Ep. 286: Food Allergy Anxiety and Comfort Kits for Children

Let’s talk about something so many families quietly carry—food allergy anxiety. For kids and caregivers, everyday moments like mealtimes, food challenges, or even medical appointments can feel overwhelming. So where do you even begin to ease that fear?

We often hear about the mind-body connection—but can it really help with the very real, very specific anxieties that come with managing food allergies?

To help guide us, we’re sitting down with licensed clinical psychologist Dr. Lisa Lombard to explore these challenges and introduce a practical tool she created to support families—the Comfort Kits for Children.

Resources to keep you in the know:

• Comfort Kits for Children Website
• Lisa Lombard, PhD

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Transcript

Caroline: Welcome to FAACT's Roundtable, a podcast dedicated to navigating life with food allergies across the lifespan. Presented in a welcoming format with interviews and open discussions,

each episode will explore a specific topic, leaving you with the facts to know or use.

Information presented via this podcast is educational and not intended to provide individual medical advice.

Please consult with your personal board-certified allergist or healthcare providers for advice specific to your situation.

Caroline: Hi everyone, I'm Caroline Moassessi and I am your host for the FAACT Roundtable podcast.

I am a food allergy parent and advocate and the founder of the Grateful Foodie Blog. And I am FAACT's Vice President of Community Relations.

Before we start today, I just want to say thank you to DBV Technologies for being a kind and generous sponsor of FAACT's roundtable podcast.

Caroline: Let's talk about something so many families quietly carry. Food allergy anxiety. For kids and caregivers, everyday moments like mealtimes, food challenges, or even medical appointments can feel overwhelming. So where do you even begin?

Again, to ease that fear, we often hear about the mind body connection.

But can it really help with the very real, very specific anxieties that come with managing food allergies? To help guide us, we're sitting down with licensed clinical psychologist Dr. Lisa Lombard to explore these challenges and introduce a practical tool she created to support families, the comfort kits for children.

Welcome back, Lisa, to FAACT's Roundtable Podcast. We always enjoy having you here because we learn so much and it's always very practical and very important.

So thank you for being here. I know you're super busy.

Dr. Lombard: Oh well, thank you for inviting me to join you today and for your ongoing interest and support in what I'm doing. But more importantly, what helps families with

Caroline: food allergies, you know, and that's all of our goals. So thank you.

And before we dive in today, Lisa, can you share a little bit about your background and then what drew you to focus on food allergy management and anxiety?

Dr. Lombard: Absolutely. Thank you. Yes. So I am a clinical psychologist based in the Chicago area and I have been providing psychological care to children and families and adults for some 30 plus years.

So I've been doing a lot and I largely work at the intersection of mental health and psychological well being and chronic health conditions and the anxiety that comes along with medical treatment and so on.

And as I have been doing that about a dozen years ago now, it was becoming very obvious when I was working largely in a school setting in addition to my private practice that a substantial minority of the kids who I was seeing, because there was some Anxiety that was interfering with their daily life.

There was also the presence of food allergies. Either they had food allergies or siblings had food allergies.

And it struck me that food allergy is a really interesting,

almost invisible health condition,

that many of the principles and clinical techniques that we know work with individuals with anxiety could be tailored and tweaked to work with food allergies, which has some unique wrinkles to it in the sense that there are reasons that people are anxious,

and some anxiety is useful and adaptive. But too much anxiety, as you know,

really interferes and disrupts children's lives and families lives.

So I started looking around into the food allergy world and also knowing it's so closely related to the central nervous system with stress and immunology and inflammation. And it just brought things together for me.

And I have an ongoing interest in those areas in helping people.

Caroline: So we appreciate that you chose us because there is this balance we need. You know, like, I'm a parent of children with food allergies, and I needed to teach them to be careful and to be alert.

But then where was that balance of anxiety? Where maybe I was instilling anxiety or I was not helping him with this. And so that's why this is such an important topic.

Because as a parent,

you really sometimes just don't know where's the balance of teaching safety versus going a little too much and moving into an area that we don't want to go into right now.

Dr. Lombard: You bring up a couple of really important points, and I appreciate your drawing upon your own experience. It is about balance. And, you know,

we know a lot about food allergy, avoidance of foods, and that was what was basically prescribed for dozens of years.

It's only now that there's many more types of interventions and treatments that are present. But the idea of avoiding your allergen is exactly a recipe for anxiety. It's like if we had swapped out allergen and put avoid the dogs, avoid airplane rides, right?

Avoid something that makes us somewhat worried or anxious in certain situations. And so it was being prescribed without any guardrails of how to do this,

how to manage it in a way that is more balanced and appropriate for different children at different developmental points in their lives. And so research shows, okay, there are certain points where families and parents have more anxiety when the child's going off to school for the first time and gonna be managing their own lunches in the lunchroom,

or when we're talking about middle school children and kids who get invol in Team sports and travel with their teams or teens who are now going off to college and are more independent and when there's dating and intimacy.

