Across the country, schools create and reshape policies to balance the needs of their many students. Every school should – but so often don’t – have a food allergy policy. This policy should protect students with life-threatening food allergies – and it should be noted that although peanut allergies tend to provoke some of the most severe reactions, an allergy to ANY food can turn deadly. [Read about other allergic reactions here and here, for example.]
A food allergy policy is critical to give parents and their food allergic students guidelines about what to expect while their children are at school. In addition, policies surrounding food allergies allow parents to prepare their children to safely manage their allergies in their school’s setting and gives parents and teachers time to prepare anything they need to keep their student both safe and included at school.
Where should schools begin? And what should schools consider as they think of updating their current policy?
Some factors schools may wish to consider when formulating an inclusive food allergy policy and procedures:
- Creating a culture of inclusion and empathy: What kinds of lessons are students receiving as part of their social-emotional learning? What kinds of messages are students taking away from role models? Does the behavior they see match the kindness and inclusion the school expects? Read Including Food Allergic Students at School to review the many simple ways to begin the process.
- How and where to store epinephrine: Is the nurse’s office centrally located or would it be wise to also store epinephrine with a trained administrator closer to a lunchroom or classrooms?
- Keeping stock or unassigned epinephrine: In many states, schools are allowed to store epinephrine auto-injectors that are not prescribed to a particular student. These stock epinephrine auto-injectors may be used with anyone who experiences a severe allergic reaction. In a nationwide study, stock epinephrine is used in 38 percent of reactions that happen at school. That means approximately 30% of reactions happen to students and staff without a known allergy.
- Nursing schedules and availability: Who is trained to recognize the signs of a food allergy reaction? Do they know what to do in an emergency? If the nurse is unavailable, who is responsible for handling this kind of crisis? Severe allergic reactions (called Anaphylaxis) are extremely serious and require IMMEDIATE attention.
- Hand washing: Hand sanitizer does not remove food protein. So actual hand washing is required when handling a student’s allergen to prevent cross-contamination. When and where should teachers enforce this habit?
- Communication with parents: Families of food allergic students need advance notice to make alternative arrangements for their children. Schools benefit from this type of forethought as well. For example, an upcoming in-school event which appeared to a teacher to be a problem for my food allergic son, turned out to be easy to manage with a few easy tweaks to the plan after we discussed the details involved.
- Availability of food storage space (for food allergy-friendly snacks and treats): whether the school supplies allergy-friendly snacks or families send them in, deciding where to store them for convenience and how to label them so that they are easy to identify is helpful.
- Field trip protocol: How will epinephrine accompany a student when he/she is off school grounds? Who is trained to recognize symptoms of an allergic reaction and know what to do in such an emergency?
- The bus ride: Are the students allowed to eat on the bus? Do they anyway? Is the bus driver prepared or trained to administer epinephrine if needed? Are students allowed to carry their own medication on the bus? Is this feasible for your students based on age, maturity, income level, etc (epinephrine auto-injectors are costly in some cases)?
- Classroom events: birthdays, celebrations, holidays, and special events. Specific guidelines for what is and is not allowed must be set as well as strict adherence to the policy established. Food allergies are NOT a preference. They can result in hospitalization in a matter of minutes.
- Nut bans: Worthy of a separate article and discussion, schools need to weigh the burden/reward of banning nuts entirely. And they need to discuss the extent of the restrictions (will it extend to cross-contamination warnings like, “made in a factory with…”) and how to enforce them.
Faculty and staff should be educated and re-educated about food allergies each year. They must learn to recognize the signs of severe allergic reactions (called anaphylaxis) and what those symptoms might sound like in the words of a young child. They need to learn how to react to an allergic reaction. Understanding the basics of cross-contamination and ingredient label reading, among other lessons, will help protect food allergic students in their classrooms.
Clear policies that are consistently enforced, as well as appropriate and reasonable accommodations, will help teachers, administrators and students alike have a safe and fun school year.