Pencils, notebooks, backpack, and . . . Epipen®. If your child has food allergies, packing up the backpack to head off to school means more than just having enough pencils and erasers—and being prepared for a food-related emergency doesn’t mean just packing a snack. The 5 to 8 percent of American children who have food allergies need to be ready to face potential life-and-death situations in the classroom, in the lunchroom, and during after-school activities. Parents, educators, and fellow students all need to be aware of the seriousness of food allergies and how to help food-allergic students. Sometimes parents need a little guidance on how to handle the school situations as well. Here are a few tips to help.
A Food Allergy Primer
The most common food allergens for all people are peanuts, tree nuts (such as walnuts, pecans, and almonds), dairy products, eggs, soy products, wheat, fish, and shellfish. “For children, peanuts, tree nuts, milk, egg, and soy are the main culprits,” explains Susan L. Hefle, PhD, codirector of the Food Allergy Research and Resource Program at the University of Nebraska—Lincoln. The rates of peanut allergy in particular seem to be increasing among children. “Recent reports from Mount Sinai Medical School indicate that childhood peanut allergy has doubled, while the adult rate has remained steady,” says Hefle. Nevertheless, it is important to realize that other foods that cause allergies can be just as prevalent and dangerous, especially among younger children. “Although peanut allergy receives the most press coverage, milk and egg allergies actually affect more children in the U.S.,” adds Anne Muñoz-Furlong, founder and chief executive officer of the Food Allergy & Anaphylaxis Network (FAAN).
True food allergies (as opposed to food intolerances) involve the immune system and occur when the body mistakenly interprets something in a food or a food ingredient (usually a protein) as an invader and produces antibodies to fight it. With repeated exposure to the offending protein, the body continues to mount its defense so that, finally, the allergenic food triggers the release of histamine and other powerful chemicals in the body. These are the components of the body’s defense that cause food allergy symptoms.
Food allergy symptoms can range from mild (such as an itchy mouth, an itchy tongue, or hives) to severe (shock or cardiac arrest). The most severe food allergy reaction is called anaphylaxis. This infrequent, yet potentially fatal, response to an allergen involves several different body systems and results in a collection of symptoms instead of the usual one or two seen with a typical food allergy. Difficulty breathing, throat constriction, decreased blood pressure, and unconsciousness may occur almost simultaneously. Anaphylaxis progresses quickly, and treatment usually includes an injection of epinephrine. According to Hefle, anaphylactic reactions occur most often when someone is eating away from home and inadvertently consumes the offending food. This is the reason why it is extremely important that school personnel be familiar with both the symptoms of food allergies (so that they can recognize a reaction in progress) and the proper treatment procedures.
Speaking Up About Your Child’s Food Allergy
Thoroughly communicating with the school about a child’s allergies is one of the most important things that a parent can do to help prevent a reaction from occurring during school hours. This is even more important if a child has been newly diagnosed with an allergy, as there won’t be any history from which the nurse, food service staff, or teachers can draw.
Meet with the school nurse and the child’s teachers.
“It’s very important to call the school early and make an appointment for a meeting; everyone will be more focused on you and your child that way,” advises Muñoz-Furlong. Even if the school staff claims to be familiar with the problem already and has had the student in class before, ask for a meeting anyway. It will help the staff brush up on your child’s symptoms and treatment plan and any changes in your child’s medical condition. Who should attend the meeting? At a minimum, your child’s primary teacher and the school nurse should be present. At the meeting, discuss the allergy, its symptoms, and treatments. Find out whether your school system allows children to carry their own allergy medications, and if not, find out who will be in charge of the medication. If your child is older and moves from class to class, request that all the child’s teachers come to the meeting, but be prepared if they don’t.
Get to know the food service manager.