So we know what the points of difficulty are and we should be doing something to introduce coping strategies in those moments. And that's really what moves me to create more and more interventions and preventative types of activities for kids and families with food allergies.

Caroline: It's all about the solutions. And as you're speaking to me, I'm like, ugh. My heart just warms. It's like, yay, solutions and support.

So now let's take a look closer at what kids might be feeling. What kinds of fears or anxieties do children with food allergies often experience in their just day to day living?

Dr. Lombard: You know, so it's interesting because there is a range, right? There are some kids who are under reactive to it all and that of course causes some concern in parents, but you know, who are really not attending to the fact that they have a food allergy and might have to ask certain questions.

And then there are those who overattend and who are hypervigilant, right? But on the whole, social situations with food are going to be one of these friction points where kids have some anxiety.

It's hard for the young child to ask a grownup who brought treats into the classroom,

what did you put in those? Right? Like, does this have my food allergen? That's a skill that just needs to be practiced and taught in a kind and gentle way because it's really kind of outside the typical behaviors of what we expect kids to do.

So for the very young child, they're going to need some coaching or some practice, some role playing.

Kids who are at the developmental point where they want to fit into their peer group,

they don't want to be different and yet they have to be different related to asking the right questions or saying, no, I can't go to that restaurant or I can't share that lunch with you or that snack or piece of pizza or whatever it is.

So they are somewhat different and they have to be able to tolerate that discomfort that comes with being different when they're at a developmental point where social groups are so very important.

Times when kids are falling asleep, we know that worries and what if questions bubble up. So that might be a point in the day that is really tough so that there are sleep disturbances or interruptions and takes a long time to fall asleep or they need to have some close proximity to a parent to feel safe and comfortable and that could be outside what we expect for that age range.

Right. We all know kids go through that at different points. But when it's a 13 year old who needs some real extra TLC around falling asleep, we should start to help to boost their independence and sense of confidence about doing something which is perfectly normal and helpful and restorative to get the right sleep.

So I think anxiety comes along in a lot of ways like this.

Checking behaviors, that hypervigilance. I just ate something, is it okay? It might be a verbal checking with other people or it could be a silent, quiet checking of going to the washroom, repeatedly looking in the mirror to see if there's any sign of some sort of reaction, an irritation around the mouth or redness or puffiness.

Right. Or scratchy throat. They start to check and their behaviors become really hyper focused on the possibility of a reaction.

And so I've worked with individuals where, where that's another way anxiety might present itself.

Caroline: And it's interesting you bring up sleep because I think we all forget about sleep.

Dr. Lombard: Yeah.

Caroline: I mean, that is kind of the magic hour as an adult, you know, when you wake up at three in the morning or four in the morning,

you know, anxious about something or forgetting something or worried you're gonna for.

But honestly, I think we overlook that in our children and in the pediatric.

Dr. Lombard: It is so true, right? Yes. And we're learning more and more about sleep being just really fundamental way to stay healthy.

Caroline: Absolutely. And so now just turning to the caregivers, what are they feeling like? So now you've given us some insight on the child, but what about the caregiver?

Dr. Lombard: Yeah, superb question.

You know, so caregivers are, they're first, I want to say they're doing the best they can in a difficult situation.

And yet,

you know, things come up which are out of the ordinary. And so they really have to juggle two sets of requirements. The ordinary everyday situation and how to make that as smooth as possible.

They're worried about the food at lunch and how to pack the right snacks and so on and so forth, how to talk to the school teacher, how to keep the child safe in school, which is where children's jobs are for the bulk of the day.

But then there are the out of the ordinary situations. It could be a family holiday meal or going to a wedding or an event or a community fair or festival.

And they know that. Or a ball game. Right. They know that they're going to have to navigate the world of food and they feel a rise in anxiety and stress because of that and if, if there is a food allergy reaction or anaphylaxis, parents feel a sense of responsibility that they didn't manage everything perfectly.

But as we know, there is no such thing as the perfect. And so that goes back to doing the best you can, asking the right questions, checking information and labels,

bringing your own food if necessary, and figuring out a way to do that so that your child stays included rather than feels excluded from things.

Those are just extra mental and cognitive tasks that parents are doing in addition to all of the other parenting that they're doing.

Caroline: The other day I was interviewing a physician, a pediatric allergist, and he had commented about perfect. And he's like, we don't want perfect, we just want trying.

And I just, that just struck me. I'm like, oh my goodness, what a great concept. And he's like, yeah. He goes, perfection isn't real. It isn't there. I just want.

Dr. Lombard: No, it isn't.

