Table 2 Parent focus groups: quotations from mothers (M) and fathers (F) of children with food allergy arranged by domain.

▪ (M): "One of my sons has had two anaphylactic reactions, and it never leaves you. You cannot ever forget. It's like a broken record.....just the feverishness, and this helplessness, horrible helplessness feeling you cannot describe. It is such a gut-wrenching squeezing of your body when you see your child going through that."

▪ (F): "You are so fearful of anaphylaxis and death. It is this kind of unknowing, this uncertainty of what degree of reaction it's going to be, and this constant [feeling]."

▪ (M): "You do find that [in] every relationship you have to address the allergy issues. So you are always talking about it because there is always something that can come up."

▪ (F): "I would say from my family's standpoint it was very difficult at first for them to understand, and in fact their tendency was to say, 'Well, you are just being neurotic and overprotective, and it is really not an issue'. And frankly, it was almost that they did not want to be inconvenienced by our situation. Therefore it was easy for them to discount it and say that [we as] the parents [were] being overprotective."

▪ (M): " [Food allergy] affects every aspect [of your life] from where you take a vacation to whether and where you go out for dinner to play dates, which we certainly cannot do on the spur of the moment sort of basis as many [other] families can do. It affects literally every aspect of our social life."

▪ (F): "Going to parties, going to restaurants, having people over, any social contact that involves food becomes very distracting. [You] always kind of have to make sure that they [food-allergic child] are not eating anything that they have not asked you about."

▪ (F): "My wife is much more into 100% prevention all the time and I am much more into trying to maximize what my son can do. [I am] trying to figure out what that limit is so he can do the most he could possibly do where [as] she is much more in tune to 'Let's not take a chance at all' and 'I do not want put my son in danger."'

▪ (F): "I think we experience stress in different ways, but I think the fundamental difference is that she [the child's mother] feels the day to day responsibility [due to] the fact that she is there, and she is making those decisions. [Food allergy] is [the] one area in our marriage that [arguments] come up because I do not think I am as aware of the amount of stress that it creates for her."

▪ (M): "Milk and cheesy things are favorite [s] of [my husband's], and he is not going to give it up. [He is] not going to give it up regardless if it is life threatening to our child. So [milk] is in the house, and I follow him around and clean up. It has caused a huge marital strain."

Domain: Definition & Diagnosis

▪ (M): "It literally took six physicians before one said, 'Let's see if maybe this [eczema] is food-related with your daughter.' [There were] six [physicians] before someone thought that [food allergy] may be a possibility, and then when we went back to our dermatologist, we were basically told that it was just a lucky coincidence that when the dairy was [removed from her diet], the eczema went away too. I do not think that the doctor was being ignorant. I think that perhaps the doctor just did not know that this was even a possibility because of her training."

▪ (M): "I think there was a time [when] food allergies were a rare thing, and I think pediatricians did not have the same level of concerns for it, just [like when] childhood diabetes was a rare thing. I think there is a bit of a lag, and a need for the medical community, especially pediatricians, to step up in terms of their level of understanding of the prevalence of this illness."