School parents want girl with peanut allergy sent home

Jolie, BSN · Mar 23, 2011

I read an article last year written by an attorney that presented the interesting perspective that the ADA requires the school to make accomodations for the allergic student, but does not require other students to make accomodations. The author argued that other students can not be legally prevented from bringing peanut-containing foods to school, or be subjected to peanut sniffing dogs, especially since many families rely on cost-effective and nutritious peanut butter to feed their children, and that there are children with allergies to dog dander, as well as deep fears of animals.

In my experience, most parents are understanding and willing to accept accomodations as long as they don't feel that their child's well-being is being placed second.

We had a highly allergic child enroll in one of our buildings 1/2 way thru the year last year. The parents contacted us well in advance and worked with us to come up with a plan for handwashing after lunch for the students in the same section of the building as their child. It worked well and we had no incidents. I'm not sure I would be comfortable with the mouth-washing requirement discussed in this current case. Seems very time-consuming, and of questionable value, not to mention the cleanliness issue of hundreds of kids rinsing and spitting.

I have a problem with the idea of "peanut-free" buildings. I think it is unfair to remove an important source of nutrition from children who may be limited in income or simply just picky eaters. I also think it creates a false sense of security among staff and may leave all unprepared in the event of an accidental exposure.

Purple_Scrubs, BSN, RN · Mar 23, 2011

This is such a tough issue, I just don't know what the answer is. I don't think the child should miss out on the social development offerred by regular schooling just because she has a medical condition. But on the other hand, I don't think all the other students should have to give up what is certainly a good and inexpensive source of nutrition. I just don't know the answer.

I guess if there were enough students in the district with allergies, there could be an "Allergy-free campus" without peanuts and other allergens in the building. Cost effective? No. Students would likely have to be bussed from all over the district. And there might not even be enough students to make it worthwhile. It also would lend to their feelings of being different than everyone else.

Like I said, I just don't know. I think this is truly one of the most difficult issues we face because there is no one good answer that will make everyone happy...no matter what, SOMEONE is going to be put out and will miss out on something. I am interested to hear everyone else's thoughts on this.

rn/writer, RN · Mar 23, 2011

Making accommodations that become ridiculously onerous--and still don't guarantee safety--is the kind of thing that looks good on paper but, in the long run, causes more harm than good.

One option is to keep the child home and use a speaker to connect her to the classroom. I know of situations where this set-up has been used for kids who were in body casts or had other conditions that made it unsafe/unwise for them to attend in person. In many cases, this option has worked out well. If her allergy is life threatening, this might be the safest choice--not because anyone wants to exclude her, but because it's just too dangerous to do otherwise.

I understand that the goal here is to keep schools from getting rid of kids who pose challenges. But surely there has to be some sense of balance, both for the sake of the kids in question and for everyone else involved.

If a child had SCID (aka bubble boy disease), would the entire school--including the people--have to be encased in plastic? Or should there be some recognition that this is neither practical nor reasonably attainable nor even safe for the child even if it could be done?

The laws governing school access should require reasonable accommodation, not turning the place upside down for the sake of a single child. And education should be guaranteed, even if it has to be provided in creative and unusual ways.

fantasia2400 · Mar 23, 2011

All children are entitled to a free safe public education. I don't think that excluding a student from school due to an allergy is either fair or appropriate. I agree food allergies are increasing and yes they are potentially life-threatening. However, if the school staff are trained efficiently in recognizing symptoms of an allergic reaction, epi pen administration and the importance of a quick response a child with a food allergy should be able to attend school along with everyone else. Also it is very important that each party in the food allergy triad do their part to maintain safety for all children. That triad includes, school administration, the parent of the student with food allergies and the actual student with the allergy. Please seach through NASN's position statement on food allergies in the classroom. They do not endorse excluding children due to allergies. That child should be taught in a school, have a 504 in place and in it specific actions can be agreed upon by staff, parent and child to help keep that child safe. I don't think that hand washing would be a bad idea before and after lunch..and certainly could be made into a safe practice and quite frankly would be good for any child to do. Swishing the mouth I don't feel would be as advantageous as washing hands. Also, I know peanut free tables are exclusional but it might be an alternative to homeschooling which is entirely exclusional. I could go on and on...

Melissa;)

mustlovepoodles, RN · Mar 24, 2011

Well, speaking from a parent's perspective i would have a hard time going along with this. I don't think it's a bad idea to have kids wash hands, but to tell me that my kid can't have his beloved PBJ just because *one* kid in *one* class has an allergy, well, it wouldn't fly with me. We've had some kids with serious peanut and other allergies and we didn't segregate those students. We did make sure their table was cleaned well after the previous class to make sure that there were no traces of allergens on the table. Our cafeteria no longer uses peanut or other nut products. But peanut sniffing dogs? Really? I don't want some other parent dictating what's appropriate for MY child's school lunch.\

raidermom · Mar 24, 2011

I have a situation like this. The child has been hospitalized and stayed in ICU 3 days after being epi-penned twice for smelling peanuts before she started school. So I do understand trying to eliminate peanut products from the school. We are a rural school and it would take EMS 20-30 minutes to get to our school if she were to be exposed. For another nurse to say that "it wouldn't fly with her" for her child not to have PB&J just bothers me.:uhoh3:If my child had this severe allergy I would hope that someone would be gracious and understanding. You are not telling them that they can't ever have PB&J , just not at school Come on here that is only 8 hours. They can have it after school when there isn't a life threatening situation. We all use the same lunchroom and occasionally have a parent forget and send it. We separate the child and have them go out different doors. I have been fortunate not to have to call 911 this year but it is because all students, teachers and parents were EDUCATED on how severe an exposure would be to this child. It takes us all WORKING TOGETHER to keep everyone SAFE.

