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School Guidelines for Food Allergies
Written by Dr. David Swanson Licensed
Clinical Psychologist Swanson, Conti & Associates Encino,
CA
A few years back, my wife and I came
home to find my youngest son lying on the sofa lethargic, lips swollen, blotches on his skin and appearing to breathe laboriously.
Needless to say, my wife and I were greatly alarmed and contacted his pediatrician right away. After
a very stressful afternoon, the pediatrician informed us that he believed our son suffered an extreme allergic reaction (also
referred to as anaphylaxis) to something he ate. Although we were happy to hear that this was treatable,
we became even more concerned to determine the exact cause of his reaction so as not to subject him to one again.
After more research, it was determined that he suffers from an allergy to tree nuts.
Since that time, I have seen a growing concern on the part of local
schools as well as my clients regarding food allergies in children. And as I question my own personal experience
and the bias I may have, it seems as if this concern is growing nationally as well. I recently completed
an interview with Kim Roth, a writer for Allergy and Asthma Today, regarding the impact of food allergies on children and
families. And last May, I engaged in a country-wide radio tour (including CNN and ABC Radio) on the same
topic. People really seem to be grabbing on to this issue and they will not let it go. But
why?
Sure enough, the literature depicts
an increasing trend in the diagnosis of food allergies in children. Food allergies result in 30.000 trips to the emergency
room every year. They also account for between 100 to 200 deaths per year. Although
3 to 4% of adults suffer from some sort of food allergy, it is said that six percent of children under the age of 3 suffer
from some type of food allergy. 90% of these allergies include what has become known as the “Big
8.” The foods in the Big 8 are peanuts, tree nuts, milk, eggs, shellfish, seafood, soy and wheat.
Families that deal with food allergies are often aware of their treatment options. Avoidance diets,
Benadryl, Epinephrine (Twinject / Epipen) are all terms openly used by these families. But these parents
struggle when it comes to protecting their child outside of the home. In particular, many of the parents
I speak with want to know how to protect their child while at school.
Fortunately, the Food Allergy and Anaphylaxis Network (FAAN) has published
guidelines for schools managing children with food allergies. Below you will find these guidelines.
School Guidelines for Managing Students with Food Allergies
The following has been duplicated from the Food Allergy and Anaphylaxis Network website. These
guidelines can be found at http://foodallergy.org/school/SchoolGuidelines.pdf
Family’s Responsibility
● Notify the school of the child’s allergies.
● Work with the school team to develop a plan that accommodates the child’s needs throughout the
school including in the classroom, in the cafeteria, in after-care programs, during school-sponsored activities, and on the
school bus, as well as a Food Allergy Action Plan.
●
Provide written medical documentation, instructions, and medications as directed by a physician, using the Food Allergy Action
Plan as a guide. Include a photo of the child on written form.
●
Provide properly labeled medications and replace medications after use or upon expiration.
● Educate the child in the self-management of their food allergy including:
-
safe and unsafe foods -
strategies for avoiding exposure to unsafe foods -
symptoms of allergic reactions -
how and when to tell an adult they may be having an allergy-related problem -
how to read food labels (age appropriate)
● Review policies/procedures with
the school staff, the child’s physician, and the child (if age appropriate) after a reaction has occurred.
● Provide emergency contact information.
●
Be knowledgeable about and follow applicable federal laws including ADA, IDEA, Section 504, and FERPA and any state laws or
district policies that apply.
● Review
the health records submitted by parents and physicians.
●
Include food-allergic students in school activities. Students should not be excluded from school activities solely based on
their food allergy.
● Identify
a core team of, but not limited to, school nurse, teacher, principal, school food service and nutrition manager/director,
and counselor (if available) to work with parents and the student (age appropriate) to establish a prevention plan. Changes
to the prevention plan to promote food allergy management should be made with core team participation.
● Assure that all staff who interact with the student on a regular
basis understands food allergy, can recognize symptoms, knows what to do in an emergency, and works with other school staff
to eliminate the use of food allergens in the allergic student’s meals, educational tools, arts and crafts projects,
or incentives.
● Practice the Food Allergy Action
Plans before an allergic reaction occurs to assure the efficiency/effectiveness of the plans.
● Coordinate with the school nurse to be sure medications are appropriately stored, and be sure that
an emergency kit is available that contains a physician’s standing order for epinephrine. In states were regulations
permit, medications are kept in a easily accessible secure location central to designated school personnel, not in locked
cupboards or drawers. Students should be allowed to carry their own epinephrine, if age appropriate after approval from the
students physician/clinic, parent and school nurse, and allowed by state or local regulations.
● Designate school personnel who are properly trained to administer medications in accordance with the
State Nursing and Good Samaritan Laws governing the administration of emergency medications.
● Be prepared to handle a reaction and ensure that there is a
staff member available who is properly trained to administer medications during the school day regardless of time or location.
● Review policies/prevention plan with the core team members, parents/guardians, student (age appropriate), and physician
after a reaction has occurred.
● Work with the district transportation administrator to assure that school bus driver training includes
symptom awareness and what to do if a reaction occurs.
● Recommend that all buses have communication devices in case of an emergency.
● Enforce a “no eating” policy on school
buses with exceptions made only to accommodate special needs under federal or similar laws, or school district policy. Discuss
appropriate management of food allergy with family.
● Discuss field trips with the family of the food-allergic child to decide appropriate strategies for managing
the food allergy.
● Follow federal/state/district laws and
regulations regarding sharing medical information about the student.
●
Take threats or harassment against an allergic child seriously.
Student’s Responsibility
● Should
not trade food with others.
● Should not eat anything with unknown ingredients
or known to contain any allergen.
● Should
be proactive in the care and management of their food allergies and reactions based on their developmental level.
● Should notify an adult immediately if they eat something
they believe may contain the food to which they are allergic.
More detailed suggestions for implementing these objectives and creating a specific plan for
each individual student in order to address his or her particular needs are available in The Food Allergy & Anaphylaxis
Network’s (FAAN) School Food Allergy Program. The School Food Allergy Program has been endorsed and/or
supported by the Anaphylaxis Committee of the American Academy of Allergy Asthma and Immunology, the National Association
of School Nurses, and the Executive Committee of the Section on Allergy and Immunology of the American Academy of Pediatrics.
FAAN can be reached at: (800) 929-4040.
The following organizations participated in the development of this document: American School Food Service Association National Association of Elementary School Principals National Association of School Nurses National
School Boards Association The Food Allergy & Anaphylaxis
Network
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