Navigating the Holidays with Asthma and Allergies

The holiday season brings joy, celebration, and time with loved ones. But for people with asthma or allergies, it can also mean increased exposure to triggers. From festive meals to scented décor and chilly weather, holiday traditions may introduce new allergens or seasonal irritants to navigate.

Whether you’re celebrating Thanksgiving, Hanukkah, Christmas or Kwanzaa, it’s possible to enjoy the season while staying safe and healthy. With a little planning and open communication, you can protect your family’s health and fully participate in the holidays.

Here’s what to keep in mind as you prepare for a safe and joyful season with asthma, allergies or food allergies.

What can cause asthma symptoms during the holidays?

For people with asthma, the holiday season can bring new triggers like cold air, fireplaces, pet dander, mold from piles of leaves, and more.

Changes in daily routine may upset the balance in your life. You may do a great job managing asthma all year, but holiday gatherings and travel can make things harder. New places and busy schedules can lead to more asthma symptoms and asthma attacks.

Before the holidays begin, schedule a checkup with a doctor to go over your or your child’s Asthma Action Plan. Review what might trigger asthma symptoms such as cough, wheeze, chest tightness or shortness of breath. Make sure medications are up to date and that you feel confident in how to handle any changes in symptoms.

With a little planning, you can avoid triggers and enjoy the season.

Common holiday asthma triggers

In many places, November and December means cooler weather. That means more time spent indoors for parties, family gatherings, or while traveling. For people with asthma, this can make it harder to avoid triggers.

Here are some common triggers to watch for:

• Cold, dry air from winter weather that tightens airways
• Respiratory viruses like flu, RSV, or COVID-19
• Cigarette smoke from guests or gatherings
• Wood-burning fireplaces
• An allergy to live Christmas trees (from pine pollen or terpene) or artificial Christmas trees (from dust in storage)
• Fragrances like scented candles, potpourri, or air fresheners
• Pet dander in homes with cats or dogs
• Stress and lack of rest, which can make asthma harder to manage

Tips to stay safe with asthma

Take a few simple steps to avoid asthma triggers and stay healthy during the holidays. Caring for yourself or your child is the best gift you can give. When your asthma is well controlled, it’s easier to enjoy the season, handle the hustle and bustle, and make the most of holiday celebrations.

Take care of your or your health:

• Get enough rest. Try not to overbook your calendar. Choose the events that matter most and give yourself time to relax.
• Stick to an asthma routine. Take your controller medicine every day, even when you’re busy or away from home.
• Dress warmly and cover your nose. Cold, dry air in winter can trigger asthma in some people. A scarf or mask helps warm the air before you breathe it in.
• Wash your hands frequently. Stay away from people who are sick, and don’t share food or drinks.
• Get your flu shot. The vaccine helps protect you from serious illness that could make asthma worse.

Be prepared for gatherings:

• Bring your medications with you. Always pack your quick-relief inhaler, daily inhaler, and any allergy medicine. Bring your nebulizer if you use one.
• Know where your inhaler is. Keep it close by at any event. Let someone else know where it is, just in case.
• Ask smokers to step outside. If cigarette smoke is a strong trigger, you may need to skip events where people smoke indoors.
• Avoid strong scents and smoke. Try to stay away from fireplaces, candles and potpourri. Gas fireplaces are usually less irritating.
• Use unscented candles or LED lights instead of scented items.
• Ask about pets ahead of time. If you’re allergic to cats or dogs, ask if the pet can stay in another room. You may want to take allergy medicine before your visit.
• Use an air purifier for extra protection. If you have guests with asthma staying at your house, consider installing an air purifier in their room.

Traveling for the holidays:

• Bring extra medication and keep it in a different bag as backup.
• If you are flying, make sure all medication is with you in your carry-on bag. Never pack medication in checked luggage.
• Pack dust-mite-proof pillow covers if you’re staying overnight.
• Ask about pets, cleaning products, carpets or fireplaces where you’ll be staying. Make sure the room you will be sleeping in is trigger-free. Find out sleeping arrangements and if others are going to be in the same room.
• Be aware of the nearest hospital or urgent care clinic where you’re staying. Ask your healthcare provider for a referral to a specialist, if needed.