Flare, ASN, BSN · Mar 24, 2011

I think one of the bigger issues here is the fact of such a young child. On one hand we have a child that - while he/she may age wise be ready to precautions such as asking what is in food offered and asking people to wash their hands before playing with him/her - that child may be too immature to actually do any of this. On the other side of the coin, i've seen more children than i have wanted to that the only half way decent meal they get is the peanut butter sandwich tossed into their backpack to make sure the school won't call CPS for child neglect.

I think the other parents are being a bit unreasonable - the children should be washing up after meals anyhow - it's just good hygiene. Rinsing mouths may be a bit extreme - but i can definitely go for hand washing.

Raidermom - i can see your point- but often times the peanut buttyer is the ONLY thing some of these young children will eat. I can uderstand the idea that it's just for the school day, but when a child is being deprived of a lunch everyday because he can't have the only thing he'll eat because of another child's allergy - a fatal allergy... there needs to be a middle ground. Perhaps a classroom can be made entirely peanut free and the handful of children that fall into the category of peanut butter being a prime source of nutrition can be grouped into a separate classroom. And we all know this isn't a forever arrangement - most children will grow out of their food jags by the time the hit 2nd or 3rd grade. Unfortunately, the same can't be said for the allergy, though i find that the allergies are preceived as less of an issue in middle school than they are in Kindergarten. Is this because the child becomes more self reliant when it comes to their condition? Is this because the parents relax and realize their child is growing older and more independent and needs to learn the aforementioned self reliance skills? Maybe a little of both or something else entirely. I'm just stating how different things are from last year's assignment in a K only school to my new assignment in a middle school.

raidermom · Mar 24, 2011

We have children who bring a jelly sandwich to eat every day. The classroom isn't the problem the lunchroom that feeds k-4 at one time is where we anticipated problems. When we started last schoolyear educating the parents then they had the entire summer to help their child find something else to eat for lunch. This has worked well for us. Like I said EDUCATION is where we focused and it has been a pretty smooth year. Not to say that there has been an occasional episode, but we handled it. We went school wide because our K student has an older brother and sister and this keeps them from accidently bringing it home to her also. When we talked with parents I asked that they put themselves in that parents shoes, would they want us to exclude their child or just cut out peanut butter?

My problem was when must love poodles said that for "1" child it "wouldn't fly" aren't we here as nurses for that "1" child too. Do they not have the right to have as normal childhood as possible? They didn't ask to have this allergy and I feel that it is my responsibility to keep them ALL safe. Our parents usually don't send lunch due to having free lunch provided. I just feel like that "1" child needs an advocate and it is our job to be there for them.

kids · Mar 24, 2011

No one was "subjected" to a peanut sniffing dog. The parents arranged for the dog and it's survey of the building took place during spring break.

The kid has a legitimate medical need and the right to a free and appropriate education in the least restrictive environment. Banning peanuts has NO effect on other children's ability to be educated.

It's always the parents who turn this into an issue, sorry but I think a child's right to breathe trumps another child's right to a crappy, high fat food that isn't a necessity. Instead of all the teeth gnashing most kids would be better served by using this as a learning opportunity in selflessness.

Well, speaking from a parent's perspective i would have a hard time going along with this. I don't think it's a bad idea to have kids wash hands, but to tell me that my kid can't have his beloved PBJ just because *one* kid in *one* class has an allergy, well, it wouldn't fly with me. We've had some kids with serious peanut and other allergies and we didn't segregate those students. We did make sure their table was cleaned well after the previous class to make sure that there were no traces of allergens on the table. Our cafeteria no longer uses peanut or other nut products. But peanut sniffing dogs? Really? I don't want some other parent dictating what's appropriate for MY child's school lunch.\

Most young kids, when it's explained to them that their "beloved PBJ" can make a classmate very sick are fine with giving it up.

I read an article last year written by an attorney that presented the interesting perspective that the ADA requires the school to make accommodations for the allergic student, but does not require other students to make accommodations. The author argued that other students can not be legally prevented from bringing peanut-containing foods to school, or be subjected to peanut sniffing dogs, especially since many families rely on cost-effective and nutritious peanut butter to feed their children, and that there are children with allergies to dog dander, as well as deep fears of animals.

Once an accommodation becomes a blanket school policy it's no longer an accommodation. Parents absolutely are obligated for adhere to school policy, or pay the consequences.

Purple_Scrubs, BSN, RN · Mar 24, 2011

Just playing devil's advocate here. So, what if a student had severe allergies to pet dander, and was triggered by the dander on other student's clothing and backpacks? Would it be OK to mandate that other children who attend that school must not have pets? Or that they cannot touch them before coming to school? At what point do we draw the line? I am all for making reasonable accomodations for children with any medical condition...but where do we draw the line for reasonable? I know some kids who have as strong an attachment to their favorite foods as to their pets, LOL.

damrcngrl95 · Mar 24, 2011

As a school I would worry about the liability. Mistakes happen and I don't know if I would want my one mistake to cost the life of a child. I don't know what the answer is to this. On one hand I do feel that all children have the right to an education, but on the other hand "reasonable precautions may not be enough to create a safe environment for this child. I also feel that any accommodations should not disrupt or cause stress for the other children in the school. For this school, these accommodations may work and are fine, but for another school it may not work. A lot of schools do have special needs children that are in this mix and this special needs child may not eat anything else. So I guess it would depend on the needs of the other students. The good of the masses should out weigh the good of one. If it doesn't cause other students to have a special need to be taken away and the school's faculty is willing to take on the responsibility/risk then I think it could be a good thing and work.