During the past few years, the cruise industry has started taking food allergies and special diets more seriously. Many major cruise lines now have policies to avoid cross contamination. Recently, Cruise Lines International Association (CLIA), an industry trade group, issued a statement about how cruise lines accommodate food allergy diets.

“Cruise lines are well equipped and happy to accommodate a variety of diets including no/low fat, vegetarian, vegan, dairy or lactose free, gluten or wheat free, low cholesterol, diabetic, Kosher and Halal diets, as well as allergy-specific diets,” the CLIA said.

What are your options for dining on board?

Years ago, cruises only offered meals in their main dining rooms, with never-ending buffets. Cruisers now want more flexibility. So cruise lines have started offering specialty restaurants, food stations and small cafés.

But for families with a child with food allergies, the dining room is usually the safest place to eat. The larger dining room galley is set up better to create allergy-free meals and avoid cross-contamination. At dinner, you will have the same waiter every night. The maître d’ should also know about your child’s allergies to help ensure you receive safe meals.

Policies on food allergies and special diets vary among different cruise lines. Here is some information about how individual cruise lines handle food allergies:

• Carnival Cruise Line offers food options that do not include top food allergens. They offer allergy-free foods in their dining rooms and on the Lido Deck.
  
  
• Celebrity Cruises is working with Dine Aware, a company that helps food service staff improve their understanding of food allergies. This program is helping them create new food allergy standards on their ships. Dine Aware started in November 2016.
  
  
• Disney Cruise Line does not have separate kitchens for allergen-free foods, but they do state they will make "reasonable" efforts to prepare safe items. They recommend that you eat in one of their main dining rooms so you can discuss dietary needs with the head server. They also offer gluten-free and dairy-free options at their table service restaurants.
  
  
• Norwegian Cruise Line includes gluten-free kitchen areas. They also have strict rules in the galleys to avoid cross contamination when preparing and serving food. A spokeswoman said they can accommodate guests with food allergies.

Are staff of children’s programs trained to handle food allergies?

Many major cruise lines have children’s programs. But each cruise line has their own specific emergency procedures and policies, including those involving allergic reactions, a CLIA spokesperson said. Check with a cruise line representative for more information.

• Carnival: Youth staff can use epinephrine auto-injectors. They also serve snacks and meals. The snacks vary per ship, including snacks for children with food allergies.
  
  
• Celebrity: Youth staff are not allowed to give epinephrine. Parents register their children, leave the epinephrine and talk to the staff. Staff are trained to recognize emergencies and to tell the medical staff immediately. Staff use a special form to help them keep children with food allergies safe during meal times. To avoid allergic reactions, children cannot bring food or drinks into Celebrity’s youth programs and snacks are not served. They do serve the children lunch and dinner in their Oceanview Cafe. It is set up to handle food allergies and other dietary restrictions.
  
  
• Disney: Youth staff are trained and can use epinephrine auto-injectors. Parents or guardians must sign an authorization to allow the staff to give the medication. Disney asks that parents provide their child’s prescribed, unexpired auto-injector.
  
  
• Norwegian:  Youth staff are trained to contact the medical staff right away if a child has a reaction. They also keep epinephrine in the kids’ areas. Norwegian did not respond when asked if staff can give epinephrine.

What if my child has a reaction while on board?

Any ship with more than 100 passengers has to follow standards set by the American College of Emergency Physicians. This means there has to be at least one doctor on board and all clinic staff has to have at least three years of experience.

The availability of stock epinephrine on board varies from ship to ship. Celebrity, Disney, Norwegian and Carnival all carry epinephrine on board. As with any trip, bring your own epinephrine and other medicine. Some ships are enormous and the infirmary may be on one of the lower floors of the ship. Emergency care could take several minutes to reach you.

“Since each ship is different in size and configuration, we are unable to provide exact ‘response times’ to various emergencies,” said Bradley Norman, corporate communication specialist for Celebrity. “However, the response is only a few minutes at most and is generally much more rapid than that which can be expected by land-based staff.”

So carry your own or your child’s epinephrine with you at all times while moving around the ship. And don’t forget to carry epinephrine on offshore trips.

Can offshore excursions accommodate food allergies?

Cruises are a great way to experience international locations. But a ship’s food allergy policy will not apply at ports and during offshore trips.

Other countries may not have formal food allergy policies. You may not get accurate information about food ingredients. Be cautious when eating off the ship and research the country you are visiting ahead of time.

Also, the U.S. Department of Agriculture won’t allow cruise lines to give safe meals to take off the ship. You can usually choose from a variety of shore excursions that are short and don’t offer food. This will allow you to enjoy the port while giving you the chance to return to the ship for meals.

Each cruise line has different policies on packing your own food from home. Norwegian lets you bring non-perishable food on board and on excursions. Disney will also allow you to bring sealed, non-perishable food on board as long as it is in its original packaging. Carnival and Celebrity do not.

USDA regulations will only allow you to take baby food and dry, non-perishable snacks off the ship at ports of call.

I’m ready to book a cruise. What do I do now?

Before you book a cruise, do your homework. Call the cruise line and ask questions:

• Ask about their specific food allergy policies, youth programs and medical policies. Policies can vary on each cruise line.
  
  
• Ask about bringing your own safe snacks on board.
  
  
• Once you choose the cruise line you are most comfortable with, ask your travel agent or cruise sales person who you need to talk to about your child’s allergies. With most major cruise lines, they will have you speak to a special department. They usually make sure your ship’s staff knows about your child’s allergies in advance.
  
  

Does my child need a passport?

If your cruise is a closed loop sailing, you may be able to travel with just a birth certificate. A closed loop sailing means you leave from and return to the same U.S. port.

However, if you have a medical emergency and need to be transferred to a hospital at one of the ports, you would not be able to reenter the U.S. without a passport. You would have to contact the U.S. Embassy or Consulate at the port for help returning to the U.S. This could be a lengthy process. So in case of a medical emergency, it is a good idea to have passports for your entire family.

Cruising has become a popular family vacation option. Many families have safely cruised with children with food allergies. But before you book, do your research on individual cruise line policies to see which one is right for you. You might find cruising to be a great way for your family to have safe, allergy-free fun.