For most youngsters, a peanut butter sandwich represents a comforting staple of childhood.
But for Laurel Bird, it could mean a trip to the emergency room, or worse.
Laurel, 2, the daughter of Kevin and Erin Bird of Lawrence, is allergic to peanuts, eggs and tree nuts such as almonds. Of these, the most serious threat to her is posed by peanuts.
The Birds, owners of Bird Physical Therapy, 3220 Mesa Way, discovered that Laurel has food allergies while the family was on vacation.
"Right after her first birthday, we were skiing at Winter Park (Colo.), and we stopped to eat at a Subway. She had about three-fourths of a peanut butter cookie, and I noticed that her eyes started swelling, and she was itching and scratching. When I went back to the condominium to change her diaper, she had welts all over her body," Erin Bird recalled.
When the Birds the couple has another daughter, Marlee, 5 returned to Lawrence, they immediately took Laurel to Dr. Christopher Miller, a general allergist with specialized training in pediatrics.
Miller, who practices at Cotton-O'Neil Clinic, 1220 Biltmore Drive, tested Laurel's reaction to different substances, and quickly determined she has food allergies especially to peanuts.
Less than 8 percent of children under 3 years old have a food allergy. In adults, that figure drops to less than 1 percent, Miller said.
But for those like Laurel who do have an allergy of this nature, certain foods can pose a lethal threat to health. Peanuts and shellfish tend to cause the most serious allergic reactions in people.
The most severe type of reaction, according to Miller, is called anaphylaxis essentially, the heart and lungs going into shock. Blood vessels begin to leak, blood pressure drops dramatically and the throat tightens up to the point that breathing is impaired.
It's a true medical emergency, requiring fast action typically, an injection of epinephrine (adrenaline) to counteract the shutting down of the body's systems.
Two to eight people die of allergic reactions to peanuts in the United States each year. That doesn't sound like a lot. But the only reason the number isn't higher is that more people who suffer such reactions simply received treatment in time to save them, Miller said.
So the Birds would have to protect Laurel, wherever she went, from coming into contact with peanut products. That included her daily visits to her preschool, Stepping Stones, 1100 Wakarusa Drive.
Laurel and Marlee had attended the preschool from the time they were infants. Stepping Stones serves lunch and two snacks to children (older than infants) every day. Peanut butter products appeared in foods on the preschool's menu fairly regularly.
The center has 114 children, ranging from infants to 10- and 11-year-olds.
"Initially, we thought we may have to take Laurel out of day care. We really didn't want to do that. We wanted her to have the same experience that Marlee is having, being a normal kid," Erin Bird said.
They didn't have to withdraw Laurel from Stepping Stones. The center decided, instead, that it would protect her by creating a completely peanut-free environment.
No peanut products would be served in the preschool, or could be brought inside. Teachers in each room would be equipped with Epi Pens (autoinjectors for shots of adrenaline). Children and their parents would be educated about Laurel's allergy and the changes the center would be making.
Shelly Platz, the preschool's director, was happy to make the transition, which took place in January 2001.
"Once you know someone's allergic (to a food), better safe than sorry. I think it's better to have the peanut ban across the whole center. It's the easiest way to keep tabs on things. It doesn't really have to be a big deal. The Birds have been very easy to work with, they've brought us a ton of information," she said.
Did Stepping Stones get any flak for taking peanut-butter-and-jelly sandwiches off the menu?
"The kids have been great," Platz said. "I thought they would be the hard ones they all love peanut butter, most of them do. We presented it (to them) that this could make someone really sick, and they've been great about it."