Aside from teachers, most people focus on the lunchroom scene when communicating allergy information. The school’s food service staff is part of the food allergy management team and should be invited to any meetings about your child’s allergy. The School Nutrition Association (SNA), formerly the American School Food Service Association, provides school nutrition professionals with information and resources on managing food allergies through conference education sessions, its Web site, and its member publications. However, “Policies and approaches for managing food-allergic students are set at the local school and district level, and they can vary widely,” explains SNA spokesperson Erik Peterson. “We encourage parents to contact their local food service director to discuss these policies one on one.” In addition, you may want to order the International Food Information Council (IFIC) Food Allergy Poster for Food Service Workers to give to your school’s food service manager. The poster, written in both English and Spanish, describes “what you need to know” and “what you need to do” to answer questions or deal with an allergic reaction to food. The poster can be ordered on the IFIC Web site at http://ific.org or by e-mail at foodinfo@ific.org.
Provide copies of your child’s Food Allergy Action Plan.
You can obtain a form to create your child’s Food Allergy Action Plan from the FAAN Web site (www.foodallergy.org). The form lists the symptoms and step-by-step instructions to treat your child’s allergy and is to be signed by the child’s doctor. It also has a place to attach a picture of your child. Have multiple color copies of the form ready to hand out to school staff.
Don’t forget adjunct staff.
Food allergies are an issue that the entire school staff—not just your child’s primary teacher—should be made aware of. “Reactions in school frequently occur when children are working with food for projects—in math class, art, home economics—and during school celebrations,” explains Muñoz-Furlong. After-school activity supervisors, such as coaches, tutors, and advisors, should also be included in the communication chain. Have Food Allergy Action Plan forms handy for all supervisory staff with whom your child will come into contact during the day.
Food-Allergic Teen? Handle with Care
Most teens aren’t too willing to let their parents proclaim the dangers of their child’s food allergy to everyone at school. In fact, they often don’t want anyone to know they suffer from food allergies at all. Teens with food allergies are considered a high-risk group because they have more opportunities to consume food unsupervised and they don’t tell others that they have food allergies. Teens have been known to just walk away from the group during the throes of an allergic reaction, simply because they don’t want to draw attention to themselves. These issues of fitting in and privacy concerns can make a parent’s job more difficult, but not impossible. “The basic difference between informing a young child’s school staff and informing a teen’s school is that the teen should be included in all aspects of the communication, whereas a younger child is not,” explains Muñoz-Furlong. For instance, your teen should be included in the meeting with the school staff so that he or she can discuss his or her allergy experiences and specific symptoms. He or she should also be involved in any school plans for handling a food allergy emergency, such as who will be informed or contacted and under what conditions.
Teens should also be encouraged to educate at least one friend about the allergy and enlist that friend’s help should an emergency occur. For instance, the chosen friend could be trained to spot symptoms and could be taught how to administer epinephrine. FAAN’s Protect a Life (PAL) program discusses the importance of sharing the food allergy responsibility with a friend and offers tips and techniques for doing so successfully. Details on the PAL program can be found on the FAAN Web site.
“Role-playing with your teen is another good idea,” says Muñoz-Furlong. “Go through a variety of situations that could occur and ask, ‘Who would you tell?’ That way both teen and parent can rehearse potential crisis situations and figure out the most acceptable way to handle it for all involved.”
Awareness, Education, and Preparedness are Key
Watching a food-allergic child head off to school for the first time can be frightening for parents. There are so many potential pitfalls, and no one will be as careful with your child as you will be. Yet, with vigilant effort you can do a lot to make your child’s journey to school a safe one. Spreading the word about food allergies, providing adequate information on allergies and treatment steps, and rehearsing problem situations are the most effective ways for both you and your child to manage food allergies when school is in session.
Starting a new school year is an exciting time for children, and there is no reason why it shouldn’t be so for the food-allergic child as well. Be careful not to overemphasize the potentially alarming and dangerous aspects of your food-allergic child’s school experience; the point is to prepare and empower the child, not scare the child. Your matter-of-fact, consistent, and thorough handling of school situations will help keep your child safe and enhance the child’s entire academic experience.
Top Food Allergens for Children
- Peanuts
- Milk
- Eggs
- Soy products
- Tree nuts (walnuts, pecans, almonds)
For More Information
Food Allergy & Anaphylaxis Network (FAAN):
800-929-4040
www.foodallergy.org
American Dietetic Association:
800-877-1600
www.eatright.org
School Nutrition Association:
703-739-3900
www.sna.org
