Food Allergies: Sending your child with food allergies to school

Food allergies develop when the immune system – the body’s protection from foreign substances – gets mixed up and fights against a particular food protein even though it’s harmless.

Many people have food intolerances, which result in conditions such as minor skin rashes or gastrointestinal upset. But food allergies, which trigger the immune system, are less common and much more serious. They can cause anaphylaxis – a severe, sudden and potentially fatal reaction to an allergen. Symptoms of anaphylaxis include: -Hives -Swelling of the lips, tongue and throat (can be to the point of complete closure of the throat) -Shortness of breath -Nausea and vomiting -Drop in blood pressure -Loss of consciousness While any food can cause an allergic reaction, 90 percent of all food allergy reactions are caused by only a few foods: eggs, peanuts, tree nuts (walnuts and pecans), milk, shellfish or fish, and soy. Who gets food allergies? There is a genetic disposition for food allergies. Children can be born with a higher likelihood of developing a food allergy if their parents have any kind of allergy, such as hay fever. Although only about 4 percent of Americans are affected, food allergies seem more prevalent today than 10 years ago. Medical professionals are unsure as to why the incidence is increasing, but research is ongoing to find out more about the causes. How are food allergies diagnosed? A child is usually diagnosed with a food allergy after having a reaction that requires medical attention. How are food allergies treated? The only treatment for food allergies is complete avoidance of the food. Fortunately, anaphylaxis can be treated with an injection of Adrenaline (called the EpiPen), which decreases swelling in the body and stops the reaction. Children who test positive on skin tests or have positive blood tests to a particular food are prescribed an EpiPen, even if they have never had a reaction. The EpiPen should be kept close to the child at all times. (There is also an EpiPen JR, which is a smaller dose based on the weight of the patient.) Many people are inclined to give Benadryl to stop an allergic reaction, but it can take 30 to 40 minutes to be processed by the body. An allergic reaction from a food allergy can often get very bad very quickly, so using an EpiPen is strongly recommended. The biggest problem, according to Karol Timmons, RN, MS, CPNP, of the Allergy/Immunology Department at Children’s Hospital Boston, is the fear of using the EpiPen. “Parents or caregivers should not be afraid to use them,” she says. “The side effects of the EpiPen include increased heart rate and anxiety but that’s a small price to pay to stop the reaction. For the most part it’s safe for everyone to use.” Parents should always check with their child’s doctor or healthcare provider regarding appropriate use of the EpiPen for their child. In addition, the EpiPen’s expiration date should be checked often so that it is effective. It should also be kept out of the heat, which can render adrenaline ineffective. Sending Your Child With a Food Allergy to School While anaphylaxis can be treated with the EpiPen, the severity and suddenness of an allergic reaction can make parents nervous when it’s time for their child who has a food allergy to enter school.”One of the most difficult things is to hand your child off to a school,” says Jane Romano, RN, MSN, of the Allergy/Immunology Department at Children’s Hospital Boston. “But there are many things a parent can do to make this time easier for both parent and child.” Partnering with the School “It’s a partnership you form with the school,” says Romano, also a former public school nurse. “Let the school know that you will help them make sure your child is safe. Teachers may be scared about the possibility of a reaction, so they will most likely sit up and listen when you tell them what your child needs to avoid and why.” To make the transition to school easier: -Develop an Action Plan for your child which means telling school officials and the school nurse: What your child is allergic to, what kind of reactions he has had,what actions should be taken (including administering the EpiPen), who your emergency contact is and how to reach that person. Before your child enters school, go to the school to meet with the nurse, teacher, principal and cafeteria monitors so they can get to know you and your child. Make suggestions, such as a peanut-free table in the cafeteria (but keep in mind what is reasonable to ask of the school. A peanut-free environment zone makes sense in a pre-school with 12 children, but may not be possible in an elementary school with 1,000 students). If you feel that the severity of your child’s allergy is not thoroughly understood by the school, offer to bring educational materials into the classroom. Find out who is responsible for your child’s action plan and administration of the EpiPen when the school nurse isn’t there or is caring for another child, or if a field-trip is planned. Make sure before or after school programs are aware of your child’s EpiPen and action plan. Even if they are at the same location as the school, they may not be affiliated. Give your doctor permission to share medical information with the school nurse. Your doctor or hospital cannot give the school or nurse any information about your child without your permission. Decide with the school nurse where the EpiPen should be stored: in the classroom, in the nurse’s office, or with your child. Have the school nurse put your child’s photo on his Action Plan and EpiPen. Ask school bus officials: Are drivers trained in First Aid? Do they have 911 access? Can kids eat on the bus? Can your child sit up front? Can the driver be trained to give the EpiPen? (Legally, bus companies can have a policy that its drivers will not administer medications including the EpiPen.) Easing your child’s mind There are many things you can do to help your child who has a food allergy feel more comfortable about going to school. Remind him that the things you’ve already taught him just need to be remembered: -Never share food -Wash his hands before and after eating -Always ask what is in food before eating it -Wear his medical alert bracelet or necklace Kids at this age are very focused on mastering the world around them, so it’s a great time to have them learn how they can manage their allergy,” says Jennifer LeBovidge, PhD, Psychology Fellow at Children’s Hospital Boston. Other ways to help your child feel at ease: Teach him how to say no when he’s offered food he is unsure about. Make sure he knows the symptoms of his reaction and to always alert an adult immediately if the symptoms occur. Make sure he has a friend who knows what your child should not eat and why, and what to do if he thinks your child is having a reaction. Role play with your child how to handle various situations involving food such as a party or field trip: Make up possible solutions, such as bringing his own snack or bringing a safe treat for the whole class. Look at the pros and cons of each idea. Choose a solution and use it for a specific situation. Monitor how it went to see if it worked well or if your child needs a different plan for the next time. Don’t act too anxious. Children often model their parents’ way of managing anxiety. Train your child to give the EpiPen to himself if he is comfortable doing so. Make sure your child, especially teenagers, know that it’s important to never feel embarrassed or worry that they’re making a scene if they have a reaction, and to never go in the bathroom or anywhere alone to give themselves the EpiPen.By partnering with the school, helping your child develop management strategies, and continuing to educate all those who care for your child, you and your child can enjoy his school years knowing he is as safe as possible from an allergic reaction. (Source: Children’s Hospital Boston: September 2006).