Share ThisThe start of a new school year can be stressful. New teacher. New friends. A daughter who refuses to wear any of the new clothes that you bought her. A son who wants to keep playing baseball all day and doesn’t want to head back to class. Between juggling the bus schedule and your work schedule, starting school can be exhausting for the entire family.
Being the parent of a child with life-threatening food allergies, however, takes that anxiety to a whole new level.
Highmark employee Corrine Satriano is a working mother of two young children. Her son, Marco, has severe food allergies. He is allergic to peanuts and most tree nuts, a category that includes almonds, cashews, walnuts and many others.
Corrine reflected back to when Marco started kindergarten: “Marco is my firstborn. Like many parents, I barely slept. In the weeks before school started, I’d wake up with nightmares about him reacting [to nuts in food someone gave him at school] and not knowing what to do. His allergies terrify me.”
Marco (and his mom, too) made it through his first year of school by working very closely with his teachers and other staff members to communicate Marco’s emergency action plan and by being vigilant about everything that Marco consumed.
“Before he started kindergarten, I went to the school in person to discuss his action plan and describe signs to look for in a reaction,” Corrine says. “Luckily, the school is allergy aware and the staff was well trained on what to look for. Even though he attends an allergy-aware school, I pack Marco’s lunch every day. He never tries anything new at school; I always give it to him at home first.”
If your child has known food allergies, the best way to protect your child at school is to keep him or her from coming into contact with any known “allergens,” or allergy-causing ingredients or goods. Educate everyone, including your child.
While preparing her son Marco to start kindergarten, Corrine stressed the importance of only eating food that she packed for him.
“The day before and the day school started, I must have reminded him 100 times not to eat anyone else’s lunch and not to let anyone else eat his. He has a five-minute bus ride to school. I told him not to eat anything there, either!”
Not only should your child know what foods may trigger an allergic reaction, but they also should know to only eat foods that have been cleared as safe by a parent or trusted adult. Teach them early that even trusted adults, such as teachers, should check food labels before deciding something is safe.
When your child is starting at a new school, it’s important to make sure that any adult who will be working with your child regularly knows about his or her allergies. That includes his or her teacher, the school nurse, the principal and the cafeteria staff. Truly, that includes anyone who will be available to help your child make safe food choices or help them in an emergency.
When the adults working with your child are aware of his or her allergy, they can help your child make safe food choices and hopefully restrict access to unsafe foods. Many schools offer nut-free lunch tables and limit snacks in the classroom. You should also request that children wash their hands after lunch to ensure no friends bring allergens back to the classroom.
Teachers should also know what symptoms to look for in your child and have a written copy of your child’s emergency action plan.
Having an emergency care plan is essential. Many schools have Food Allergy Action Plans available for parents to identify their child’s known allergies and outline the treatment plan if he or she is accidentally exposed to a known allergen.
If your school does not ask you to complete a formal action plan before or at the beginning of the school year, work with your child’s allergist to develop one and/or use the resources available through Food Allergy Research & Education (FARE).
FARE’s Food Allergy & Anaphylaxis Emergency Care Plan outlines recommended treatments in case of an allergic reaction, will be signed by your child’s physician, and includes emergency contact information. The second page of the FARE plan even includes instructions for giving epinephrine using the most common types of injectors. Epinephrine is an injectable medication to treat emergency allergic reactions.
According to Dr. Allison Freeman, allergist and immunologist at West Penn Hospital in Pittsburgh, part of Allegheny Health Network (AHN), some parents seem hesitant to use an epinephrine injector. Many parents are anxious that the injection will hurt or traumatize their child. But in reality, the injection can save their life. The most common over-the-counter allergy drugs do not treat all of the body’s reactions to an allergen, and may not be effective in emergencies.
“While epinephrine helps reverse the reaction’s effects on circulation and breathing, antihistamines are treating only the skin symptoms,” Dr. Freeman says.
The most critical aspect of an action plan is being able to identify the symptoms of anaphylaxis. Anaphylaxis is a severe, whole-body allergic reaction.
Each child may react differently to an allergy. We often think of hives, having a runny nose and itching as common symptoms of an allergic reaction. But vomiting and anxiety or confusion can also be an indication of a more severe reaction.
It’s important for you as a parent to understand the warning signs of anaphylaxis when your child is at home. And, as parents, we need to make sure that the adults caring for our children when they are at school also know them.
Yes, the school nurse is probably aware, but is your child’s teacher or bus driver? Does your school require training in identifying an allergic reaction and administering epinephrine? These are all questions that you should be asking at the start of the school year.
As soon as you, or the school staff, suspect an allergic reaction, it’s time to start following the emergency plan.
“If using your child’s EpiPen (epinephrine auto-injector) even crosses your mind in the emergency situation, you should do it,” Dr. Freeman says. “The risks of not using the EpiPen far outweigh the risks of [hesitating to use the pen and] waiting for your child’s reaction to worsen. Minutes matter. You don’t have to wait to get to the ER for the physician to tell you that the reaction is severe enough to warrant epinephrine.”
Talk with your allergist and pediatrician. Ask them for tips to help keep your child safe. Look to other parents of kids with allergies for guidance. Many will be happy to share practical tips that worked well for their family. FARE also offers many resources for parents, kids, teens, college students, schools and camps.
The American Academy of Allergy Asthma & Immunology and Asthma and Allergy Foundation of America websites also offer many allergy-related resources.
Even if no one in your family has severe food allergies, it’s a good idea to learn about them if your child attends school or interacts with other children regularly. When you understand the potential outcomes, you become far more understanding about why you can’t send cupcakes in to school. It can absolutely mean life or death for some kids.
Dr. Freeman points out that a child may suffer their first serious allergic reaction — to a new food or an insect — during school hours, which is why many schools have started to keep epinephrine auto-injectors on hand. However, not all schools have adopted this policy and parents should check what emergency procedures their school is following.
My own daughter is allergic to peanuts. We found out when she was around 18 months old and broke out in hives when she ate peanut butter. Our pediatrician referred us to an allergist who confirmed that she is allergic to peanuts. While she has never had an anaphylactic reaction to accidental peanut exposure, she has an epinephrine auto-injector just in case.
To make sure that I wasn’t missing any critical steps when she started kindergarten, I talked with other parents about what they did to prepare for school, including Corrine Satriano. I attended an event at AHN’s Wexford Health + Wellness Pavilion about understanding food allergies and anaphylaxis. And I spoke with the school nurse and administrators at my daughter’s school.
On the first day of school, I talked with her teacher to make sure she is aware of my daughter’s allergy. Thankfully, all teachers at our school are trained in how to recognize allergic reactions and administer epinephrine. Her cafeteria card is also flagged with a sticker to alert the staff to her allergy. Our school also does not allow food treats for birthdays.
My daughter has loved every minute of school so far. I am excited to see what each year brings for her and confident that she is in good hands should she accidentally be exposed to peanuts.
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