Navigating Food Allergies During the Holiday Season

For families living with food allergies, the holiday season can be one of the most stressful times of the year. According to Allen Lieberman, M.D., an allergist at Austin Family Allergy & Asthma, the weeks stretching from Halloween through the winter holidays are when allergists worry most about accidental exposures—and for good reason.

Lieberman emphasizes that this time of year revolves around food. From classroom parties and family gatherings to potlucks and holiday travel, patients with food allergies face repeated situations where ingredients may be unclear or mislabeled. While vigilance is important year-round, the sheer number of food-centered events during the holidays significantly raises the risk of a serious reaction.

Potlucks and home gatherings are particularly concerning. Unlike packaged foods, homemade dishes don’t come with ingredient labels, and even well-meaning hosts may unintentionally leave out key details. A dish that looks safe, like mashed potatoes or a dessert, may contain milk, nuts or other hidden allergens. Lieberman notes that people are sometimes hesitant or embarrassed to ask questions about ingredients, but he emphasizes that this hesitation can be dangerous. “It only takes one bad exposure,” he says. You can be careful 99% of the time, but one mistake can lead to a severe reaction.

Certain allergens tend to cause the most serious reactions during the holidays. Peanuts and tree nuts are especially risky and are often found in desserts and baked goods. Milk is another major concern, as it’s commonly used in holiday recipes. Lieberman also highlights a growing issue with cashew allergies, particularly related to vegan products. Many plant-based cheeses, milks and sauces rely on cashews, and patients may not realize this until after a reaction occurs.

Because accidental exposure can happen anywhere, Lieberman strongly advises that patients carry epinephrine at all times — ideally two doses. He acknowledges that some people, especially teens, avoid carrying auto-injectors because they’re bulky, but stresses that newer, more portable options make this easier. Having epinephrine readily available can be lifesaving when reactions happen unexpectedly.

Preparation is the key to staying safe. Lieberman encourages families to ask about ingredients in advance, bring their own food when necessary and plan carefully when traveling. Air travel, in particular, can be risky due to confined spaces and limited access to medical care. Calling restaurants ahead of time, reviewing menus online and confirming allergy accommodations can significantly reduce risk.

Lieberman stresses the holidays don’t have to be scary. With planning, communication and constant access to epinephrine, families can enjoy the season while staying safe.