THE ALLERGIC CHILD AT SCHOOL
INTRODUCTION
Food allergies have increased tremendously in the past few years, and data in South Africa suggests a food allergy prevalence of around 2.5% of the urban childhood population. This means that up to 1 in 40 children has a food allergy! In most average-sized schools with 3-4 classes per grade, this equates to 1-3 children per grade.
Going to school is an extremely stressful time for food-allergic children and their families, as they move from a “controlled” to a relatively “uncontrolled” environment. Understandably, many parents and children tend to be anxious during this transition. It is a child’s right to stay safe during eating time and to be socially included.
More and more schools are starting to understand the severity of allergies. Interestingly, studies have suggested that going “allergen free”, for example nut-free, is not necessarily the best approach for all, as this can lead to allergy-sufferers and care-givers “letting their guard down.” All schools should be “allergen-safe” and have policies in place for protecting the food allergic child. These may be designated allergen-free classrooms or eating zones, or closely supervised meal times and a no-sharing of food policy for younger children.
UNDER ALL CIRCUMSTANCES, WHETHER ALLERGEN-FREE OR ALLERGEN-SAFE, THE FOLLOWING STEPS NEED TO BE TAKEN IF THERE ARE FOOD-ALLERGIC CHILDREN IN SCHOOL :
- Awareness of the child’s allergies. Each school should have a form capturing medical conditions, including allergies and chronic medications, to be completed by parents/guardians at the beginning of each year.
- Eliciting the support of co-learners, their families and school staff to limit the presence of specified food allergens on the school premises, in tuckshops, and at after class activities, parties, trips and school events. In the case of a severely allergic child, a letter written by the child’s doctor/allergist to the parents/caregivers in the class explaining the need for allergen awareness will go a long way in educating learners and parents, and in gaining their support.
- Avoiding use of common food allergens in classroom projects or activities, as rewards or incentives if there is a food allergic child in the class. Suitable “safe treat” options can be discussed with the child’s parents or doctor.
- Vigilance around meal times and a designated routine for meal times.
- Absolutely no lunch box sharing with an allergic child.
- A general habit that children wash their hands before and after meal times to reduce the carriage of allergen.
- The allergic child must have an official emergency treatment plan for accidental ingestion of allergens. This includes identifying a reaction and the action that should take place. We suggest that this action plan be kept in the child’s classroom, as well as in the school secretary’s office. The action plan should include a photo of the child and should state where the child’s emergency kit is kept.
YOUR ALLERGIST CAN ASSIST YOU WITH ACTION PLANS AND LETTERS TO THE SCHOOL
Emergency medications need to be available, accessible and up-to-date. We suggest that the child has an emergency kit, including the action plan, that is kept in a safe place (either in the child’s bag, or accessible in the secretary’s office, or both).
Staff need to be well trained in recognizing a reaction and using emergency medication. Schools must maintain a record of all medications used in an emergency, notify parents immediately and document circumstances of the incident.
Staff need to be reassured that no legal action will be taken if they give the emergency medications when deemed necessary.
Consideration should be given to keeping a generic “emergency box” with allergy medications such as antihistamines and an adrenaline autoinjector (Epipen®) for use on children with previously undiagnosed allergies, or for those who for whatever reason do not have an emergency kit at hand.
We strongly suggest that each child with a suspected food allergy be seen by an allergist, to confirm the diagnosis, and to grade the severity of their reactions. This can help put the risk into perspective. For example, the school strategy for someone with mild oral itching in response to nuts may be very different to that for someone with a severe life-threatening reaction.
Allergy-related teasing or bullying should be treated seriously with activation of the school’s anti-bullying policies.
Copyright © Claudia Gray
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