International Travel with Severe Food Allergies

A Parent’s Guide to Staying Safe, Sane, and Soaking up the Spectacular

We’ve hesitated to travel internationally for years due to my daughter’s severe anaphylactic food allergies to wheat, barley, and rye. Even cross-contact with her allergens can require epinephrine and a trip to the hospital.

We worried that the challenge of assuring safe meals would be too stressful or would monopolize too much time to fully explore and enjoy the location. But the allure was to great!

We finally worked up the courage this summer and had an amazing international trip!

Expectations: Keeping it Real

I’m not going to lie. It was not a carefree, taste your way through the country and pop into any café you choose kind of trip (which is how I formerly rolled:). International travel with severe food allergies involves constant logistics. But isn’t that part of all travel?

Set your expectations. Traveling with food allergies requires a lot of extra work and a less food-focused trip. No foodie tours or market stall tastings, and much to sibling’s disappointment, no dining in the museum cafés (or most restaurants, for that matter).

But OUR TRIP WAS AWESOME. And we will travel internationally again every chance we get!

In this article, I’ll share how we planned, packed, and enjoyed beautiful local meals throughout our international travels. I hope our story can help pave the way for you!

Destination: Choose a City with Allergy Options

We had already chosen our destinations and had been looking forward to planning a trip to Paris and Scotland for years to visit friends.

If you haven’t chosen a destination, Google Maps is your new BFF. Search for GF (dairy free, egg free, etc) bakeries and restaurants in any city. If the map lights up with options, set your sights! If not, you may want to look elsewhere or plan to prepare every meal at home.

As I planned our Paris portion of our trip, I scoured the internet for safe gluten-free restaurants and bakeries. What we found is that there are plentiful gluten-free and allergy-friendly options in traditional cafés, bistros, and patisseries in Paris.

However, because of the severity of my child’s allergy, we only considered 100% gluten-free restaurants and bakeries. I contacted each one we planned to visit via email to ensure their safety. We didn’t make it to every one I wanted, but our bellies were full.

These are few and far between, but the risk and consequences of cross-contact was simply too great for us.

**If you use an allergy travel site for information, you should still contact the restaurant personally to verify that they are still in business and still allergy safe for your family. We learned our lesson the hard way on our last domestic trip!

Accommodations: Kitchen + Close to Safe Food

• KITCHEN: For stays more than one night, I always recommend reserving a place with a kitchenette or kitchen. That way you’ll have easy access to a refrigerator, cooktop, and likely a microwave.

• SAFE BAKERY: We chose our accommodations based on proximity to a food market and a 100% Gluten-Free bakery (Copains), only a four-minute walk away.

This way we could easily pop over for pastries each morning on our way to see the sights or buy a GF sandwich to pack for lunch. This is something I can’t even do in my own city, so it was such a pleasure!

Side note, watching my daughter eat her first GF chocolate croissant EVER was magical and emotional and worth every penny of our trip. I know you allergy parents understand:)

• CLOSE to MARKET: Staying near a market made for easy stops for gluten-free picnic items or food to prepare at our apartment at the end of the day. Small grocers like Carrefour and Monoprix are located in many Parisian neighborhoods. We often picked up cheese, salami, veggies, fruit, eggs, olives and made a feast at home.

I highly recommend choosing accommodations near a market and/or bakery or cafe that meets your allergy needs.

Communication: Learn Allergen Words

One of the joys of international travel is being surrounded by different languages and the fun of trying my best to speak the local language.

Knowing the words and phrases related to your child’s food allergy and how to correctly pronounce them is an absolute must. It’s essential for reading labels, menus, and communicating with staff.

I speak enough French that I felt comfortable discussing my child’s allergy with staff, but I still made sure to get thorough and detailed allergy cards prepared by a native speaker. I cut them into wallet size and carried them with me at all times. I also had copies on my phone in a dedicated album.

I also practiced speaking the phrases I might need.

