Photo of family in the snow close-up of faces

By Gary Fitzgerald

Lights sparkle. Cookies bake. Music plays quietly. Conversation flows around the dinner table. The holidays are here – the season for giving, and giving thanks.

The most wonderful time of the year? You can make it so – and asthma and allergies don’t have to get in the way of holiday celebrations and family traditions, says asthma educator and certified health education specialist Andrea Jensen of Salt Lake City, Utah.

Andrea and her three children have asthma. In years past, the hustle, bustle and good cheer of their holidays were often accompanied by stress.

“Sometimes you try to be the perfect family and you feel that you have to do everything, and it creates stress,” says Andrea, who blogs about her life as an asthma mom at “Last year we thought, ‘Let’s pull back and just enjoy family and friends.’ That really helped.”

It’s difficult to escape stress during the holidays: shopping in overcrowded malls, searching for the perfect gift; planning, coordinating and cooking dinners and parties for family, friends and neighbors; or traveling long distances to visit relatives.

Studies show that stress – particularly chronic stress – can worsen asthma and allergy symptoms, says Talal Nsouli, MD, a Washington, D.C., allergist and former member of Allergy & Asthma Network’s Board of Directors.

During stressful situations, the body releases a chemical that makes the muscles around the airways tighten, causing difficulty breathing. Stress can also weaken the immune system, inviting winter colds, flu and asthma episodes.

“Asthma and allergy patients can control stress by eating healthy, avoiding caffeine products, exercising regularly and getting plenty of sleep,” Dr. Nsouli says.

Adds Andrea: “When I’m stressed, I can feel my chest get tighter. I have to remind myself, ‘Calm down, relax – you can handle this.’ Often I use deep breathing in which I slowly breathe in through the nose and exhale through my mouth. It helps steady my airflow.”

Time management is an essential key to minimizing stress in the Jensen home. Andrea maintains a wall calendar that details everyone’s daily schedule.

This year, she got an early start preparing for the holidays. “We took our family photo in September, and we ordered the holiday cards and had them addressed and stamped early,” Andrea says. “I also already bought little containers for holiday cookies.”

By staying positive and proactive, the Jensens can focus on nurturing family relationships — those precious moments when traditions are created and memories made.

’Tis the Season For Dining Out

John and Joanne Morton of Duxbury, Mass., love to go out to eat during the holidays and have mastered ways to make it fun and safe for their son William, who is allergic to egg, peanut and tree nuts.

“We establish an open dialogue with managers and servers – and sometimes chefs – to help ensure William receives a safe meal,” Joanne says. “We stress his food allergies to servers, but there’s always a chance for miscommunication. These days you often get more than one server, and you cannot take for granted that every person serving your table is informed, so start a dialogue with each staff person.”

Good advice is to call the restaurant ahead of time to make sure they are able to prepare an allergen-free meal. Read the menu closely and ask about ingredients. And always carry a pair of epinephrine auto-injectors in case of an accidental exposure.

“If the restaurant staff is confusing food allergies with gluten-free, for example, this is a red flag for us and we won’t eat there,” Joanne says. “The more you talk with the staff, the more you develop an intuition whether the restaurant is a safe place to dine.”

Home For the Holidays

  • Wash the Christmas tree, particularly the trunk, with a garden hose before you bring it into your home. This helps remove mold spores, pollen and terpene, an allergenic substance found in the sap of trees. Bring the tree inside once it’s fully dry, but keep in mind the piney fragrance of the tree may irritate some people with asthma and allergies.
  • Make sure artificial trees and holiday decorations are free of dust from storage.
  • Don’t share or offer food to children other than your own. Use one serving spoon per dish to avoid food allergen cross-contamination.
  • Seat young children with food allergies near family members who can help them learn table manners that include no food sharing and using utensils and napkins rather than fingers. Remember, food allergens must not touch the food allergic child’s mucosal membranes, such as the mouth, eyes, nose or an opening on the skin.
  • Don’t feel obligated to visit homes that contain known allergens and irritants, such as cigarette smoke, wood-burning fireplaces and scented candles or potpourri. If family and friends do not always respect your wishes to avoid allergens and irritants, then it’s best to not go.
  • Get the flu vaccine. The CDC recommends the flu vaccine for everyone 6 months of age and older. Visit to find flu shot locations in your area or schedule an appointment with your doctor.

Over the River And Through the Woods …

Like many families, the Jensens travel hours to visit relatives during the holidays. Some live in warmer climates and the sudden change in temperature and humidity can cause asthma symptoms to develop.

Staying with relatives presents challenges as well, especially when there are pets in the house, Andrea says. Animal dander can lead to asthma flares. Most relatives are  aware of her family’s asthma, so they’ll help by vacuuming the house prior to a visit. In the guest bedrooms, they’ll put on fresh linens and bed covers.

Andrea takes an anti-inflammatory asthma medication daily and she reminds her kids to do the same, in accordance with their Asthma Action Plans. This helps prevent airway inflammation if allergens are present.

“We always pack lots of extra allergy medication, plus all of our equipment: the nebulizers, peak flow meters and inhalers,” Andrea says.

Food allergies also impact the Jensen family – Andrea is allergic to seafood and her youngest son is allergic to tree nuts – and they carry epinephrine auto-injectors wherever they go. During visits, Andrea gently reminds relatives about her family’s food allergies.

“Don’t expect all of them to remember, because bless their hearts, they’re busy and they forget,” she says. “You have to be your own advocate. If there’s a potluck, check on the ingredients of all the dishes. And I always fix something I know my family can eat.”

With careful planning, the holidays can truly become the most wonderful time of the year.

Holiday Stress-Busters!

  • Shop for holiday gifts throughout the year and avoid the last-minute rush. Set a date when all your holiday shopping is finished.
  • Don’t start time-consuming or costly renovations to your home close to the holidays.
  • Just say no. It’s okay to decline invitations to parties or requests from schools and churches.
  • Create family traditions that don’t require a lot of time or work and bring a smile inside – hanging special ornaments or decorating the house.
  • Don’t fall into the trap that holiday perfection is attainable or necessary. The perfect family in the perfect decorated house with the perfect gifts are myths. Remember, ads and commercials are created to sell products.
  • Ask for help! No, it won’t be done as well as you would do it, but that’s okay.