Allergy & Asthma-Kent H. DeYarman, MD

Topics in Allergy

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Managing Food Allergies At School

Managing your child's food allergies is daunting enough in early years when he or she is under your constant supervision but what about the day your child begins school.. Life suddenly becomes more complicated when you are not always present to be on guard for hidden food allergens. Schools have different knowledge bases about anaphylaxis and food allergies and policies to handle the problem of children with food allergies vary greatly from school to school. There are no easy answers and there is much we have yet to learn. One example is the question of what is the risk from very low exposures such as a trace of peanut on intact skin or airborne particles of peanut dust. Recent evidence suggests these exposures, though capable of causing reactions, rarely cause life threatening anaphylaxis. Unfortunately we do not have enough evidence to be certain of this. Clearly the highest risk is accidental ingestion and avoiding accidental ingestion, recognizing the early signs of a reaction and administering treatment immediately when a reaction is noted are high priorities.

 

Perhaps the best way to approach these concerns is to begin a dialog with your child's teachers and school about food allergy and anaphylaxis emphasizing ways to minimize the chance of accidental ingestion, recognizing reactions and the importance of early administration of adrenalin (epinephrine). Below are a few links you may find useful in this dialog with your child's teachers. There are many suggestions in these links. Some will be more practical for some schools than others. Some of the more important suggestions are:

 

*Providing your child's teacher with a Food Allergy Action Plan (downloadable below).
*School policy to not allow homemade snacks.
*Providing a small "cache" of snacks for your child to eat if the class is eating and the food being served is either clearly a problem or it is uncertain if the food is safe or not.
*Avoiding the whole concept of repeated snacks through the day. We have enough obesity problems in the US as it is.
*Having epinephrine (such as an EpiPen) available in the classroom rather than locked away in the office.
*Allowing children to carry and use their own EpiPens when their parents are comfortable with their ability to do so. Immediate administration is critical and children can tell when they are having a reaction before it is evident to anyone else.

 

Here are the links:

 

AAAAI School Anaphylaxis Position Statement
http://www.aaaai.org/media/resources/academy_statements/position_
statements/ps34.asp

 

FAAN Food Allergy Action Plan
http://www.foodallergy.org/downloads/FAAP.pdf

 

Avoiding Food Allergens at School
http://www.foodallergy.org/school/archive/avoid.html

 

Cleaning Methods to Avoid Peanut Allergens
http://www.foodallergy.org/school/archive/cleaning.html

 

Field Trip Suggestions for Children with Food Allergies
http://www.foodallergy.org/school/archive/fieldtrips.html

 

School Buses and Food Allergens
http://www.foodallergy.org/school/archive/bus.html

 

Children's Descriptions of Anaphylactic Reactions to Foods
http://www.foodallergy.org/school/childdescribe.pdf

 

Food Allergies-Suggestions for Food Service Staff
http://www.foodallergy.org/school/archive/cafeteria.html


Tools for Parents & Schools to Help Manage Food Allergies
http://www.foodallergy.org/school/toolkit/getstarted.html