Dr. Hoyt’s RAST Framework: What Parents Should Do After a Food Allergy Diagnosis

In this episode, Dr. Alice Hoyt shares a practical and empowering mental model—the RAST framework—to help families navigate the complexities of food allergies with confidence. Whether you're newly diagnosed or have been managing food allergies for years, this approach offers clarity and actionable steps to enhance your journey.

food allergy diagnosis, new food allergy parent, epinephrine, allergist advice, managing food allergies

Resources

📖 Navigating Food Allergies: A Parent’s Guide to Care, Coverage, and Confidence by Dr. Alice Hoyt - order from Amazon and more 

For Parents ➡️ Office Hours for Parents 

For Providers ➡️ Food Allergy Pediatric Hub

For Schools ➡️ Code Ana

For Potential Patients ➡️ Hoyt Institute of Food Allergy

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This podcast is the official podcast of the Hoyt Institute of Food Allergy. Information on, within, and associated with this site and Food Allergy and Your Kiddo is for educational purposes only and is not medical advice.

Transcript

Introducing The Book And Its Purpose

Why RAST Became A Framework

Recognize: Naming The Problem

Accept: Facing Hard Truths

Strategize: From Avoidance To Options

Find An Allergist And Confirm

Triumph: Defining Success For Your Family

Using SMART Goals To Move Forward

Evidence, Art Of Medicine, And Next Steps

SPEAKER_00 0:04

Hello and welcome to Food Allergy in Your Kiddo. I'm your host, Dr. Alice Hoyt. Excited to be back from Philadelphia, where I attended the American Academy of Allergy, Asthma and Immunology conference. It was a great conference. My favorite part about the conference was catching up with my friends, my colleagues, talking to people who are doing really cool things in the food allergy space, outside of the food allergy space, learning more about some of the best things coming out for food allergies. It is a whole new world. If you have been in this space for a while, this is a new day. It is a new day. If you're new to the space and all maybe you really know about the space so far is maybe things that you've heard 10 years ago. It is a new world, a whole new world. So what I wanted to talk with you about today, and thinking, okay, things are things are changing. What can I really bring today to talk about, especially if you're new, especially if you're new. And one reason I really want to talk specifically to if you knew, or really, I mean, this is gonna be relevant wherever you are on your journey, but I wanted to share something that's in my book, which my book comes out April 21st. Um, very excited about it because this is a book navigating food allergies, the parent's guide to care coverage and confidence. This is a book where I basically tried to take everything I have here and put it into this book so that you, as a parent of a child with a food allergy, has a guide, has a guide by which to help you walk this road with your child. And it doesn't matter with this book if you're new to the food allergy world, if you've been on your journey for a while, if you have an IgE anaphylactic food allergy, if you have EOE, F Pies, whatever your kiddo has, this is going to be a very helpful resource for you. Um, very blessed to have had so many wonderful people review different chapters. Um, and in the back of the book, I have my acknowledgments, thanking all those amazing people. Um, but what I wanted to talk with you about today is a framework that I introduce in the book. And I totally took the term RAST, which is an old term for immunocap testing. That's technically is not correct. Technically, immunocap testing and RAS testing are different, but they're both checking for IgE in the blood work. And RAST in in the scientific testing world stands for radioallergo sorbent test, RAST tests. And again, it's a way to check for allergic antibodies in the blood. We don't really use RAST testing anymore because we have a different way to test for allergic antibodies in the blood. It's called immunocap testing. Um, but I took that RAST and I made a mnemonic to give you a really tactical approach in the book to focus more on managing food allergy anxiety situations. But really thinking more 40,000 feet, this 40,000 foot view, this framework, this Rast mnemonic can be so helpful, really anywhere you are in your food allergy journey and uh somewhat in life as well. And so that's what we're gonna talk about today. So, what does what does my Rast stand for? It stands for recognize, accept, strategize, and triumph. And so what this whole framework really means, what this whole mnemonic really means and why I created it was because sometimes food allergies can seem kind of overwhelming, right? If you are new to this space and your child was just diagnosed with a food allergy, or just last week, just last month, your child ate a food and had a reaction, you went to the ER and and now you're waiting for that allergy appointment. It it's it's a different season of life than you thought you were going to be in. And the first step in navigating this season of life is to first recognize where you are. Recognize that, okay, he had a reaction, she had a reaction, or maybe he had a reaction, maybe she