Christmas tree allergy and other holiday decoration triggers

Holiday decorations make the season festive, but they can also bring environmental allergy triggers into your house. One of the most common is an allergy to Christmas trees, sometimes called Christmas tree syndrome.

A live tree can carry mold, pine pollen, and a chemical in the sap called terpene. If you have an allergy to live Christmas trees, it can lead to allergy symptoms like sneezing, itchy and watery eyes, itchy nose and coughing. It can also trigger asthma symptoms.

Decorations, artificial trees and other holiday displays can accumulate dust while in storage. If dust is a trigger for you, wear a mask while unpacking decorations. Make sure to wipe everything down before putting it out. Then seal items in airtight plastic bags or sealed boxes at the end of the holiday season.

A festive environment can also come with strong smells from scented candles or potpourri, which can bother sensitive airways. Even popular holiday plants like poinsettias may cause problems for people with latex allergy.

Here are some easy ways to enjoy your favorite decorations while avoiding asthma and allergy flare-ups:

• Wash real trees and wreaths before bringing them inside. Focus on the trunk to remove mold spores, pollen, and terpene. Let the tree dry fully outdoors.
• Clean artificial trees, wreaths and decorations. Wipe them down to remove dust from storage.
• Avoid poinsettias if you or a guest has a latex allergy. Choose paper chains, garland, or banners instead.
• Skip latex decorations, such as balloons, if anyone has a latex allergy.

What to look out for with food allergies during the holidays

Food is a big part of most holiday celebrations. From family dinners to classroom parties, meals often bring people together. But for people with food allergies, holiday foods can be a source of stress and danger. From nutcrackers to a game of dreidel, food allergens often appear in many traditions. 

If you’re hosting a gathering or attending one, it’s important to take food allergies seriously. Anaphylaxis is a severe allergic reaction to food that can become a life-threatening condition. So if someone says they can’t eat a food, it’s not a preference, it’s a medical need.

With planning and good communication, you can help everyone feel safe and included.

Common holiday food allergy triggers

Many popular holiday foods contain common allergens or are served in ways that increase the risk of cross-contact. Here are some things to watch for:

• Holiday foods like stuffing, cookies, pies, latkes, and eggnog may have many ingredients, some of which are common allergens.
• Unlabeled candy used in games or handed out as party favors.
• Open bowls of snacks, which may not be labelled and can lead to cross-contact.
• Buffets and potlucks, where serving spoons may be shared between dishes.
• Well-meaning hosts who may not fully understand how to prepare allergy-safe meals.

Tips to stay safe during meal time

There are many ways to reduce the risk of an allergic reaction during the holidays. Whether you or your child has food allergies or you’re hosting someone who does, these tips can help.

Plan ahead:

• Mention allergies early. Talk to the host as soon as you get the invitation. This gives them time to plan safely.
• Ask about the menu. Learn what will be served and how it’s made. This is a good time to suggest safe dishes or offer to bring one.
• Bring your own food. Pack a safe meal or snack in case there are no allergy-friendly options.
• Practice food safety with kids. Teach them how to ask about ingredients and to only eat food from trusted adults. Role-play saying “no thank you” to shared food.
• Talk about alcohol. Remind adults to wash their hands after eating or drinking before helping children. If you have food allergies yourself, drink responsibly.

At the party:

• Use separate serving utensils. Each dish should have its own spoon or fork to avoid cross-contact.
• Serve allergy-safe foods first. This reduces the chance of allergens getting into the safe food. Make your child’s plate before others serve themselves.
• Keep safe foods separate. On a buffet, place them at the beginning or on a different table. You can also set aside a portion specifically for guests with food allergies.
• Avoid passing shared dishes. Ask if everyone can plate food in the kitchen or buffet-style instead of passing platters around the table. If you have to pass platters, make sure that the food allergy guests are served first. 
• Label all dishes. Clearly list ingredients so guests can make safe choices.
• Save food labels. Keep packaging nearby so people can double-check.
• Don’t offer food to children who aren’t yours. Let parents or caregivers decide what’s safe.
• Seat kids with food allergies near someone you trust. This helps with watching for sharing and keeping an eye on what’s being eaten.