Caroline: Parents who are just trying to. That everyone's just trying.

So now that we have a better sense of what kids might be feeling, you know, and the caregivers too, and what triggers those moments,

how can we gently step in then to support them? What are some ways parents and caregivers can help their child feel safer and more confident?

Dr. Lombard: Yeah, I think that again, it goes back to what you had mentioned about balance.

So we want to listen to the child's concern.

Right. But not necessarily jump in and confirm that the worst case scenario is about to happen. But we do want to listen. So it might be asking open ended questions.

Can you tell me a little bit more about that or. Oh, that sounds really hard. Right. Some reflective listening.

I can understand that you feel upset or I understand you feel worried about this or I understand you feel scared.

And then it's the pivot to we're in this together to problem solve and help you feel better. A parent can't undo or erase at this point in a snap of the fingers, a food allergy.

But there are ways to make a kind of a collaborative plan with the child. Assuming the child is a little bit older of how are we going to handle this?

And be thankful that the child is sharing some of those difficult emotions,

but help to contain them. Right. Put some emotional boundaries around them and say, yeah, it really is hard. And that's also where for parents, if they can manage their anxiety and co regulate with their child and have a place where they can later talk about it, a partner who can help them or talk with someone or be part of a group and have some support,

they can be more present for their child so that they can tolerate the anxiety and worry and say yep, this is a hard one,

let's figure it out. As opposed to oh my gosh, right. And really flailing around because kids are sponges and they absorb the parents levels of emotional arousal and we do need to be aware of that.

Caroline: So you just mentioned co regulate. So as a parent,

how do you recommend or suggest we find the tools to learn how to co regulate? Because I definitely know, speaking from experience, I could go to 0 to 60 in a blink.

And so I did have to reach out to some therapy and professional help to learn those skills. But what do you suggest?

Dr. Lombard: I love that, that you had the awareness to do that. And so some of it, I think that's the first place is that awareness. Do I go from zero to 60?

Am I easily feeling overwhelmed? There are some kind of casual at home things to do or it runs the spectrum of getting involved in therapy to learn some coping skills.

And you know, it's all very valid, but certainly taking care of yourself, it's a cliche, but putting your own oxygen mask on first is quite important.

So for parents and caregivers it is getting the right amount of sleep back to that which we were talking about. Adults need their restorative sleep as well. Eating healthy foods, exercising, movement, being outdoors in nature, finding ways to really tap into some of the healing components of the natural world,

or music or art,

some distractions like reading and being able to dive into things that take you out of your own worries for a bit. And one of the simplest though is breathing. Regulated breathing.

I can't say enough about that because it's really the gateway to many of these other activities being effective, taking a few breaths,

slowing down your central nervous system and re regulating before you tackle this situation with your child.

Caroline: These are stellar tips that we can all just jump right into. So thank you for those.

This just feels like the perfect moment to introduce and discuss your comfort kits for children. So can you walk us through what they are,

how they work, and then why they can be such a meaningful support tool not only for the kids, but also the caregivers just navigating this food allergy anxiety.

Dr. Lombard: Absolutely.

So Comfort Kits for children are a collection of some simple toys and instructions that provide mind body comfort activities for children. And they have been used and clinically designed some 30 to 40 years ago by pediatricians and psychologists.

When kids are experiencing traumatic events like natural disasters or medical treatment or other kinds of sudden losses and over Time. The same practices have become almost standard in many settings.

When we know children are going through medical procedures and treatment, showing up at the doctors even for things that are obviously really important and typical. But routine care that involves inoculations, or in the world of food allergy management,

going in and getting any testing done, or oral food challenges, or dosing with oral immunotherapy, those are all things that raise a kid's sense of anxiety when they're going through this.

So I have been very committed to translating what comfort kits for children in other traumatic and difficult situations, how it helps them to help kids with food allergies. So in A K,

there are six sets of instructions for different types of activities to help kids manage the big feelings and reregulate. And those are really helpful,

particularly at non emergency situations, because what we're doing is helping kids get familiar with calming themselves and creating comfort so that when a big situation comes along, it's much easier to again access that comfort, to change their physiological experience as well as how they cognitively assess the situation.

Right? It's less of a catastrophic doomsday situation when their body is calmer, when the relaxation response is on,

then more of their problem solving brain can deal with the problem. But when the body is not calm,

right, when they're very stressed, when they're out of it control, if you will,

you cannot ask that child to solve the problem like why don't we sit down and work it through, right? They have to be calm first. So these coping skills, which range from some little finger puppets so that kids can enact dramatically to the situation and play it out,

to a small bottle of soap bubbles to practice the slow breaths that are necessary and which are really good diaphragmatic breathing or belly breathing. So it's a nice toy that helps them do that rather than let's do our breathing alone, you could use a pinwheel in the same manner.

