How to Manage Your Child’s Food Allergy at School

The holiday season, beginning with Halloween and culminating in Christmas, is still celebrated in many schools with festivities – including a heavy dose of treats. This is particularly problematic for children with food allergies.

A study reported in the Journal of Pediatrics indicates that eight percent of children under the age of 18 have food allergies. The report noted that food allergies were most prevalent among preschoolers, and teenagers were most likely to have dangerous and deadly reactions. Peanut allergies were the most common, followed by milk and shellfish allergies.  Other foods triggering food allergies were: tree nuts, eggs, fish with fins, strawberries, wheat and soy.

While many food allergies in children are mild and fade as youngsters grow, others can be severe and life threatening. According to the study, 40 percent of children with food allergies experience acute symptoms, such as wheezing, and anaphylaxis– a medical emergency, which involves trouble breathing and a sudden drop in blood pressure.

More students than ever are currently attending school with severe food allergies. And some believe that food allergies are on the rise. For more than a decade, I supervised the school nurses in an 11,000-student school district. I often consulted with parents, principals, and nurses about students’ allergies, the parent’s role, and the schools’ response. Parents need to be proactive about their children’s food allergies throughout the school year, but particularly when shared foods are abundant during class celebrations.

If your child has a food allergy, you are your child’s best advocate. Make sure you are thoroughly informed about your child’s needs and rights. It is critically important for you to communicate with the school principal, school nurse, and your child’s teachers, as well as other parents. Be actively involved in helping the school to understand and provide the services and attention your child needs to succeed. Here are some suggestions to help you be proactive.

• Become an expert on your child’s allergy.  Read about it, speak with your allergist, and consider joining a food allergy support group. Know what foods your child must avoid, and the signs and symptoms of an allergic reaction. Learn how to use an epi-pen if your doctor prescribes it.
• Prepare information about your child’s allergy, possible reactions, and medications, and share it with the school.
• Learn how your school generally handles food allergies. For example: is there a peanut free table in the cafeteria? Are children allowed to bring snacks from home and share them? What happens at birthday parties and other celebrations?
• Work with school personnel to build a support team for your child. Educate them to avoid allergens, how to respond to your child’s symptoms, and how to react in an emergency. You will also want to discuss issues, such as field trips.
• Check the school’s policies, protocols and guidelines in regard to the handling of food allergies.
• Update prescriptions, doctor’s orders and other necessary paperwork at the start of each school year or when there is a change in your child’s treatment.

Often, food allergies can be addressed successfully by developing a medical management plan that gives the school guidance on your child’s specific needs. Creating a medical management plan for how your child’s allergy will be handled at school should be a team effort that includes you, your child, school personnel, and your child’s doctors. It is very important that the plan is documented in writing.

Parents often ask about whether they need a 504 Plan to manage their child’s food allergy at school. 504 Plans are comprehensive plans created collaboratively by parents, nurses, and other interested parties to address the student’s individual needs. While a medical management plan provides guidelines, a 504 Plan is legally binding. It is your call whether you want to request a 504 Plan for your child.

School districts are required by the Rehabilitation Act of 1973 (29 U.S.C. § 794) to provide all students, regardless of disability, with a “free appropriate public education.” This provision, found in section 504, applies to any condition – physical, mental, or emotional – that might interfere with a student’s ability to receive an education in a public school. That means that no student with a disability can be excluded from school.

A severe food allergy, such as peanuts, is a condition that may or may not fall under the Rehabilitation Act. For example, 504 Plans may address the use of anaphylactic medications, such as epi-pens, and how staff will be utilized to recognize and respond to allergy symptoms. 504 plans may also address specific responsibilities of students and staff.

A student must have a condition that “substantially limits one or more major life activities,” to qualify for a 504 Plan. Students have to be evaluated by the school district to determine whether they are eligible. The district will take into consideration the age and capability of the child. If parents are dissatisfied with the outcome, they may appeal.

The bottom line has to do with the seriousness of your child’s symptoms and how capable he/she is to take care of his/her health needs. You are the best judge. It is your decision whether you want to have a legally enforceable plan or if you are comfortable with a medical management plan. Whichever you choose, it is always a good idea to make sure everything is in writing. If you are in doubt, consult with your child’s doctor, and an attorney who has expertise in this area.

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