Gabrielle Alter poses for a photo in her cross country uniform.Meet Gabrielle Alter.

She’s an energetic high school senior who’s squeezing in college visits between her involvement in homework, the drama department, cross country running and reading.

And, if you offer her some food, she’ll insist on reading the nutrition label.

Smart girl! Gabrielle has a severe milk allergy that’s landed her in the emergency department more times than she cares to remember. Her EpiPen is her constant companion—it’s saved her life many times. Despite the restrictions and challenges, she doesn’t let her allergy hold her back.

“I don’t let anything get in my way,” the 18-year-old said. “I want to live life to the fullest.”

That’s not to say her allergies haven’t impacted her lifestyle. If she visits a sandwich shop with her friends, she carefully reads the ingredient list (they change constantly) and she asks the employees to change their gloves and use a clean knife.

At school, Gabrielle has befriended the cafeteria manager. He lets her into the kitchen to review labels, ensuring that no milk products are lurking in the food she’ll have for lunch. During college visits, she found the most allergy-friendly campus to be the University of Kansas, with a well-trained staff and allergy-free zones.

It’s hard to be a teen these days. It’s doubly hard for the teens whose food allergies set them apart from their friends, noted Karyn Gell, MD, an allergist at Grand Rapids Allergy.

“As teens grow and gain independence, they are with their parents less,” Dr. Gell said. “They don’t want to be different. And if they have a life-threatening food allergy, they may not make the choices their parents would make for them.”

The headlines tell the story: Chocolate chip cookies or other snacks with peanut butter have killed teens in Sacramento, Milwaukee and Plymouth in the past few years. These deadly eating mistakes happen where teens hang out: at camp, riding in a car or visiting a friend’s apartment. Further, some teens are taking risks–sometimes because they want to fit in and sometimes because they are, well, teenagers and believe themselves invincible.

As a parent, how can you help your teen stay safe?

Honest, direct, personal communication is key, Dr. Gell said. Listen to your teen about their goals and equip them to take control of their choices when you aren’t around. Her tips for teens include:

  • Epi everywhere. Your EpiPen is just as essential as your cell phone. This can be especially hard for boys because EpiPens don’t fit neatly into jean pockets and boys don’t generally have purses. (Dr. Gell recommends Auvi-Q, a device developed by twin brothers with severe allergies. Auvi-Q is roughly the size of a cell phone and easily slips into a back pocket.)
  • Read every label, every time. Never eat food without knowing exactly what’s in it. If the packaging says the food “may contain” something you’re allergic to, don’t take a chance.
  • Get comfortable with “No, thank you.” You must find ways to opt out. For Gabrielle, this meant skipping the cross country team pre-meet pasta dinners instead of risking that the pasta might be tossed in butter.
  • Let others know. Your friends probably know about your allergies. But that’s not enough. You should wear medical alert jewelry or carry a medical alert card in your wallet in case there’s a situation in which you can’t speak for yourself. Also, when dining out, use a food allergy chef card so the restaurant staff can prepare food that’s safe. You need to be very clear and straightforward about the issues in order to be taken seriously.
  • Choose a medical team you want to be around. You should see an allergist at least once a year. And it should be a doctor you’re comfortable with, one who understands your goals and helps you achieve them.
  • Practice what you’ll say in uncomfortable situations. Get ahead of issues by practicing in advance how you’ll handle them. These could include a variety of social situations, including dances, athletic events, parties and shopping.

Gabrielle Alter runs outside for a cross country race.It helps for teens to know they’re not alone. Food Allergy Resource & Education offers resources for teens, including a Facebook group, a blog, a kissing study and more tools to cope with the special challenges of being a teen with allergies.

But maybe the best advice comes from Gabrielle: “Be careful. But don’t let your allergies hinder you. There’s a whole world out there that you will never experience if you stay in your own little bubble.”