For parents with children who have a food allergy, sending kids off to school can be worrisome.
In fact, about two children in every classroom have a food allergy. The most common food allergies are peanut, tree nuts (like walnut, cashew), shellfish (like shrimp), egg, milk, wheat, soy, fish (like salmon and cod) and sesame seeds.
Treatments are emerging and researchers at the Jaffe Food Allergy Institute at Mount Sinai are working hard to find better therapies and cures.
For now, the primary approach to managing food allergy is to avoid eating certain foods and to recognize allergic reactions and treat them promptly. Serious allergic reactions are treated with epinephrine, a safe medication delivered through an autoinjector. The epinephrine helps to relieve symptoms that can be life-threatening, such as trouble breathing and problems with blood circulation.
Scott Sicherer, MD
If you are sending your child to school with food allergies, here is a checklist of tips from Scott Sicherer, MD, Director of the Jaffe Food Allergy Institute and author of The Complete Guide to Food Allergies in Children and Adults (Johns Hopkins University Press).
Make sure you work with your allergist to confirm the diagnosis of food allergy. Often, children are avoiding foods to which they are not truly allergic. Sometimes they may be allergic to a food not yet identified. Your allergist will consider the past reactions, and allergy test results to make sure your child’s food allergies are properly identified.
If there is a potential severe food allergy (anaphylaxis), learn how to recognize and treat it. Talk to your allergist or pediatrician about symptoms of an allergic reaction. These can include:
- hives (itchy rashes that look like mosquito bites) on the skin
- swelling of the lips/face
- gut symptoms such as vomiting, nausea, or pain
- asthma type symptoms like cough, wheeze, trouble breathing, voice changes, and throat or chest tightness
- signs of poor circulation such as paleness, dizziness, or passing out
It is important to treat a progressive allergic reaction early with epinephrine and to seek medical attention for severe reactions, such as calling 911. Several epinephrine products are on the market and are activated in different ways—check out online videos and practice with trainer devices.
Share a written food allergy and anaphylaxis emergency plan with the school. A written plan is important to confirm with your school that there are allergies, and what to do in the event of a reaction. An example plan from the American Academy of Pediatrics is here.
In an age-appropriate fashion, make sure your child knows how to avoid allergens and when to inform an adult for any reactions. Depending upon their age and abilities, children may either have simple responsibilities (such as knowing who is trusted to provide them food and snacks and to let an adult know if they are not feeling well), or they may be able to read ingredient labels, identify allergic reactions, carry medications and even self-treat. However, in school, adults should be ultimately responsible to assure avoidance strategies are in place and to have a plan to identify and treat any allergic reactions.
Check that your child’s medications are up-to-date. Epinephrine autoinjectors may need to be renewed. Keep track of expiration dates.
Discuss how the school will keep your child safe. Most schools have had experience with children having food allergies. Discuss their approaches. Craft projects using food can avoid the allergen with substitutions. Celebrations could favor non-food approaches, such as playing a game or watching a video. Younger children may have supervision during meals. Discuss how food service will provide safe meals, including careful ingredient control with attention to avoiding allergen cross contact and identifying hidden allergenic ingredients. Supervising adults should be familiar with recognizing and treating allergic reactions.
Think about bullying. Children with food allergies report a high rate of bullying associated with their allergies. Ask your child about this. Let the school know if there are any issues.
On the bus. For those taking the bus, some good approaches include:
- ensuring the driver knows about the allergy and has a cell phone in case of any emergency
- not eating on the bus
- never putting a child on the bus if they are experiencing a possible allergic reaction
- having younger children with food allergy sit closer to the driver