were focused on less than their allergic sibling. Given that just over half of the siblings (54%) denied feeling they got less attention, it suggests that many feel they get a comparable amount of attention as their food allergic sibling does. With that said, it didn't surprise me that 27.3% sometimes felt they got less attention and 18.2% confirmed feeling that they perceived not having a food allergy equaled less attention on them. Parents of children with food allergies spend a lot of time focused on safety preparations, which might translate to some non-allergic siblings as an abundance of attention being given to their allergic sibling, therefore leaving less time for them. Some kids may make this known, while others may keep it to themselves, so it's important to have this on the radar. Be mindful of finding time devoted to focusing on the non-allergic child.  It can also be helpful to include the non-allergic sibling in food allergy preparations so that it feels like the family as a whole gives attention to navigating the food allergy and not just to the allergic child. 
  
  

Every family is different, so family roles, relationships, and outlooks will vary. But this small, informal survey helped me gain more insight to be able to share with others about the emotional impacts and effects on the non-allergic sibling, which isn't always an area of focus. What are your thoughts on these results - do they seem in line with your family experience? (Curious how dads feel about allergy parenting? Check out this larger informal dad survey and the very honest results dads shared!)

Read More On This Topic: 

• Siblings of Children with Chronic Illnesses or Disabilities  (HealthyChildren.org, 2015)
• Siblings of Children with a Chronic Illness: A Meta-Analysis (Journal of Pediatric Psychology, 2002)

​

It's hard when friends don't understand or follow your family's food allergy rules, but it's even harder (and more disappointing) when your own family members don't get it. Unfortunately, it's a frequent topic in food allergy social support groups, so it seems to be a common scenario.

Whether the rule-breakers are your in-laws or extended family members, navigating this scenario can be tricky.

​Here are a few suggestions to help you deal with these down-right frustrating dilemmas:  

1. Be A United Front - Before either of you approaches the non-compliant family member, create a plan and confirm that you're on the same page. Discuss your family's food allergy rules that are being broken, what acceptable solutions you'll suggest, and confirm that you're both committed to following through with any negative outcomes that may result from the conversation (i.e. family member gets upset; visits need to be limited or stopped, etc). If you don't agree on those points, you should hold off on talking with the family member until you discuss things further and come to an agreement. Otherwise, you run the risk of the family member "splitting" you two on the topic (which would likely result in arguments).  
   
   
2. Speaker of the House - So who should approach the rule-breaking family member? If it's one of your parents or in-laws that is the culprit, then ideally, it should be the spouse whose parent isn't following the guidelines who should address it. It’s perfectly fine to address the person together, but each of you likely know your parents best, so take the lead if it's your parent who is the offender. If it's an extended family member, such as an aunt or cousin, decide which approach feels best, which may depend on the relationship you have with that person. If it's decided that it may be best for you or your significant other to go it alone, agree to emphasize that you're absolutely in agreement on this topic. ​
   
   
3. Prepare Facts & Solutions - Start the conversation off by reviewing your food allergy guidelines and why they're important. Share facts and examples of possible negative outcomes if such rules aren't followed. Then move on to potential solutions. As hard as it may be, try to remain as calm and focused as possible. If the conversation becomes too heated or arguing ensues, it may be best to pause and revisit it another time. If the family member isn't willing to comply with your family's food allergy rules, then it's highly unlikely that he/she would have potential solutions figured out. Therefore, it's up to you to have a list created. Here are some potential solutions to consider: 

• If your house has a “no-outside food” policy, stay firm with that rule. Kindly inform them that if they bring any food over, they won’t be able to eat/share that item at your house, and you will need to send them home with it. If you allow outside foods, share a list of safe items/brands to choose from, as that will still given them some freedom with foods. 
• If they want to bring homemade foods, you can alternatively encourage them to prepare the food item at your house (with approved ingredients and allergen-friendly edits to the recipe, of course). They may enjoy bringing their favorite recipes to prepare with your kids in your kitchen (bonus - no dishes cluttering their kitchen)!  
• If they insist on bringing something when they visit, suggest that they bring a non-food item, such as beverages, an activity/game, or a project to work on - something non-food focused. Alternatively, you could suggest meeting at places where foods aren't needed or aren't the focus, such as parks, stores, or libraries.
  
  

* Holidays/Family Gatherings - When the food allergy rules are an issue during holidays/family gatherings, your approach may need to be different. If you're hosting, then you can apply the suggestions above - you make the rules at your house. However, if someone else is hosting, it's typically not cut-and-dry. Ideally, all family members would stick to the food allergy guidelines, even at other houses. But be prepared that may not be the case. If you've determined that you're not comfortable being around your allergens, which will be present at large gatherings, and you have to miss out due to safety concerns, then get creative. Maybe you could stop by after the meal is over, just in time for a family game? Or perhaps your house is nearby, so consider inviting family to stop by afterwards for a visit. If there are no solutions for seeing family on holidays, you'll likely need to consider other options to visit with family members at a later date and different location. (And yes, there will be hurt feelings associated with that outcome). 

The reality is that no matter how it’s handled, discussing this topic with non-compliant family members may cause ripples, as well as overwhelming feelings, which you'll need to work through. But ultimately, you have to do what’s best for your family. In doing so, not only are you putting your child's safety first, you're also modeling how to navigate tough scenarios, even if the outcome isn't ideal. (Comment below with what solutions have worked for your family in these situations. Your suggestions may help a fellow family with food allergies!)

Additional Articles Related to This Topic: 

• How Healthy Couples Deal With Their In-Laws (PsychCentral.com)
• 7 Strategies to Deal With Difficult Family Members (PsychologyToday.com)