I’m lucky enough to have a French friend who could help, but there are websites for allergy cards that can help you in almost any language. Plus, Google Translate has become much more accurate as well.

Even so, you must familiarize yourself with all the words for your child’s allergen so you can check labels yourself.

Packing Food: Bring a Few Essentials

Although you will be able to buy staple items at the grocery store, the brands will likely be unfamiliar, which can cause you or your child some anxiety. And when you’re jet lagged and feeling a bit overwhelmed with navigating a new place, the safety of familiar foods can be a great comfort for your child (and you!).

We packed the following foods in our carry-on in addition to our usual travel snacks just to make our lives easier and less stressful upon arrival.

• a loaf of GF bread
• a package of GF pasta
• GF Cookies
• GF Mac-n-Cheese
• GF Instant Oatmeal
• box of GF crackers

Ah, the irony of taking a baguette to France:)

Flying Internationally with a Food Allergy: How to Stay Safe

This was my biggest source of anxiety. Nine hours over the ocean. But I’ve safely navigated domestic air travel countless times, and I’ve developed a solid checklist.

For some children with severe airborne or contact sensitivity, the risks may be too great. However, for many, there are steps and precautions you can take to address each of these so you can get on with your adventures.

For more details on each of the items in the checklist, see this other article, How to Safely Navigate Air Travel with Food Allergies.

PACK EMERGENCY KIT in CARRY ON BAG

Pack your Epinephrine and all Emergency Medications in your carry on bag. Take at least two Epinepherine injectors. I usually bring my full arsenal of 4 that way they are all in one place.  Put the correct dose of each medication (antihistamine, pepsid, etc.) and a copy of your child’s anaphlyaxis plan in a ziplock so it is ready in an emergency.

Having these items in a case with a medical cross symbol helps airport staff identify the items and makes security screening easier. It also makes it easy to put in a beach bag, backpack, or purse for activities on vacation.

BYOB: PACK SAFE FOODS

I tend to overpack food for travel because we do not risk purchasing foods at the airport (except maybe a bag of chips so she doesn’t feel excluded when her sisters get to buy a meal).

Here are some guidelines that help us safely feed her on travel days:

• Bring plenty of snacks and at least one meal for your child. Delays happen.
• Use a combination of clear plastic containers and Ziplock bags so nothing needs to be opened to inspect it.
• Pack foods in the same carry on bag as the medical supplies so the connection between the items is clear to TSA. Some allergists will provide a letter for TSA that allows you to bring extra food and ice packs through security. And while I’ve often been pulled aside in the TSA line for inspection of our foods and medical supplies (especially during OIT), I’ve never had any major issues.
• In addition to snacks, remember to bring toys and distractions to keep little hands busy with safe things. Movies on the iPad do the trick for us:)

PRE-BOARD to PICK a SAFE SEAT

In the U.S., severe food allergies qualify as a disability under the Air Carrier Access Act (ACAA). Under the act, “Airlines must allow passengers with disabilities the opportunity to pre-board who self-identify at the gate as requiring additional time or assistance to be seated (transportation.gov).

With No Advance Seating:

If flying an airline like Southwest for a leg of your trip, request pre-boarding when you purchase your ticket so you can pick a seat that is safe for your child’s medical condition (no visible crumbs, peanut butter wrappers/smears, etc.). Some airlines, like Southwest, have a checkbox for “peanut dust” allergy, but if you have ANY life threatening food allergies, you can check this box. Still, when you arrive at the airport, go to the ticket counter to check in and confirm your pre-boarding status.

With Advance Seating

If you are flying on an airline with pre-selected seats, request pre-boarding to give you time to wipe surfaces down and make the area safe for your child. You will need to go to the ticket counter to check in and request this. Tell them your child has a medical condition that requires pre-boarding. You can have your emergency medication case (with the medical cross) in your hands and gesture to it as evidence, but they should not ask you any personal questions.

In all cases, smile, be polite and gracious, but be firm if you meet with resistance and don’t be afraid to ask for a supervisor. 

