You probably remember Halloween as the night your kids come home with a bag heavier than they are.
For most families it is pure fun. For a smaller group, every piece in that bucket has to be read first.
About 1 in 13 US children has a food allergy, according to the CDC. That is roughly two children in every classroom.
Peanuts and tree nuts are among the most common triggers, and both show up across the Halloween candy aisle.
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A Canadian study published in 2020 in CMAJ found that children were more likely to end up in an emergency room with peanut-triggered anaphylaxis around Halloween than at other times of the year.
Researchers at McGill University pulled nearly nine years of pediatric anaphylaxis cases from four provinces.
Around Halloween, the rate of peanut-triggered anaphylaxis ran about 86 percent higher than the yearly baseline. Easter showed a similar spike for unidentified nuts.
Anaphylaxis is a severe, whole-body allergic reaction that can close the airway within minutes. It needs an epinephrine shot, right away.
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Why fun-size candy is not just a smaller version
Halloween candy comes in miniature "fun-size" wrappers, and that is where the quiet exposure lives.
Fun-size bars are often made on different production lines than the full-size versions, with different ingredient lists.
A chocolate bar you have bought safely all year may still carry traces of peanut or tree nut in its fun-size form.
The brand looks the same. The ingredients, in a very small font on the back, do not.
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Mayo Clinic allergy specialist Arveen Bhasin has made the point directly to parents.
"It's very important to remember that [for] fun-size candy bars, the ingredients in those are actually different than in the full-size candy bars," she told Mayo Clinic's news service.
Mixed bags of assorted candy raise the same problem. A piece without a wrapper has no ingredient list at all.
Homemade treats and loose decorative chocolates bring unlabeled fillings and glazes that can carry hidden allergens.
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What families with food allergies can do
The simplest tactic is also the hardest to enforce. No candy on the walk home.
Every wrapper gets checked under a kitchen light, and anything unlabeled, unfamiliar or in an unverified fun-size format gets set aside.
Carry an epinephrine auto-injector, and carry a second one.
Epinephrine, not an antihistamine, is the first-line treatment for anaphylaxis, and some reactions need a second dose before an ambulance arrives.
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Hosts can lower the risk for the whole street by joining the Teal Pumpkin Project, the awareness movement FARE has run worldwide since 2014.
A teal-painted pumpkin on the porch signals the house hands out non-food treats like glow sticks, stickers or small toys.
A child with a severe allergy can then take part without a wrapper to read.
If your child has a known food allergy, call your allergist before Halloween night. Check that the auto-injector has not expired and confirm the dose for your child's current weight.
This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.