A nice slow, steady breath can make a pinwheel spin.

But if it's big choppy breathing, that's not gonna make the pinwheel spin. And so kids can learn the difference between slow belly breathing and aroused short breaths. There are also instructions for some absorbing them in an imaginative experience where they might remember feeling really safe and calm and enhancing that by asking,

the caregiver can ask all of the questions such as, you know, I wonder what you see while you're there on your special magic carpet. I wonder what you hear there, you know, and really heighten the sensations and the experience.

And kids become highly distracted by that and disconnected from the current problem.

And it helps to reregulate them because then they can do that again and again when there is another problem, they can remember what it feels like and know that they've had that mastery of it, which is quite important.

Caroline: This is brilliant. This is so exciting. As you're explaining this, I'm having, like, fomo. I'm like, gosh, I wish my kids weren't in their 20s.

Dr. Lombard: Well, even some of these things. I mean, as adults.

Caroline: Right.

Dr. Lombard: I do breathing all the time and give myself some of those moments, little short breaks. And I think the point is to do that repeatedly in short little bursts like that increments,

because the more we do it, the easier they get and we can again access them at difficult times.

So this is building up associations and skills, muscle memory, people could call it, so that you can use it over and over again throughout the course of life.

Caroline: Well, and it sounds like the kits need to be used preventatively. You know, you want to get a kit now and start working with it, like you said. So then when those moments happen,

you've built up that muscle memory, you've built up the skills.

You know, just like when you were saying, you know, bubbles and pinwheels, I'm like, oh, I would. I'm gonna go buy bubbles today.

And pinwheels. And I mean. Cause honestly, I think for anyone just reminding themselves, even just looking at it is going to make you go, oh, wait a minute, I'm gonna redo my breathing.

I'm come back, reconnect.

You know,

this is. This is amazing. How long did it take you to create these kits or to create the concept?

Dr. Lombard: Well, as I said, so that they have been created and kind of evolved so people use components of them. I have colleagues with whom I work who are always using components of these and.

And they really were established decades ago. There's an NGO that distributed them globally. And then in 2022,

I systematized it again and created this nonprofit comfort kits for children and made some modifications and updated the items in the kits. And what I've been working really hard on and intensively is reworking the instructions so that caregivers can use them with their children,

can get access.

There are videos of how to use them on our website. And I'm in the process of making audio record that I think will have a QR code. So if you have a kit with the QR code, you'd be able to hear the audio recording and your child could walk through how to use them as I said there are six standard activities.

And then in the comfort kits for children with food allergies, what I've done is I've really leveraged my familiarity with kids with food allergies and the research that I have been involved in in terms of quality of life and psychosocial components of food allergies and added more activities.

So there are new activities that go beyond the standard six that very tailored to kids with food allergies about how to remember brave moments of asking questions about the food or saying no thank you or being able to eat at a new restaurant after going through certain steps.

And so those have activities associated with them to track the progress and the successes and to elevate kids and families who are working really hard at managing the food allergy anxiety.

Caroline: This is so exciting. And thank you for explaining the kits and just helping us dive into anxiety in this whole topic.

And listeners, I will make sure you in the show notes I have the links so then you can specifically find that food allergy comfort kit and all the other information that Lisa has for us.

I'll make sure I've got the links in there. But Lysa, before we say goodbye today, is there anything else you want our listeners to hear from you?

Dr. Lombard: Thank you so much. Of course. And I do want to just underscore that my mission and long term goal is really to put these kinds of simple, everyday,

commonplace types of activities and ways of thinking about the connection between the mind and the body,

to put those into the hands of children and families. You don't have to go to a fancy class or to a whole course of therapy in order to to get hold of these mind body comfort activities.

We know that many work, if one doesn't work, try another. That's why there's more than one here in the kit. And I think it's just really important that people can get a sense of mastery and create the balance that they're looking for and know that they're doing it at a grassroots level.

Caroline: Thank you so much. And just again and again, this is so exciting. I love solutions. And especially this is the one part of food allergy management that's perplexing to all of us.

So we just don't know. And so it's very exciting to actually have a kit that we can turn to and bring out these items. And just again, the more tools the better.

So thank you so much Lisa, for your time and for again, all the work that you do in our community. You just make our world better. So thank you for everything.

Dr. Lombard: Oh,

thank you. Thank you so much for inviting me and hosting this and asking these questions. And your passion is contagious in such a good way that you, you make me and many others want to do do better for everyone.

So thanks Caroline.

Caroline: Well, thank you.

Caroline: Before we say goodbye today,

I just want to take a moment to say thank you to DBV Technologies one more time for being a kind and generous sponsor of FACT's roundtable podcast.

Caroline: Thank you for listening to FAACT's roundtable podcast.

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Have a great day and always be kind to one another.