WIPE DOWN SURFACES

After you pre-board and choose a safe seat, wipe down all surfaces with wet wipes to get rid of any crumbs or protein particles that could trigger a reaction. Be sure to get all the nooks and crannies of the seat, seatbelt, tray table, window, touchscreen, etc. As your child gets older, let them help with this process of taking care of their space. It helps them learn how to keep themselves safe for future independent travels. 

Remember that spraying the surface with hand sanitizer is good for killing germs, but it does not remove the allergens. The friction of wiping is the critical part, particularly if your child is sensitive to contact with their allergen.

COMMUNICATE with FLIGHT CREW

Communicate your child’s allergy to the flight attendants during pre-boarding. Tell them that they have a severe/ life-threatening food allergy and that you have  brought emergency medications and have taken all the necessary precautions. Most staff will be empathetic and supportive. If not, keep your cool and save your breath. Focus on what you can control and file a complaint after you arrive at your destination.

One mental health caveat: Consider your child’s age and anxiety level when having this conversation. If they are already fairly anxious about their allergy, as my daughter was from multiple Epi-pens by age 5, avoid using the words “life-threatening” or “deadly” in front of them. Step aside to talk to the staff out of earshot. Sadly, we learned this lesson the hard way and fear of death exacerbated our daughter’s allergy anxiety for several years.

COMMUNICATE with NEIGHBORING PASSENGERS

After the seats around you have been filled, you may want to communicate with the neighbors in front of and behind you about your child’s food allergy.

This can be the tricky part.

While many airlines no longer serve nuts, airlines regularly hand out products that contain wheat, dairy, and other allergens. And while you can’t demand that fellow passengers don’t eat the food they’ve brought (or been handed), you can inform them of your child’s allergy and ask for their empathy and cooperation.

If your child sits at a regular lunch table at school, like mine, and plays at playgrounds and public places without incident, you may not feel the need to take this precaution. But if they have an airborne allergy, I’d recommend making seat neighbors aware.

• Be friendly. Keep it short and sweet.
• Inform your neighbors of your child’s life-threatening allergy and ask if they plan to eat any foods that contain it.
• Offer to move to a different seat if needed.
• Lastly, thank them for their help.

Most people will gladly wait to eat their snacks to keep your child safe, but some may not. At that time, you can choose how to handle the situation and enlist the flight attendant’s help moving if necessary.

My daughter has had mild, localized reactions to contact (itchy, red eyes) and once developed wheezing and coughing in response to airborne flour in the grocery store. But since we’ve not had issues from people eating wheat snacks around her, we’ve never asked to move seats. If flying just the two of us, I make sure she sits in the window so I can be a buffer between her and anyone else’s foods. 

CALCULATE the RISKS

For our family, the calculated risks of air travel are well worth the the cherished memories and joyous experiences of travel. Although I remain intensely vigilant throughout our travels, I feel that we can take enough precautions to travel safely.

Obviously, each child’s situation is unique and you need to make that decision yourselves with your child’s doctor. Ask them about the real risks and likelihood of an airborne or contact reaction onboard and if there are additional precautions you can take. That can help guide your decision.

In the end, trust yourself. You know best.

Eating Safely in Town

Plan to feed your child at home or pack their meals as much as possible to minimize risk by shopping at markets or grocery stores. In Paris, small grocers like Carrefour and Monoprix are located in many Parisian neighborhoods and open late. In Scotland, we found Tesco to have many options.

We often picked up cheese, salami, veggies, fruit, eggs, olives at the end of our day and made a feast at home or to take for a picnic.

Easy Meals to Make at Your Apartment: You can make these meals with just a few ingredients and little cleanup.

• -Omelettes and Salad
• -Pasta with Meat Sauce or Chicken Sausage
• -Grilled Sandwiches like Ham and Cheese or Reuben’s
• -Charcuterie and Cheese Board with GF Baguette
• -Stir Fried Veggies with Rice

Food is essential, but for people with food allergies, unknown foods can be scary. In the GF World, many international brands have made their way to the U.S. so we recognized some of the products from home. But many were unfamiliar. Here’s how to navigate the aisles.

