Preparing to send your food-allergic child to school

The first day of school can be an anxious time for parents as well as their children. It is an especially anxious time for parents of food-allergic children.  For many it is the first time that their food-allergic children are on their own, away from their parents, making independent decisions about food. That can be excruciating for parents. 

“Navigating food allergies in a non-allergic world is a huge challenge, and the first-day of school is a major milestone,” said licensed clinical social worker Jennifer Moyer Darr. Ms. Darr works with families at National Jewish Health, helping them cope with the demands of parenting a food-allergic child. “With proper preparation, however, parents can let their children venture out on their own reassured that the school will provide a safe environment. ”

Ms. Darr offers advice for parents who are sending their food-allergic children to school for the first time, or to a new school

Meet with school officials -- early. Don’t wait until just before school begins to alert school staff about your child’s food allergies. If possible, meet with the principal, teachers, nurse, and cafeteria staff, in the spring or summer before your child starts a new school.

Parents can inform school officials about their child’s allergies  and special precautions that need to be taken. They can also learn from staff about the various measures and precautions schools already have in place for food-allergic children. Below are some questions and talking points for discussions with school officials:

• Inform them about your child’s allergies, symptoms and needs.
• Ask how the school staff generally manage food allergies.
• Ask about Epi-pens. Where does the school keep them, who has access to them, and how would my child receive an Epi-pen injection if she needed one?

Written Plan. If possible, develop with school staff a written plan for your child. That can outline necessary information and actions to prevent exposures, recognize reactions and respond to accidental exposures. Good templates are available at the Food Allergy and Anaphylaxis Network (www.foodallergy.org/page/food-allergy-action-plan1) and the American Association of Allergy, Asthma & Immunology (www.aaaai.org/patients/food_allergy_guidelines.stm). These sites are also rich sources of all sorts of information about food allergies.

Lunch seating. Many schools now have a separate table in the cafeteria for food-allergic children. Although many schools and parents feel safer with separate seating, most school-age food-allergic children can be safe sitting with their classmates at lunch.

“Eating is a social activity that takes on more importance as children grow older,” said Ms. Darr. “Parents and children need to weigh the issues of safety, anxiety and healthy social interactions when making a decision about where to eat.”

Studies have shown that common cleaning agents effectively remove peanut butter from cafeteria tables. Research has also shown that skin contact with allergenic foods causes a much milder reaction than eating the food.

“The vast majority of moderate to severe allergic reactions to foods are the result of accidentally eating the food,” said Dan Atkins, MD, Professor of Pediatrics at National Jewish Health. “Touching the food may cause local contact reactions, but almost never leads to a severe reaction.”

Children who understand their allergies, are aware of  the importance of avoiding potentially allergenic foods, and can be counted on to make safe choices should be able to sit at the table of their choice.

Some young children may be prone to taking food off another child’s plate or accepting foods given to them by other children. Those children require more supervision and distance from their peers. Sometimes a fully separate table is not necessary. A separate desk at the end of the cafeteria table allows for both increased safety and social inclusion.  Although it may not be necessary to sit at a food-allergy table, a child’s comfort level and preference should also be considered.

Tour the cafeteria. Although many parents pack lunches for their children, others may want to have the school cafeteria as a possible alternative. Talk to food-service staff to learn if they do anything special for food-allergic children, where the food comes from,  and precautions they take against cross-contamination to learn what might be safe for a child to eat.

Show and tell. If your child is comfortable, it can be valuable to have him tell the class about food allergies. What they are allergic to, foods that contain the allergens, what happens when they have a reaction, what students should do if they see the child having a reaction.

Pictures. In the classroom, pictures of a child with a label about his/her food allergy can help alert anyone who enters the room. You can place one on the classroom wall and a smaller one on the child’s desk, which can serve as a secondary reminder when snacks are served.  

Safe snacks. Give the teacher a small supply of safe snacks for your child in case someone brings in an allergenic snack for the class.