Cindy Blonder of Swampscott had done absolutely everything she could think of before her family’s trip to Hawaii last year to keep her children safe.

Her son and daughter both have potentially fatal food allergies, so she scrutinized the menu for every meal they’d eat on the cruise ship, talked with the chef, and packed foods that are safe for her children to eat.

But as parents of children with food allergies quickly learn, there are always some risks beyond your control.

One evening on an overnight stay off the boat, they decided to eat at a chain restaurant that sells ribs. Blonder had talked to the restaurant staff about her kids’ allergies and got reassurances that what they were about to eat was safe.

But toward the end of the meal, her 11-year-old son Zachary’s eyes puffed up, he felt itchy and he had trouble breathing.

“It was either a hidden ingredient or cross-contamination,” Blonder said.

She gave her son Benadryl and they rushed to the closest emergency room, which just happened to be near their hotel and easy to find. Fortunately, the Benadryl worked, and by the time they arrived at the hospital, his symptoms were fading, but it was scary enough to put everybody on edge for a while.

“We were definitely shaken,” Blonder said.

Traveling with a child who has severe food allergies can be so difficult that some families simply don’t do it, said Sharon Schumack, director of education programs for the Asthma and Allergy Foundation of America’s New England chapter, based in Needham.

“It varies a lot from family to family,” Schumack said. “People have different ways of coping. Some people never eat out. Some people are very determined to have a normal life for the rest of the family.”

Planning ahead

For those who do travel, there are certain strategies for making the trip safe, she said. Families may stay in places where they have their own kitchen so they can cook their meals themselves. They may pack extra epinephrine injectors and locate the nearest emergency room just in case.

Maryellen McAdam of North Andover said her family takes vacations to Vermont regularly, in part because she wants to make things as normal as possible for her two children who don’t have food allergies. She just has to take special precautions so her son Liam, 4, doesn’t have a reaction to peanuts or beef.

“We have just really gotten into a routine, making sure we have our EpiPens where we are, knowing where there is a medical facility,” McAdam said.

It helps that they stay in a family home in Vermont, she said, so they have a kitchen and don’t eat out very often.

The few times they have traveled by airplane for vacation, McAdam has called ahead to the airlines to request peanut-free flights.

Pam Piehl of Andover, whose 9- and 11-year-old sons are allergic to peanuts and tree nuts, does a lot of air travel to visit family in Nevada, California and Florida. She calls the airlines ahead of time, too, she said, and she also tells the flight crew when she checks the family’s luggage, again at the gate, and again as they board the plane.

Sometimes the airline will announce that there are children with peanut allergies on board and ask passengers to refrain from eating peanut products, she said, and other times they won’t.

She packs her own food for the boys, such as pretzels or lunch meat sandwiches, after an airline once promised them an alternative to the standard peanut snack and instead gave the boys cheese and crackers that contained peanut oil.

Piehl also begins each flight by wiping down her boys’ seats, the armrests, the tray table and anything that’s not upholstered, in case the previous passenger was eating peanut products.

On the occasional trips when they don’t stay with family, the Piehls have taken cruises, in part because the food is easier to control than at a variety of restaurants on land.

Piehl contacted the cruise lines ahead of time, just like Blonder did, to discuss her children’s allergies. Then when they boarded the ship, they got a tour of the kitchen and met the staff who would be cooking their food.

Each evening, the boys got to look at the menu for the next day and choose their dinners. The kitchen would then figure out a way to alter the recipes to make them safe for the boys to eat.

It sounds like a lot of fuss, Piehl said, but the boys actually had a great time.

“They loved the attention,” she said.

The kitchen staff was so good at showing her labels and verifying that there was no cross-contamination with nuts on a cruise in March that the boys were able to eat soft-serve ice cream for the first time.

Worth the effort

Piehl is usually ready for a vacation of her own after returning from these trips because of all the planning and special arrangements, but she said it doesn’t bother her.

“I think that’s the role of being a mother,” she said.

Blonder came home from her family’s trip to Hawaii exhausted, too, from all the planning and managing food.

“It’s what we do all the time,” she said. “It’s just what I do constantly. It was just more intense.”

Yet in retrospect, she said, it was a great feeling to pull it off and to give her children such an exciting experience. They spent time on the beach, hiked to waterfalls, shopped and generally had a good time.

“At the end, it was a great relief,” Blonder said. “It was really a big accomplishment when we finished and we got through safely and we realized that we could pack and plan and go someplace that was not just around the corner.”

For all Blonder’s planning and worry about food, the vacation actually served as break for her children, she said.

“The nice part about it was that it wasn’t all about food,” she said. “We went sightseeing. The kids went parasailing. It was beautiful.”