Web Only ArticleJanuary 1, 2008

Food Allergies and School

Prepare now for the new school year.

Autumn is traditionally back-to-school time. Kids dust off their book bags, meet their new teachers and prepare for another year of lessons. Back-to-school rituals have special significance for food-allergic families, particularly for those with children who are leaving the safety and familiarity of home for the first time.

This special section contains information to help plan ahead, including delicious foods for the lunch box and terrific products designed with your child in mind. It also offers guidance, support and advice that will help keep your child safe at school.

Denise Bunning, co-founder of Mothers Of Children Having Allergies (MOCHA), a Chicago-area support group, recommends that parents follow an allergy care timetable. And that requires early planning. When her oldest son, Bryan, who has anaphylaxis to milk, eggs, and tree nuts, entered kindergarten, Bunning initiated contact with his elementary school six months before school began.

"The beginning of the school year for food-allergic families is not August or September. It's April and May," she says. She advises parents to call the school and introduce themselves as "the parents of a child with food allergies. Ask for an appointment with the principal and the school nurse to discuss the upcoming year and the steps that can be taken to make the school safe for your child." Parents should arrive at the meeting armed with information about their child's particular food allergy and anaphylaxis. The school can then help them draft an individual health care plan for their child or, if appropriate, establish a Section 504 plan (a requirement for disabled students). The care plan should include information on the child's particular allergy, signs of a reaction, exactly what to do if there is a reaction, instructions on how to use an Epi-Pen, and emergency contacts.


Both Bunning's children, Bryan, now 10, and Daniel, 8, have life-threatening food allergies. Her introduction to anaphylaxis started when Bryan was only 61/2 months old. Bunning, who had been exclusively nursing him up until then, offered him a bottle of formula early one morning. After just one sip, the baby began ballooning. "His lips swelled, his tongue swelled, his whole body swelled. He got hives all over. There I was, a new mother and I had absolutely no idea what was happening. I had never heard the word anaphylactic. I didn't know you could have a life-threatening reaction to a food," she says. "I called my mother who told me to call 911."

Instead, Bunning panicked and hailed a cab in her pajamas, rushing the baby to the hospital. A lot has changed since then for Bunning. She is now an expert on food allergies who frequently speaks to schools about the subject and helps parents set up allergy care timetables. Summer is an important time, she says, to get organized and ready for a safe school year. In June and July, parents should make sure their child's medications are updated and current for the upcoming school year. Order a new Epi-Pen, if necessary, and check with the pharmacist to be certain it won't expire during the middle of the year. "Summer is also a good time to order a medic alert bracelet for your child," Bunning says. "Anyone with a life-threatening allergy should wear one. If a child has a reaction and can't talk, he can still raise his arm and show the emergency medic the bracelet."

Bunning also recommends creating a "goodie bag" for the teacher and any other adult in the school who might be in close contact with the child, such as the school nurse. "This is a paper bag with the child's food allergy alert plan and medications. I put in a bottle of liquid Benedryl, a measuring cup, and an Epi-Pen." She also suggests including general information about the allergy, signs and symptoms of a reaction, and an ingredient list.

In August, Bunning says the school should send a letter to the other parents in the class, alerting them that their child will be sharing a classroom with a food-allergic child. "Ideally, this letter should be printed on school stationery and should be from the principal, the school nurse, and the teacher - not from a parent," she says. "That way, the other parents know that this is an established policy coming from the top administrators, not some whim of an over-anxious parent," she says. "The letter shows that the allergy is serious and that all parents should pay attention."

In September, parents should work with their child's teacher to ensure that snacks are safe. Bunning says the methods to ensure safety can differ depending on the teacher. "Although we often see parents bring in snacks from a sanctioned list of so-called safe products, we don't recommend this because ingredients can easily change. The parent of the allergic child, not the teacher, should be in charge of reading labels and making certain there are no mistakes," she says. Some teachers ask that the allergic child bring in his own snacks each time with no sharing from others.

Other teachers allow only fruit or vegetables as snacks, a healthy tactic that works well but may elicit some complaints from kids used to sweets. "One kindergarten teacher would only permit popsicles in her class, and the kids enjoyed that," Bunning says. Whatever method the teacher uses for snacks can also be established for safe birthday parties. "The same thing goes for holiday parties throughout the rest of the year," Bunning says. Other areas to examine for food allergy safety are lunch time, birthdays, field trips, the school bus, and special programs, like art and science projects. "Make sure the art and science teachers know about a child's allergy. They should not be making bird feeders out of peanut butter with peanut-allergic kids. And hatching eggs is a great science project, but it's a no-no for kids who have anaphylaxis to eggs," Bunning says. "Tempera paints contain eggs.We're talking about the entire school, the whole system, needs to know the risk of the life-threatening allergy. It's not just the classroom. Everyone has to be made aware."

Spreading the word to parents and others involved can occasionally result in less than friendly cooperation. "Let's be honest. Not everyone is as nice as you want them to be," Bunning says. "There are some people who won't understand that your child has a life-threatening allergy and there are some who just don't care. That is reality, so bite the bullet and move on. The bottom line is to make sure your child is safe."

Her advice on handling confrontation? "Kill 'em with kindness. Tell them you understand that they're feeling frustrated about the food parameters. Tell them you appreciate their honesty and thank them for sharing their ideas," Bunning says. "Just because some people won't cooperate doesn't mean you have to behave unkindly."

In the end, Bunning says she tells parents the same things she tells her children. "Look, I tell them, we didn't choose this - this is the life we have to live," she says. "We would love to eat a pizza and have some ice cream. But we can't, so that's that."