Back to School With Food Allergies

American Academy of Allergy, Asthma and Immunology Provides Tips and Guidelines on Anaphylaxis for Parents, Schools and Childcare Staff

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MILWAUKEE, Aug. 24 -- Preparing children to start a new school year can be exciting. However, for parents of children with food allergies, that excitement is often replaced by anxiety. An estimated 7% -- or up to 2 million -- children have food allergies and are at risk for a life-threatening reaction called anaphylaxis. To assist parents, school staff and childcare providers in preventing and providing emergency treatment for anaphylaxis, the American Academy of Allergy, Asthma and Immunology (AAAAI) has released a position statement offering a series of tips and guidelines.

Anaphylaxis is a severe allergic reaction that affects multiple systems in the body. Symptoms can include severe headache, nausea and vomiting, sneezing and coughing, abdominal cramps, diarrhea, hives, swelling of the lips, tongue and throat, itching all over the body, and anxiety. The most dangerous symptoms include breathing difficulties, a drop in blood pressure, and shock -- all of which can be fatal. Foods that most commonly cause allergic reactions include peanuts and tree nuts, shellfish and fish, milk, eggs, soy and wheat. Each year, approximately 100 Americans die from anaphylactic reactions to food.

Avoiding allergy triggers is key to preventing anaphylaxis. If severely allergic patients accidentally come into contact with a substance to which they have a reaction, they should use a short-term emergency treatment medication, epinephrine, to control the reaction. This medication is available as self-injectable shots that those with severe allergies can carry for emergency use. To assist parents in protecting their children and to reduce the number of yearly deaths caused by anaphylaxis, the following guidelines have been set by a recently released AAAAI position statement on Anaphylaxis in Schools and Other Childcare Settings. According to the statement, school staff, childcare providers, and food service personnel must:

• Identify children with life-threatening allergies, take measures to protect them, and be prepared to handle any severe reactions that occur despite precautions.
• Be aware of those students who have been prescribed epinephrine. An identification sheet with the child's name, photo, and specific allergy should be distributed to all appropriate personnel; however, the information should not be accessible to other students or parents for reasons of confidentiality.
• Know the technical and scientific names for common foods and readlabels to avoid giving the child hidden ingredients.
• Implement a "no trade" rule for food and utensils throughout the schoolto avert peer pressure.
• Wash surfaces clean of contaminating foods, and wash hands after handling food. Food used in lesson plans for math, science, crafts, or cooking classes may need to be substituted depending on students' allergies.
• Substitute special meals of equivalent quality for regular meals that the child cannot eat, at no additional cost to the family, according to the policy set by the USDA Child Nutrition Section in charge of school lunches.
• Be knowledgeable about food cross-contamination during handling and preparation. It should be stressed that minute quantities of certain foods,such as peanuts, can be life-threatening when ingested by a child with peanut allergies.
• Learn how to recognize a reaction and administer an epinephrine shot. Epinephrine should be kept in an unlocked area that is accessible to all staff.
• Immediately transport children who have been given epinephrine to a hospital, even if symptoms resolve.

"This position statement will help clear up some of the stress and confusion for parents and school administrators by providing guidelines that everyone can follow," commented Anne Munoz-Furlong, CEO and Founder of the Food Allergy Network, the nation's foremost organization dedicated to increasing public awareness about food allergy.

The AAAAI encourages parents to take the following steps to protect their food-allergic children and prevent anaphylaxis:

1. Reinforce to your child the importance of knowing his or her potential food allergy triggers and identifying them to teachers or care providers. If possible, provide your child with a medical bracelet or necklace that identifies his or her specific allergy.

2. Tour your children's school or childcare facility before school starts, and meet with staff to inquire about policies regarding foods brought into the classroom.

3. Provide staff with information and resources to educate them about your child's allergy. Have your child's allergist provide clear, written instructions on recognizing a reaction and administering medication in case of a reaction. Teach staff when and how to properly administer medications such as injectable epinephrine, encouraging them to handle the medication and ask questions. Explain to them that they cannot delay in administering medication to your child, and that they are obligated to assist your child and to include him or her in normal school activities, according to federal laws.

4. Do not sign a liability waiver absolving the school of responsibility for administering epinephrine. Several federal laws protect the rights of children in this situation, including those with life-threatening food allergies.

5. Let staff know that you want to work with them to keep your child healthy and in school, with little or no disruption to peers or the class schedule.

"Our concern is to get all school staff and classmates to take food allergy seriously, to understand the danger of even tiny amounts of food to a highly sensitive person, and to realize the importance of immediate treatment for reactions, since most life-threatening reactions occur because of carelessness or a delay in giving epinephrine," noted David B.K. Golden, M.D.,FAAAAI, Chair of the AAAAI's Anaphylaxis Committee and a practicing allergist in Baltimore and Owings Mills, Md.

For free informational brochures on allergies and anaphylaxis or referral to an allergist in their area, parents of allergic children and patients are encouraged to call the AAAAI's Physician Referral and Information line at 800-822-2762, or visit the Academy's Web site at http://www.aaaai.org. To obtain emergency action plans for food allergy, the public may contact the Food Allergy Network (FAN) at 800-929-4040, or visit FAN's Web site at http://www.foodallergy.org.

The American Academy of Allergy, Asthma and Immunology is the largest professional medical specialty organization in the United States representing allergists, asthma specialists, clinical immunologists, allied health professionals, and others with a special interest in the research and treatment of allergic disease. Allergy/immunology specialists are pediatric/internal medicine physicians who have elected an additional two years of training to become specialized in the treatment of asthma, allergy and immunologic disease. Established in 1943, the Academy has more than 5,700 members in the United States, Canada and 50 other countries.

Web Site: http://www.foodallergy.org.

CONTACT: Sarah Cox of American Academy of Allergy, Asthma and Immunology, 414-272-6071, media@aaaai.org