Celiac Disease Health Plan

[bakert]

Hey everyone - just getting back in the swing of things here in WI. I have a KG student coming in with celiacs....parents are pretty anxious and high maintenance. Anyone have careplans for a student with celiac I can use for examples? I'd like to see how everyone else handles it at the elementary level.

The current daycare she is at is very giving....even bought special art supplies for her. Dad wants her food warmed up at lunch every day, etc. I think we all know this student can't have her own personal microwave in a public school!

Any suggestions are welcome!!

[NRSKarenRN, BSN, RN]

Hope one of our sage school nurses can assist you.... warm lunch daily: meet with school nutritionist to determine which meals are gluten free would be my 1st guess if parents expect child to buy her lunch. Nurse should not be involved in meal prep.

[lifelearningrn, BSN, RN]

In our district, a doctor's order is all that is needed for special dietary meal preparation, the cafeteria orders and provides the special diets if the parents want the children to have a hot lunch. If the parents want to provide the meals, then they can bring the food in hot, or prepare a cold lunch (unless they can arrange with the cafeteria to heat the lunch for them).

[JustBeachyNurse, LPN]

The microwave issue is potential cross contamination. Requesting a microwave or toaster oven restricted to heat the child's lunch is unreasonable. My son had severe restrictions at one point. He had a snack stash in the school nurse's office. For less than $10-$15 you can get a thermos container (on sale in Target) that keeps hot food hot for 6-8 hours.

Teachers & PTA should be notifying parents of known events that involve food so safe alternatives can be ensured. In a school of 650 stipend my son was the only one with wheat/gluten restrictions .

The other issue depending on the child's restriction level there may be issues with certain art supplies and if the class does food based projects (macaroni necklaces can be a problem). The celiac disease foundation has lists of gluten free school supplies. There are also gluten free toothpastes and other products.

If you have allergen precautions for other food allergies use those for this student.

The dietician for the child is often a great resource. I know my the dietician affiliated with my son's GI sent his school nurse & the cafeteria manager all the educational material they needed.

[JustBeachyNurse, LPN]

And if the student qualifies for free or reduced school lunches there are mandates that the cafeteria have training to provide allergen safe foods. Parents can opt out and send their own

[Wave Watcher]

She needs a 504 which should also cover food accommodations. Also, I would clarify with the doc what "reasonable" accommodations are for Celiac. New school parents do not understand that their children cannot and will not be catered too if it not necessary. You do not have time to run around heating up food and praying like h*ll it doesn't have a hot spot in it and burn the students mouth. I have a set of new kinder parents with a child that has MCADD. I spoke to the nurse specialist to figure out what I REALLY needed to do for this child. The parent wanted me to watch her kid all day long and make sure she was eating 5-6 times a day in the classroom. Nope. Not doing it. I told her I was not a private duty nurse or nurse aide, but I would make sure if there were any medical needs or issues I would be there to take care of her. Guess what? No medical problems or issues with my student. :-)

Hope you get it all worked out. I also have a student with Crohn's and the parents send his food to school....if he doesn't feel well then I call them and they pick him up. Some parents don't understand not to make things complicated. :-) Hang in there!