Food Allergies and School

Janet Imp, MD FAAP

Summer break is almost over and school is getting ready to start again. While this can be an exciting time, it can also be very stressful. This is especially true for children with food allergies. Due to the difficultly of controlling the school environment, risks of an allergic reaction at school can be greater than at home.

Here are some helpful tips:

• Check with your school on any Food Allergy and Anaphylaxis Paperwork.
  • Some schools require your child’s pediatrician to fill out a Food Allergy and Anaphylaxis Form while other schools only require a parent to fill it out. If your child’s pediatrician needs to fill it out, an appointment may be required.
• Time is critical in an allergic reaction and an Allergy Action Plan can help.
  • Great action plans can be found at https://www.foodallergy.org/life-with-food-allergies/food-allergy-anaphylaxis-emergency-care-plan. This site helps ensure that your child’s teacher, the school nurse, your child (if old enough), and other adults at school know what to do if your child has an allergic reaction. Most importantly, it informs what signs of an allergic reaction look like:
    • Hives, difficulty breathing, wheezing, vomiting, scratchy throat, and dizziness.
• It is very important that your child has ready access to emergency medication.
  • In most cases, emergency medication means having a labeled unexpired epinephrine auto-injector (EpiPen, Auvi-Q) at school, but always ask your pediatrician first about the most appropriate emergency medication for your child. If an epinephrine auto-injector is required, you should make sure that your child’s teacher and other adults have been trained to inject the medication. If your doctor feels your child is old enough, and understands how and when to use an epinephrine auto-injector, they are legally allowed to carry it with them at all times.
• Make sure that your child’s teacher(s) are aware of your child’s allergies.
  • Teachers need to know what the allergies are, how severe they are (ingesting only vs. touching vs. smelling), and what symptoms your child has had in the past when having an allergic reaction. Also, confirm that they understand how and when to use an epinephrine auto-injector, if needed.
• Teach your child about their allergies.
  • Your child should understand what they are allergic to and what the symptoms of an allergic reaction are. Children with food allergies should know what foods are safe and unsafe to them, and to never share food with friends or eat anything if they are not sure what is in it. If they are old enough, they should be taught how to self-administer an epinephrine auto-injector.
• Any child that is at risk of an allergic reaction should wear a medic alert bracelet.
  • This will help responders understand that the child may be having an allergic reaction and treat accordingly.
• Make sure all adults who may care for your child also know about your child’s food allergy and what to do.
  • Bus drivers, after-school program employees, athletic coaches, and babysitters all need to understand the Allergy Action Plan.
• Parents and guardians of children with allergies should become as educated as possible about food allergies.
  • Every year children who have died from food allergies had an epinephrine auto-injector at home but didn’t use it.
  • Parents should be comfortable reading food labels so they know when to avoid certain foods.
  • Discuss with your child’s pediatrician about statements like “Manufactured in a plant containing …” Parents should also practice and be comfortable administering an epinephrine auto-injector. If you aren’t comfortable then ask your pediatrician to teach you or go online and watch a video like the following: https://www.youtube.com/watch?v=FXlqSuzzrws.
  • Parents should understand the signs and symptoms of an allergic reaction so that they know when to administer an epinephrine auto-injector.
• Advocate for your child and food allergies. Almost every state including Florida (as found in http://laws.flrules.org/files/Ch_2013-063.pdf) has passed legislation regarding stocking epinephrine auto-injectors without a prescription in schools.
  • Epinephrine auto-inject may be used for an undiagnosed allergic reaction by a student or adult at school. Unfortunately many school districts have not taken this as an opportunity to provide this life saving device.

If you have any questions about food allergies please make an appointment with your pediatrician.