Students with severe food allergies

[mrsfoster601]

Hello my fellow school nurses, I am in need of some advice on my students with severe food allergies. In the lunchroom, we have a peanut free table for the kids that's allergic to nuts and other foods. But, we have a few parents that goes over board with their child allergies. What are some ideas you guys use at your school to help prevent the students that's highly allergic to certain foods not to come in contact with the "DEADLY" food? My suggesting is to have parents fix their child's lunch for them to bring to school. But some parents don't want to do that so I'm out of ideas. Any suggestions will help. Thanks again

[kidzcare]

My suggestion is that these parents realize that we cannot guarantee that their child will not come into contact with their allergen. We just can't. To put too many protocols in place is to form a false sense of security. Just as the parent cannot guarantee that the cashier at McDonald's did not just eat a Snickers bar before handing Junior his Happy Meal.

The one and only time I have given an epi pen, it was because a student was eating her Halloween candy on the bus next to a girl with airborne allergy to peanuts/treenuts. Guess what? There is a rule about eating on the bus-- it's not allowed. But this 6th grade student did not care about that rule. We cannot guarantee safety.

[NurseBeans, BSN, RN, EMT-B]

I like to remind parents that as the allergy belongs to their child and won't likely ever go away, they need to learn early how to protect themselves. Like any other health issue. The more the school coddles and protects those allergic, the less alert the child and parents have to be. It creates this false sense of security, like kidzcare said. The entire world won't act in their child's best interests so...put the obvious safety measures in place, let the cafeteria staff know of the student's allergies, and teach all the students not to share food in school.

[Flare, ASN, BSN]

Agreed! I put the responsibility right back on the parent if they start requesting things that are outside our normal protocol. It's a matter of teaching a child how to live safely. We will maintain the peanut/nut free table and request that holiday party foods not contain peanuts/ nuts. But at the end of the day, the cafeteria serves PB&J and it's prepped in the kitchen. The workers are all trained to wash hands and thoroughly clean counters after handling nut products, but to me that is still no guarantee. If the allergy is so severe that the parent is concerned about incidental cross contamination, then it's probably best that the student stick to foods from home.

I have had students with celiac disease where the parent was concerned about incidental contact of "safe foods" for her child like the salad or roasted chicken with wheat containing products. Again, I recommended food from home, as 90% of the offerings from the cafeteria contain some sort of gluten.

[BCgradnurse, MSN, RN, NP]

I'm not a school nurse, but I am an allergy NP. First of all, food allergies can be deadly and should never be taken lightly. I encourage parents and children to take control and responsibility, and to always bring their lunches and snacks from home if they need to be concerned about cross contamination. The school can only do so much. Any school age child should understand what they're allergic to, and be taught not to eat something "unknown" without checking with an adult who is aware of their allergies. I also teach my patients how to read labels for potential allergens once they have 3rd-4th grade reading skills. Ultimately, it's the parents' responsibility to ensure their kids are safe.

[JenTheSchoolRN, BSN, RN]

I'm not a school nurse, but I am an allergy NP. First of all, food allergies can be deadly and should never be taken lightly. I encourage parents and children to take control and responsibility, and to always bring their lunches and snacks from home if they need to be concerned about cross contamination. The school can only do so much. Any school age child should understand what they're allergic to, and be taught not to eat something "unknown" without checking with an adult who is aware of their allergies. I also teach my patients how to read labels for potential allergens once they have 3rd-4th grade reading skills. Ultimately, it's the parents' responsibility to ensure their kids are safe.

This.

My school is a peanut/tree nut school, but even it can't always be policed as well as we hope (though we try). We have no cafeteria, so students eat in classrooms, which we want to be a safe place. I've given an Epi-pen to a student exposed because another student next to her ate a peanut butter protein bar. The student's mother was great, though, and appreciative of my fast response and follow-up on policy with staff - she knew that in the real world her child could be exposed and we looked at the positives, the fact that student knew right away about the exposure, symptoms to look for, and to see me.

(Of course, that same student also had a reaction after eating cookies that a friend gave her that had nuts in them. The friend didn't even know and the student didn't think to ask. Mom and I did a lot of review together about asking and checking ingredients on every single food. Not fun, but necessary. This student is in high school.)

I think a good strong allergy action plan and reviewing with affected students possible symptoms and when they should be speaking up/etc is key. Older students should know how to use their own Epi-pen. Most of my MS/HS kids carry their own and I will review how they can inject themselves if needed.

[WineRN]

Our kindergartners have afternoon snacks in the classroom that the teachers, or myself when there is a sub, check the labels for peanuts because I have 4 little ones with peanut allergies.

As most of the others said, there is only so much we can do. Kids (and parents) will break the rules sometimes.