Monday, October 19, 2009

Travelling with food allergies

There is no doubt about it: travelling with food allergies takes a lot of forward planning. You can’t simply book your ticket online and turn up at the airport like everyone else. In most cases, you need to go through a sales centre, disclose your food allergies and then think about what sort of nutritious meals and snacks you can pack. This is further hindered by security measures on liquids.

And you can expect more of a headache if you have to carry an auto-injector. I remember a security guard carrying my daughter’s EpiPen and escorting us through Brisbane international airport after our check-in person tried to wrestle the injector away from us (despite our doctor’s letter). We refused to be parted, thus the escort (as it was another security guard told them it was ridiculous and let us resume control of the EpiPen).

Considering we have no option but to travel by air, what can we expect from airlines? Penny, our chief executive, went to the Food Allergy and Anaphylaxis Alliance meeting in the USA in September and there was a lot of vigorous discussion on this topic.

The general consensus was we can’t expect airlines to guarantee safe meals. This is because meals are being prepared by different caterers, in different parts of the world, and under a wide range of legislation.

What we should expect is for airlines to allow us to take our own food on board. In some cases, flight attendants are kind enough to put your food into their convection ovens to heat up, but this is that at their discretion (and if you go down this route, you will need to put your food in something that is not going to melt!).

We should also expect airline staff to be trained in an emergency response to anaphylaxis and to be able to administer adrenaline auto-injectors if required. Most airline staff receive first aid training, and Virgin and British Airways staff receive five days of training, including life support, and do an annual refresher. Virgin Airlines Australia staff are now trained in recognising and treating anaphylaxis. We think all airlines should follow Virgin’s steps. At the opposite end of the spectrum, one airline has forced passengers at risk of anaphylaxis to sign a form that says they will pay all costs if the airline has to turn around in an emergency. Members of the Food Allergy and Anaphylaxis Alliance are currently investigating this.

In the meantime, recent research indicates that we need better education all-round, and particularly within our food-allergic community. A letter published in last month’s Journal of Allergy and Clinical Immunology looked at self-reported allergic reactions to peanuts and tree nuts on commercial airlines. The study surveyed 471 people known to have severe peanut, nut or seed allergies. Almost 10 per cent of those surveyed (45) reported reactions and, alarmingly, only 12 of these people notified their flight attendants. Peanuts were the main culprit. Six people went to an emergency department after the plane landed.

In the majority of cases, the allergic reactions were a result of eating the airline food. The study noted that while a proportion of people believed the reaction was to inhalation of peanuts, there has not been enough evidence to support this, even from other similar studies. The authors suspect the reactions are due to some form of ingestion, for example, getting allergen on their hands.

What are your thoughts on airline travel?

  • Do you think airlines should minimise risk for those with peanut allergies but not serving peanuts? What sort of experiences have you had when travelling?

  • How have you managed your meals, particularly on long-haul flights?

  • Another important question is: how easy is it for you to find out airlines’ policies on food allergies and anaphylaxis?

  • How do you get hold of the relevant person at the airline?

  • What can we suggest to airlines to make travel easier for food allergy sufferers?

We would love to hear your experiences, and your input will help us with information we are putting together on travelling with allergies.

If you prefer not to comment on the blog, but still wish to share your experiences, you can email me at

Inga St├╝nzner
Information Officer


  1. My 10 year old son has a peanut allergy and we have only flown across the Tasman, but have flown Qantas, Air New Zealand, Pacific Blue and domestically Jetstar. We have had no problems with any of them and I would say everyone has gone out of their way to be help us. We always take our own food, none of them have served peanuts (not that we have requested this - and I have to say I am not sure if I would be comfortable travelling on one of those flights). Pacific Blue has by far been the best - their information is easiest to find and they tend to be a lot more thorough. Same as Jetstar - they actually did a special clean down for us before we boarded.

  2. Hi, I have a question for others. My 8 year old had a friend fly to visit us recently as an unaccompanied minor. She is now very keen to do the same. That lead me to question when she might be ready to manage her own epipen. I would be keen to hear from anyone who has been through that 'handover of responsibility' with a teenager. Thanks, Kate

  3. Hi Kate,
    that's a great question, because I have thought the same thing. I will put this question to one of the allergy specialists, as I would like to know when I can send my kids to Qld to visit their grandparents during school holidays (without me!). I will let you know when I get an answer.


  4. I have an answer:
    According to Dr Jan Sinclair, Paediatric Allergy and Immunology, Starship Hospital, there is not one right answer: it really depends on the maturity of the child and the family's confidence in them. She knows of some 12-year-olds she'd have confidence in, and then there are 18 or even 20-year-olds whom she wouldn't.
    You can check out Air New Zealand's policy on travel here
    I will be exploring this more in the summer issue of Allergy Today magazine, which will be out in the first week of December.
    Desperado plug here: if you have any tips you'd like to share, fling me an email at

  5. We've travelled three times without incident with our milk allergic (anaphylactic) son to the UK via both Hong Kong and LA and once to Australia. All with Air New Zealand. We pack all his food and snacks for the journey in a small cool bag keeping the liquids like small cartons of soy milk at the top. Every security check is a complete pain pulling out the plastic bag of liquid foods, the epipen, the letter and an explanation but, other than the UK, we have had no problems. In the UK as soon as I pulled out the small cartons of soy milk (250 mls)the very officious security person held them up and said "you can't take those!". I replied I'd travelled round the entire world with no problem at which point the supervisor was called who cleared them. In HK the supervisor was also called and my passport details noted but there was no fuss. Recently I travelled alone with my son to the UK and felt far more anxious, however, a chat with the airline staff revealed they are all trained to use an epi-pen which was a relief. My biggest concern was an accidental spilling of milk into the open cartons of juice or from a jug of milk being poured into tea......I guess I could take all my own drinks for him but that would be another whole challenge at security. The things we have to worry about as parents of allergic children!!!

  6. Great to hear you can actually get food through customs (most of the time). That has been the biggest problem for a number of people I have spoken to. I guess it is a matter of explaining the situation, having all the documentation, and hoping you don't some small-minded person - as I often see when I watch "Border Control" on a Monday night!
    If anyone has some more tips, please share! What sort of food do you take on a long-haul flight? Sandwiches, pasta??

  7. Make sure your ready for any Anaphylaxis emergency! 
Healthcorp Australia have an Anaphylaxis Epipen training course available
 Australia wide. Check out the details at