Starting a New School Year with Food Allergies: the Basics
This is one of a series of posts to help parents and teachers as they prepare for the upcoming school year. Please note that the information below is based on my personal experience and should not take the place of guidance provided by your child's food allergy medical team. This is simply a guide that I feel may be helpful to those navigating the new school year with a food allergic child.
I'll be honest: I was terrified when my son Cade started elementary school. Coming from a church preschool where he was always well-protected in a small, peanut-free classroom, I felt like I was throwing him to the wolves by sending him to our much larger, public school. I was also clueless. I had no idea where to begin to set up a plan that would protect him in the classroom, the lunchroom and anywhere else he'd go within the school.
I'd be lying if I didn't admit that even after all these years - and a second child with food allergies attending school - I still get scared. It's hard starting in the fall with new teachers and building a level of trust all over again. But, you know what I've learned? The start of the school year is an amazing opportunity to not only create (or strengthen) relationships with your school's administration and staff, but also step up and show your teachers that you are in this together and willing to do absolutely anything you can to help them in their effort to protect your child. It's a chance to show your kids that you love them, you're fighting for them, and you are confident that they will one day be able to advocate for themselves in the same way, too.
So, where do you begin? I understand that food policies differ from school to school and within districts, and each family has its own level of comfort when it comes to how allergies are addressed. But, this is crucial for EVERY food allergy family: you need to sit down with your school administrator, nurse, and child's teachers before school begins to discuss your child's food allergies and come up with a PLAN. Whether you are simply creating a food allergy plan for your child, or drafting a 504 (see more about 504 plans below), here are some steps you should take to prepare for this season and ensure your child's safety.
1. Review your food allergy action plan, in detail, with your school administrator, nurse and teachers.
Each district has forms that it will need for you and your pediatrician/allergist to fill out prior to school starting; these forms provide authorization to administer medication in case of an allergic reaction and very explicit direction on when to do so. This is called a food allergy action plan. Your school team should clearly understand the steps that should be taken if an allergic reaction is suspected; what medication to administer and when; what to do in case of escalated symptoms (and what those symptoms might look like); and who to call in case of an emergency.
But there's more to consider, particularly your child's food allergy background. Here are some questions to help guide you through that part of the discussion:
What is your child's food allergy history? What types of reactions has he/she had in the past?
*What types of "signs" have you had in the past that your child was having a reaction (hives, vomiting, swelling, etc.)?
How vocal is your child? Will he or she let the teacher know if something is wrong, or are there other non-verbal clues that the teacher should look for to indicate that your child might be in trouble?
*It is extremely important to stress that no one reaction is indicative of the next. Just because your child presented with hives in the past, doesn't mean hives will be your first or only sign next time. This is particularly true if your child has asthma, as anaphylaxis can often present like as asthma attack. This is crucial for your school team to understand. However, it's still important to review this information; the more detail your teachers, administrator and nurse knows about your child's previous food allergy reactions, the better equipped they will be to recognize a problem if it occurs.
2. Review, in detail, food policies for your school and the procedures your teacher and staff will put in place to keep your child safe.
School Food Policy
What is the school's policy on food (is food allowed at class parties, birthday celebrations, etc.)?
*If food is being brought in for parties or a special occasion, who will contact me to let me know?
*If food is being used as a part of a classroom lesson, who will contact me to let me know?
*You should have the opportunity to bring in a safe alternative for your child.
Within the Classroom: Is there food allowed within the classroom (snack time, birthday celebrations, class parties)? If so, where will my child sit in the classroom when food is involved, and what procedures (hand washing, wiping down tables) will be put in place to ensure his or her safety?
In the lunchroom: Is there an allergy-free table or an "allergy-safe" area at my child's table, where he or she will be protected, and what exactly does this look like? Who will be allowed to sit with my child at lunch? *Who will monitor the children at lunch? What is the hand washing procedure for students after lunch?
Epi-pens: Where are epi-pens stored at school? If my child travels with his or her own epi-pen in a backpack or lunchbox, or carries it on his/her person, how will teachers, lunch helpers, etc. know where to find it? **What is the procedure in case of an emergency (i.e., what is the school protocol)?
* Any adult monitoring lunch should be epi-pen trained AND fully briefed on your child's allergy plan.
** Teachers, lunch helpers and other trained staff should always be given full reign to administer the epi-pen without the nurse present, if the situation warrants it.
3. Keep in mind these additional things when when meeting with your school team:
EVERY teacher who comes in contact with your child should be on the same page regarding everything discussed and agreed upon for your child's allergy plan.
If your child rides the bus, the same goes for your your bus driver. Your administration and/or school nurse, and you, should speak with him or her at length about these procedures, including signs of reaction, where to find your child's medication if he or she is carrying it, etc.
A final note: even after all of this, you will probably still feel nervous as your child starts school. That is normal. But, you need to have a general level of comfort going forward. If you sit down with your school staff, and still don't feel confident about the plan you've come up with to keep your child safe, that just means the discussion is not over. Please remember, your food-allergic child is protected by the law. Here are some links to help you understand better how the law protects our food allergy kids:
Carrying Ephinerphrine: https://www.foodallergy.org/advocacy/epinephrine-at-school
504's and The Americans with Disabilities Act: https://www.foodallergy.org/advocacy/disability
Good luck! And just remember - there are so many of us in your same position this fall. You're not alone, and we support you! If you have questions, please send me a note and let me know.
For more in this special back-to-school series, please refer to the Food Allergy Resources tab of my website and click "Allergy Safe at School."