Severe Allergies at School -- How to Be Prepared

When your child has serious allergies, work with their school. Meet with the principal, their teachers, and the clinic staff. Find out if the school already has a policy to deal with food or other allergies. Then, make a plan to help your child avoid triggers while still being able to fully take part in school activities. Don’t forget after-school programs and the school bus. Most states have laws that allow, and in some cases require, schools to keep epinephrine on hand for emergencies. 

In an allergy emergency, seconds count. Every child who has been prescribed epinephrine should have an emergency plan. Make one with your child’s doctor and the school nurse. It should have your child’s photo, specific allergy warning signs and symptoms, and treatment instructions. Put copies in your child’s classroom, the office, and the cafeteria. Also ensure that the emergency drugs for your child are packed for field trips and before- and after-care activities.

Epinephrine should be with your child at school, not locked up or refrigerated. It should be passed between staff members wherever your child goes (unless the child is old enough to carry it). Explain the doctor's instructions about when and how to use the drug. Caution the staff that they shouldn't wait to use it if your child has any signs of anaphylaxis, even if it's unclear whether the symptoms are allergy related. Your child should always have access to two doses of epinephrine. Check expiration dates often. 

Go over your child’s triggers with them. For food allergies, tell them not to share food, utensils, or containers, and to wash their hands before and after eating. For insect sting allergies, teach them to wear long sleeves, pants, and shoes outside and eat inside when they can. If they're eating outside, keep food covered and use a straw.

Children and school staff (even substitute teachers and lunch monitors) should know to watch for these warning signs:

• Hives and itching, pale or flushed skin
• Swollen throat or tongue
• Wheezing, trouble breathing or swallowing
• Dizziness or fainting, or rapid or weak pulse
• Vomiting, diarrhea, or stomach cramps

School staff shouldn't expect your child to give themselves epinephrine during a reaction, even if they know how. Your doctor will make an emergency response plan for the staff to follow. It will tell them how and when to give epinephrine, call 911, and start emergency first aid. School staff should also be educated to never leave a child who is having a reaction alone.

Ask your child's teacher to avoid using triggers in lesson plans, crafts projects, and cooking classes. Some iffy items include:

• Tempera paints that have eggs
• Clay or dough made with peanut butter
• Icing made from egg whites

Also establish clear communication about class parties and events in which food items are brought in.  Request a list of ingredients before these events.  Then decide with your child if it's safer to pack them a treat from home.

Teachers should also be mindful that some cleaning supplies -- such as bleach, antibacterial sprays, and air fresheners -- can trigger asthma attacks.

Preventing insect stings can be hard. But your child's school can take these helpful steps:

• Remove insect nests on or near school grounds
• Store garbage in covered containers away from where students play or line up for school
• Have at-risk students eat inside, at least during sting season

A medical alert bracelet reminds school staff during an emergency that your child needs epinephrine. It also gives paramedics a special number to get important information quickly. Bracelets designed for kids can feature beads or cartoon characters.

If you’re sure your child won’t swap food, packing a lunch is OK. But schools must make meals for kids with special diet needs at no extra cost. Food service staff should know your child’s food triggers and the technical and scientific names for those foods to help them when reading packages. Surfaces and utensils should be washed to avoid cross contact.

Limiting contact with triggers can be done in a way that doesn't make kids with food allergies feel alone. If your child is allergic to nuts, for example, work with school staff to:

• Have a special lunch table where anyone can sit whose lunch is nut-free
• Make school-wide rules not to trade food or share utensils or straws
• Create a nut-free snack policy in the classroom

By volunteering at school, you can help teachers watch what's going on. Be involved in planning and going on field trips and class parties. Write a letter that the teacher can send to other class parents to let them know about your child’s allergy. Offer to provide kid-friendly allergy info for classmates.