Food Allergy Counseling: Interview with Dr. Michael Pistiner

My colleague Dr. Michael Pistiner’s website is now hosting a free, downloadable PDF handbook called: Living Confidently with Food Allergy. It was created in conjunction with Anaphylaxis Canada and co-written with Jennifer LeBovidge, PhD, Pediatric Psychologist.

Here are some previous conversations with Dr. Pistiner posted on Please Don't Pass The Nuts:

I had an opportunity to ask Dr. Pistiner a few questions about him as an allergist, a food allergy dad, an EoE patient and co-author of this exciting free handbook for food allergy parents.


Allergic Girl: Briefly, tell us about your practice and your specialty?

Dr Mike Pistiner: I’m a pediatric allergist in a large multispecialty medical practice. I see almost exclusively children with a large proportion of my patients having food allergies.  I like the challenge of taking care of families, with kids included in their own care. Kids are key players in their own health.  They are important participants in their own food allergy management at all stages of development. To help reinforce this, I really pride myself on getting the kids to get involved in their visit and try to set that precedent for when they leave and go home with their families. I usually start by introducing myself to the child asking them a ridiculous question to make them comfortable followed by a question getting at why they’re here. The visits quickly transition to the parents but I keep involving the kids for as long as their attention holds. Getting their buy in and perspective is so important. The same goes for physical exam and any procedures. I hope that their direct participation in the visit sets the tone for when they leave my office. Playing developmentally appropriate roles in their own food allergy management can engage kids and empower them to be self confident and active participants in their own health.

AG: What have you learned living with a child with food allergies (and you with eosinophilic esophagitis)?

MP: My family’s experience with food allergy has been both challenging and enlightening. Being a father of child with food allergy and having eosinophilic esophagitis myself has opened my eyes not only to the practical challenges my patients and their families face, but has allowed me to feel first hand the emotional and social side. Having food allergy affects many aspects of life - our personalities and our relationships can help or hinder necessary daily management.

For those who discover that they have allergies as adults, and for parents of newly diagnosed, it can force a shift of already established patterns and routines. If a food allergic individual is soft spoken, not accustomed to making their needs known and used to going with the flow, he or she now needs to advocate, communicate, and educate, which may feel quite overwhelming and out of a comfort zone.  Also, if someone is used to being spontaneous, now needing to plan meals, coordinate child care, and being prepared to appropriately deal with an emergency might feel compromising to a free spirit. For some, these new roles are easily incorporated into their lives and families, and for others it is a significant shift that will take time to get used to. Ultimately learning how to comfortably incorporate food allergy management strategies into our lives is necessary, character building and cannot be compromised or discounted. With time, learning how to make it work while retaining our spirit and flexibility is achievable and an important goal.

AG: You have done alot of work in food allergy education and advocacy.  What has motivated this?

MP: When my son first had his reaction I was already an allergist. Despite having a significant knowledge base and understanding of food allergy and food allergy management there were a surprising number of challenges that I didn’t see coming.  Many of these centered around transitions in care, teaching others, relying on others, and communicating effectively.   I made mistakes along the way. My newfound perspective inspired me to make it easier for other families.  There is no reason why we all must recreate the wheel and start from scratch. Since then I have dedicated great effort to food allergy education and advocacy, one outcome of which was

AG: What is the mission of  

MP: My close friend, John Lee and I are serious about AllergyHome’s mission to keep children with food allergies safe and happy no matter where they are or who they’re with. Also, AllergyHome is determined to play its part in ensuring that there are no longer food allergy related deaths, especially in our schools. The website provides practical tools to train and educate all who may be responsible for caring for a child with food allergy. These resources are designed to make training others a bit more regimented, reproducible, and practical. We account for different learning preferences and by offering a spoken format. To make the content even more relevant and memorable we use engaging pictures and tailor the modules to the specific target groups. We hope that the versatility that we offer will increase the chance that those who need food allergy education will understand and retain the information. Collaboration is a theme that permeates who we are and what we do.  Partnerships are necessary when it comes to food allergy education. Parents must partner with schools, doctors with families, etc.  Same goes for all institutions, organizations, and governmental agencies that share the desire to protect and nurture our children. Pooling resources, and meeting unmet needs makes sense when we must ensure the safety and happiness of millions of children.

AG: For our school communities, what do you suggest can be done to address bullying?

MP: While taking care of bullying when it happens is incredibly important, stopping bullying before it starts is equally important. With the rapid increase in food allergy prevalence, our school communities may not have had time to adapt to new and necessary accommodations to protect the safety and self esteems of students with food allergies. Students pick up on the messages of their teachers, parents, and others in the school community. Also, their own perception of an unexplained difference in a peer with food allergies can foster bullying, teasing and isolation. Replacing negative misperceptions with education and awareness can create an environment of support and understanding. A child’s perceptions of food allergies may come from picking up on the attitudes of teachers and parents, but direct education may be very effective. Children without food allergies also can play an important role in teaching each other, their parents, and play a critical role in establishing a supportive school community. Kids are key players in creating communities of support. Here's Kids Awareness Module.

AG: is now hosting a new exciting product that was just launched, a free, downloadable PDF handbook called: Living Confidently with Food Allergy. It was created in conjunction with Anaphylaxis Canada and co-written by you and Jennifer LeBovidge, PhD, Pediatric Psychologist. Tell us more!

MP: For over two years, I’ve had the privilege to work with an amazing team to develop a handbook for families and children with food allergies. Our goal has been to create a resource that can help guide parents and caregivers in food allergy management and give them the tools to educate their children and the surrounding community. A major goal of this handbook is to guide families to find the middle ground between risk taking and anxiousness as early as possible. Ultimately most families do find it, but for some it can be a struggle where safety, happiness or both can be at risk. If early on families know where the risks are and where they are not, they can learn to incorporate this into their routines, then they can accommodate without undue social and emotional strain. We wanted to make sure that this handbook was free and available in a variety of formats to help get this to as many families as possible.  Although many in our community, especially those that are reading this have access to a computer and multiple resources, a vast amount of the families dealing with food allergies do not.  We wanted to also offer in chapters in PDF version to allow doctors offices to print out relevant sections for families.  Our hope is that anyone that cares for a child with food allergies will have access to this and all of the information in it. This handbook can be found in webased and PDF versions at both and

Michael Pistiner, MD, MMSc is the content provider for AllergyHome a free, food allergy education website. He works as a pediatric allergist for Harvard Vanguard Medical Associates. He volunteers at Children’s Hospital and is a food allergy educator and advocate. Dr. Pistiner is a fellow in the American Academy of Pediatrics where he is a member of the Council of School Health and Section of Allergy & Immunology, and a member of the American Academy of Allergy Asthma & Immunology where he is a member of the Adverse Reaction to Food Committee and co-chair of the Food Allergy Awareness in Eating Establishments sub-committee. He serves as a voluntary consultant for the Massachusetts Department of Public Health, School Health Services. He is chair of the Medical Advisory Team for Kids with Food Allergies Foundation, serves on the board of the Asthma and Allergy Foundation of America, New England Chapter, and member of FAME's National board. He is the recipient of awards from the Food Allergy & Anaphylaxis Network in 2009 and 2010, as well as the American Medical Association Young Physician Section Community Service Award (2010) for his work on the Food Allergy Awareness in Restaurants Act. Additionally, he is the author of Everyday Cool With Food Allergies, a children’s book designed to teach basic food allergy management skills to preschool and early school age children and co-author of Living Confidently with Food Allergy, a free food allergy handbook.


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