Prepare for emergencies

• Always have epinephrine nearby to treat anaphylaxis. Know where it is and who is carrying it.
• Use epinephrine right away if there are signs of a severe allergic reaction.
• Prepare your family. Make sure others in your family know how to administer epinephrine.
• Call 911 if you don’t have epinephrine, symptoms get worse or come back after a first dose of epinephrine, or you’re not sure what to do.

Preparing your child with food allergies for holiday parties

What can you do behind-the-scenes to prepare your child to avoid food allergens? A little role play can go a long way.

1 – Help your child learn how to be a good guest.

Teach your child to always ask if a food is safe before eating something that didn’t come from home. Stage a few practice parties at home and role play. Going to a potluck or buffet? Practice this, too. At the party, ask the host if you can move your child through the buffet line first to reduce risk of cross-contact from shared serving implements. Children are more confident when they know what to expect at a party and how to handle themselves.

2 – Work with facts, not fear.

Schedule a well-visit with your child’s allergist to talk about food allergy. Help make a list of questions to ask – then let your child do the talking. “Can I sit next to my cousin if we don’t share food?” “Will I get sick if my aunt kisses me if she has eaten something I’m allergic to?” Role play how to handle difficult situations like teasing or well-meaning people who don’t understand food allergies and think one little bite will be fine.

3 – Keep watch.

You don’t have to hover, but keep a watchful eye on what’s going on. Depending on the age or maturity of your child, you might want to avoid parties where children have separate play areas and dinner tables, but for family parties where everyone is all together, just keep your eyes and ears open. Make sure your child always knows you’re there for support, no matter what.

4 – Be prepared.

Keep two doses of epinephrine close at hand. Epinephrine is the first-line treatment for anaphylaxis. If your child develops symptoms of anaphylaxis – hives; swelling of lips and mouth; dizziness or trouble breathing – use epinephrine right away. Here’s another role-playing opportunity – make sure the child is familiar with epinephrine and what will happen if it needs to be used. If you stay calm, cool and collected, your child will, too.

Dining out during the holidays

John and Joanne Morton of Duxbury, Massachussets, love to go out to eat during the holidays and see restaurant decorations. They 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 epinephrine in case of an accidental exposure.

“If the restaurant staff is confusing food allergies with gluten-free, 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.”

Practical tips for a stress-free and safe holiday season 

The hustle, bustle and good cheer of the holidays are often accompanied by stress. Shopping in overcrowded malls, searching for the perfect gift. Planning, coordinating and cooking dinners and parties for family, friends and neighbors. Traveling long distances to visit relatives.

Studies show that stress can worsen asthma and allergy symptoms. During stressful situations, the body releases a chemical that can make the muscles around the airways tighten, causing difficulty breathing. Stress can also weaken the immune system, inviting 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, says board-certified allergist Talal Nsouli, MD, a former Board of Directors member for Allergy & Asthma Network.

If you’re stressed and you feel your chest get tighter, try deep breathing techniques. Slowly breathe in through the nose and exhale through the mouth. This can help steady your airflow and reduce stress.

Time management is also an essential key to minimizing stress. Maintain a calendar that details the daily schedule. Get in the holiday spirit early – start shopping in September or order family holiday cards in October – so that it’s not a last-minute scramble.

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

Stress-busting tips for the holiday season

The holidays are about connection, not perfection. Whether you’re managing asthma, food allergies, or environmental allergies, a little planning can help you and your family feel safe, included, and calm during the season.

• Talk openly with hosts or teachers about your or your child’s needs before parties or events.
• Respect your limits. It’s okay to say no to parties, extra activities, or anything that feels overwhelming.
• Focus on what matters most. Safe spaces, loving people, and meaningful moments are more important than decorations, grandma’s pie or big plans.
• Shop for holiday gifts throughout the year and avoid the last-minute rush. Set a date when all your holiday shopping is finished.
• Ask for help. You don’t have to do it all yourself. Let others pitch in, even if it’s not done your way.
• Keep traditions simple. A favorite ornament, a shared movie, or a decorated window can bring joy without adding stress.
• Practice ahead of time. Help your child build confidence by role-playing how to speak up, stay safe, and have fun in social settings.
• 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.