Allow Time

Be sure to give your child time to browse and yourself time read all the labels.

Head to the market or shop before your child is in meltdown mode to make their decision making easier. Not all options will be available to them, so they may want to do a lap around the store to see options before choosing. Treat the store like you would a menu and let them peruse a bit.

Unfamiliar Ingredients

In Europe we encountered a lot of items that contained glucose syrup (similar to maltodextrin), which can be derived from corn, wheat, tapioca, or other plants. Unless we could verify the source by calling the company, we avoided those foods as we do with maltodextrin. Know the additives that may contain your allergen and be on the lookout.

Mental Health : Minimizing Food Anxiety

To assuage your child’s anxiety about eating away from home, invite your child to get involved in the research and planning.

• Talk through what you think meal options will be during your trip and involve your child in choosing from the available restaurants.
• Show them the Allergy Information for the restaurants and let them see the email correspondence (or take it on themselves:).
• Plan the foods you will take from home ahead of time with your child and choose 2-3 meals you will prepare on your trip.
• Pack enough of some favorites to rely on just in case. Things like packaged
  GF Mac-n-Cheese and GF Oatmeal may not be the cultural experience you want for your child but they’ll feed them in a pinch- all you need is hot water from a café.
• Prep your child for what to expect- she may be eating a lot of homemade sandwiches, fruit, and fresh veggies. She may not be able to eat the gelato at all the stands, but maybe you can buy a pint at the grocer for her to take to the garden or park.

Emphasize the scenery and experiences you’ll be having together and let them have some input on planning activities. I bought my kids guidebooks geared towards children and they loved pouring over them and mapping out our trip destinations.

Allergy Travel: Tips for Sibling

Let’s face it. Not being allowed to do or eat certain things because of someone else’s allergy is a struggle. It’s hard to handle with grace and takes some emotional maturity to have the required empathy and not build resentment. It’s a big ask for siblings.

These things help:

• Prep the siblings for the need to be flexible how to be supportive on the trip.
• Remind them that you will not be bringing allergens into the hotel/apartment (if that’s the usual rule at home).
• If you’ll be eating at only specific allergy approved restaurants (especially when you walk with tired feet by alluring sidewalk cafes), remind the siblings why, and that’s part of what makes the trip possible.
• Find ways to let siblings indulge in items that are not allergy safe. We allowed our other kids to go to the traditional bakery to get their morning pastries and then we all met at the GF bakery. We also let them order from other cafés if we planned to picnic. We wanted them to have an incredible cultural experience, too.

We found that they were awesome advocates for their sister and were so gracious and compassionate about limitations we encountered. Go team!

Top Tips for Other Families

In short:

• Chose an allergy friendly location. We managed the land of baguettes with a wheat allergy, so there is hope!
• Contact restaurants and bakeries personally to verify allergen policies. Every time I’ve forgone this step, we’ve encountered a closed or inadequately safe restaurant.
• Stay at a place with a kitchen and close proximity to safe food options.
• Involve your child in the planning. Invaluable!
• Prep siblings to help set expectations about meals and limitations.
• Pack some staples and all plane foods. Don’t take risks over the ocean.
• Plan for the worst, but hope for the best.

Final Reflections

Is international travel with food allergies scary? Yes, and I carry an arsenal of epinephrine.

Is it logistically challenging? Absolutely. Plan, plan, plan.

But it is possible and beyond memorable and it opens the whole world to your child.

I acknowledge that I can only speak for myself and recognize that each child’s situation is different; your child’s allergy situation may be even more complicated or challenging to navigate.

But for us, travel is absolutely worth the calculated risks it requires and I hope I’ve given you some confidence and support you as you plan your adventure.

I wish you blue skies, safe travels, and opportunities to explore far and wide!

In partnership,

Colleen