had a reaction, maybe you're not sure yet. That's okay. Because as long as you have a plan by which to clarify what's going on and move forward, that's okay. And but you can't have a plan, right, until you recognize that you need one. So if you have a child who maybe eats peanuts sometimes and gets some hives sometimes, but maybe you haven't talked with your doctor about that, or maybe you've talked to your pediatrician, but haven't seen an allergist, now is the time, right? Because you're recognizing something is going on. And as I open this show, I said, this is this is a whole new day in the world of food allergy. There are so many different ways now, good ways, approaches to managing food allergy, to actually treating food allergies. It's not just here's your Epi, see you next year to refill it. There are actually ways to intervene on these allergic conditions. But you can't intervene on something until you recognize it, right? You can't intervene until you recognize it. And then the second step, the second part of the RAS framework, we said recognize. The second is accept. So we have to accept, okay, something's going on here. We have to accept that. And sometimes it's hard to accept that. Right? Sometimes it's hard to accept that a food is a potential danger to your child. I totally get that. I totally get that firsthand. So to think about how we can help our children, how can we help navigate them through their journey? We have to first recognize there's an issue, see it, and then we have to accept that there's an issue. And this might seem very basic. You might be thinking, wow, Dr. Huit, this is not rocket science. No, it's not. It's not rocket science. But I see so often in my practice where families, parents have not just sort of stopped and thought about these things. They recognize there's an issue. They're they're my office, right? But accepting that there is an issue, and acceptance isn't just saying, okay, yeah, there's an issue. It's saying there's an issue. And I don't want to be okay with that, but I'm going to be okay with it for now. Because accepting there's an issue means that we can strategize ways to manage it. Manage it the best way for your child. And that's the S in my Rast, in my mnemonic rest. Recognize, accept, strategize. Okay, so you've recognized there's an issue, you're accepting it, and now you're going to strategize a way to navigate this journey, to have some control over the journey. And that's what I think so many families for so many years just felt so lacking in control because really the only option was okay, you have an allergy, you have to avoid it. It might seem like it's easy to avoid a peanut. Yeah, it's easy until it's not. It's easy until you have an accidental ingestion. Or I hear it from my kiddo's parents who are allergic to peanut and egg, or peanut egg and milk, or peanut and milk, or egg and milk being more foods that are a little more like prevalent, harder to avoid. Um I'm not diminishing peanut. Peanut is not all that easy to avoid sometimes, especially when it's like hidden and things. That's why it's very important to, when you're dining out, it's very important to be very upfront with your dining team, with your server, as I've talked about in other episodes of this show. But coming back to needing to strategize and recognizing something's going on, accepting it, strategizing so that you can intervene. And the lack of control that families felt for so long, now there are treatment options. So now there are options. Does that mean that if you are choosing avoidance as the management strategy for your child, does that mean that you're not being proactive in your child's allergy treatment? No way. I think I ran up went on record saying that a few years ago when there was an ad out for palphorsia, which is now, as you know, no longer going to exist, just an episode on that, and that's okay. That's okay. If your child's on palphorsia and you're hearing, okay, it's going away, your child's not going to have that anymore, that's okay. Because there are other ways to continue oral immunotherapy for peanut allergy with other peanut products. Um, but practicing avoidance is still an active way of managing your child's food allergy. And the next step to not just avoiding, but really taking it the next step of saying, okay, we're gonna avoid now, but I'm going to stay informed on what therapies are available on oral immunotherapy, on sublingual immunotherapy, on omalism app, on these things that are coming down, the patch, the peanut patch is coming out. All these different ways that could potentially, potentially help my child. I am choosing avoidance for my child right now because that is the best step, the best path for my child right now in this season of life. But I'm going to continue to educate myself through evidence-based resources on what other options there are. And I'm going to continue to weigh those against avoidance. And that is being proactive on managing your child's food allergy. So we talked about recognize, we talked about accept. We talked about strategize. And I want to get back too for a minute on if you're new to this journey and you've recognized, okay, my child probably has a food allergy, you're you're accepting