Chances are, at least one student in your school has a food allergy. Cases of food-allergic children have been rising since medical researchers first started following patient reports several decades ago. A recent study reported 5.9 million U.S. kids suffer from life-threatening food allergies. The good news is, food allergies (most common are nuts, wheat, soy, fish, shellfish, and dairy) are manageable if proper policies and protocols are in place.
It is important to remember that mild reactions such as hives, redness, and swelling can worsen with each interaction, evolving to life-threating reactions including tightness of the chest, trouble breathing, a severe drop in blood pressure, and rapid pulse. A student who shows signs of mild irritation once can have a severe reaction when exposed again—and severe reactions can become dangerous in a matter of seconds. Food-induced anaphylaxis, a medical emergency that requires treatment with epinephrine (most commonly in the form of an EpiPen or Twinject), can become a classroom nightmare if your school isn’t aware of the student’s allergy and isn’t prepared for the situation.
Schools have begun to adopt student policies that address peanut allergies. We’re only a few weeks into the new school year and already Deans of Students are conversing about their policies on the ISM e-Lists, sharing their policies and risk management protocols for handling reactions. Communicating with families about their responsibilities as well as the school’s (and each students’ regarding food restrictions on campus and/or in the classroom) is a vital step in protecting your students. As mentioned on our e-List, it’s not enough for the family to simply notify the school of their children’s allergies. To ensure your school is properly prepared for an emergency situation, both faculty and staff should be well informed concerning how to react if a student comes in contact with a food allergen, including any after care that may be needed.
It’s not surprising that this topic arises so early in the season. Last year, numerous stories about food being used as "weapons" made headlines. In January of 2013, The Journal of the American Academy of Pediatrics published the results of a survey that showed students with food allergies were often the targets of bullying—and that nearly half the time, parents weren’t aware of the dangers their children faced daily. This study is consistent with one conducted in July of 2010, which found that 30% of allergic children reported being bullied because of their allergies.
The increase of food bullying cases inspired the Food Allergy Research and Education (FARE) organization to publish a public service announcement to educate students and educators of the dangers of food allergies and the serious risks of bullying. According to FARE, there has been an 18% increase in food allergies between 1997 and 2007. And although there is no clear reason as to why the numbers continue to increase, the elevating number of cases warrants attention and certainly education.
Fifteen states have gone as far as to implement laws protecting students with food allergies, administering food allergy guidelines for schools. Texas for example, has mandated a zero tolerance for bullying related to food allergies.
Educate students about the dangers surrounding food allergies. To create a safe environment for your students, teachers should be prepared to discuss symptoms and threats of reactions as well as address the risks involved with bullying. Additionally, students need to be informed of their own responsibility to reduce risk. Provide them with a list of banned foods, and remind them often of the risks and repercussions. Professionals agree that mentioning the seriousness of food allergies and bullying those with them once is not enough—remind students again and again.
Here's a look at a sample shared on the ISM e-List:
FAMILY'S RESPONSIBILITY
- Notify the school of the student’s allergies.
- Work with the school administration to develop a plan that accommodates the student’s needs throughout the school, including in the classroom, in the cafeteria, in after-school care, and during school-sponsored activities.
- Provide written medical documentation, instructions, and medications as directed by a physician. Include a photo of the student on the written form.
- Provide properly labeled medications and replace medications after use or upon expiration.
- Educate the student in the self-management of his or her food allergy including:
- safe and unsafe foods,
- strategies for avoiding exposure to unsafe foods,
- symptoms of allergic reactions* how and when to tell an adult they may be having an allergy-related problem, and
- how to read food labels (age-appropriate).
- Review policies/procedures with the school staff, the student’s physician, and the student (if age-appropriate) after a reaction has occurred.
- Provide emergency contact information.
- It is the responsibility of all families to refrain from bringing foods known to cause severe allergic reactions onto campus for school-sponsored activities or events (class parties, after-school care, field trips, etc.)—see next section on School Responsibility for clarification on communication of the food restrictions.
SCHOOL'S RESPONSIBILITY
- Review the health records submitted by parents and physicians.
- Include food-allergic students in school activities. Students will not be excluded from school activities solely based on their food allergy.
- Create a safe environment for food-allergic students by providing all families with an updated list of foods banned from school activities at the beginning of each school year and ensure that faculty and staff refer to the most recent list in planning those events with parents throughout the year.
- Assure that all staff who interact with the student on a regular basis understand food allergies, can recognize symptoms, know what to do in an emergency, and work with other school staff to eliminate the use of food allergens in the allergic student’s meals, educational tools, arts and crafts projects, or incentives.
- Ensure medications are appropriately stored and that an emergency kit is available that contains a physician’s standing order for epinephrine or other appropriate medication. Students will be allowed to carry their own epinephrine (if age-appropriate) after approval from their physician/clinic, parent, and the school office, and as allowed by state and local regulations.
- Designate school personnel who are properly trained to administer medications in accordance with the Good Samaritan laws governing the administration of emergency medications.
- Be prepared to handle a reaction and ensure that there is a staff member available who is properly trained to administer medications during the school day regardless of time or location.
- Review policies/prevention plan with core team members, parents/guardians, student (age-appropriate), and physician after a reaction has occurred.
- Discuss field trips with the family of the food-allergic student to decide appropriate strategies for managing the food allergy.
- Enforce a zero-tolerance policy concerning threats or harassment against an allergic student.
STUDENT'S RESPONSIBILITY
- Do not trade food with others.
- Do not eat anything with unknown ingredients or known to contain any allergen.
- Do be proactive in the care and management of your food allergies and reactions based on your developmental level.
- Do notify an adult immediately if you eat something you believe may contain the food to which you are allergic.
For more information concerning clinical studies of kids with food allergies, visit kidswithfoodallergies.org.
Additional ISM resources of interest
ISM Monthly Update for School Heads Vol. 10 No. 7 Handling the Needs of a Student With Life-Threatening Allergies
Private School News Vol. 11 No. 2 Bullying the Food Allergic Student
Private School News Vol. 8 No. 5 Do You Need a 504 Plan for a Food Allergy?
ISM Monthly Update for Admission Officers Vol. 10 No. 4 Registering a Food Allergic Child