it. Maybe you're waiting to accept it until you see the allergist. But in order to accept it, you've got to strategize. You need to see a board-certified allergist. I've said that a lot of times on this show because I can't underscore enough the value of a family having a discussion with a board-certified allergist. Allergists are the physicians, the experts on food allergies. Yes. Some allergists get really in the weeds and really focus their careers on food allergies. Yes, absolutely. And I would encourage you to try to find an allergist who really just loves being in the weeds on food allergies. But there are also allergists who are amazing allergists who practice general allergy, but are still trained in food allergy. And so you need to talk to an allergist to really confirm the diagnosis because you cannot treat something. We learned that intern year, right? You can't treat something until you can really diagnose something. So you want to diagnose and then you want to treat. So we talked about recognize, we talked about accept, we talked about strategize, and all of that, and checking in in my book, comes to our T for triumph. Triumph is a word that you get to decide the definition. What does success look like for you? Whatever it looks like, you cannot be successful on your food allergy journey if you're not first recognizing, okay, yeah, we've got some food allergies, accepting them, like, okay, this is our season of life. This is it. We're gonna strategize with whatever path forward we're considering, but we are going to consider different paths. We're going to seek out good information so that we can triumph. And I hope that this Rast mnemonic, this Rast framework, is a blessing to you, to your family. If you listen to the show regularly or watch this on YouTube, then you know I I do really like frameworks. I really like practical, tactical, strategy, ways to sort of make some of these different challenges that you're going through ways to really distill down the issue, not dilute it, distill it down to what is the issue. What where is your struggle today with food allergy? Is it you're unclear on what options are available for you? Is it that you're you're having a lot of anxiety over a certain situation at school? Whatever it is, being able to use the RAST framework, recognize, hey, I'm having an issue here. Not just sweeping it under the rug anymore, but I'm having an issue here, accepting it. Okay, I'm not gonna ignore this anymore. And then strategizing how to address that. And this is also I'll highlight, and I talk about this in the book. You know, I probably couldn't write a book without talking about SMART goals. A SMART goal is specific, it's measurable, it's achievable, it's relevant and it's time-bound. Love SMART goals, right? Because it takes things that can seem so overwhelming, so big, and helps you distill it down and figure out very doable step-by-step approach to bring you from a place of I don't really know what's going on, I don't really know what my options are. Maybe I just want to try to keep ignoring this, to this is the issue, this is my plan for it. The plan can change, the plan can absolutely change, but we're going to have a plan that we're going to continue to seek what is the best option for my child so that we can triumph. And again, triumph you define success. For your child, success might be oral immunotherapy. For your child, success might be getting the Zolar shots going so that y'all can go to your Europe trip. Whatever the case may be, triumph you decide. But the way you can decide it is by focusing in, recognizing an issue, accepting it, strategizing it so you can have your triumph. I hope this episode has been helpful for you. When you have questions, I hope, I hope you sign up for our Joyful Living newsletter. I recently revamped the newsletter and I love it because it it really is the title. It's Joyful Living. You know, if so, if you're new here, this is not the place to come for sensationalized, over-the-top food allergy information. This is the place to come for an evidence-based discussion. Yeah, we talk about serious issues. We talk about the facts, but we're not going to sensationalize things. Um, we're going to talk about the facts, how experts interpret data, why experts interpret data certain ways, why different allergists do different things. There's so many different approaches. Medicine, if you're doing medicine right, it is an art. You're applying concepts, you're keeping up to date with the literature to apply all of that to what's best for that patient in front of you. And so if you are new to this journey, I welcome you here. If you have been on this journey for a while and you've been part of the kiddo network for a while, then hello again. And I hope that on this journey that I continue to serve as a blessing to you and your family. God bless you and God bless your family.

Closing, Disclaimers, And Newsletter

SPEAKER_01 18:19

Thanks so much for tuning in. Remember, I'm an allergist, but I'm not your allergist. So talk with your allergist about what you learned today. Like, subscribe, share this with your friends, and go to foodallergy in your kiddo.com where you can join our newsletter. God bless you and God bless your family.