As families across the U.S. get ready to send their children back to school, parents of kids with food allergies have a different sort of homework. They must make sure their kids are safe in the classroom, playground and lunchroom. For kids with nut allergies, does their school have a nut-free policy and, if it does, what does that mean?
Unfortunately, there is no cure for food allergies. According to the American College of Allergy, Asthma and Immunology, management focuses on three things: education, avoidance of the allergen and immediate access to a life-saving epinephrine auto-injector. There is no “safe” amount of food, and even cross-contact with food preparation equipment can cause an allergic reaction in some children. Parents are often anxious at the thought of losing the ability to supervise what their child eats. They don’t want to rely on a school’s kitchen staff to be aware of potential allergens and to read all food labels carefully.
Managing food allergies in schools can be very challenging. With large numbers of students spread among different classrooms as well as moving through different locations during the school day, constant supervision isn’t possible. Allowing food in the classroom for birthday or holiday celebrations, or through art projects, can increase the risk of reaction. Cafeterias, of course, are the main focus of concern, as meals pose the greatest risk for an allergic reaction.
[See: 8 Surprising Facts About Asthma and Seasonal Allergies.]
In response, many schools have adopted nut-free policies. While this may provide reassurance for families sending their nut-allergic children to school, it can be a source of contention as well. A nut-free policy will not protect children who suffer from other severe food allergies. And families who rely on peanut butter as an inexpensive source of protein and nutrition are forced to find alternative lunch options. Anger can develop for the few that force a policy that affects all. This has become highly emotional on both sides.
Should all schools adopt nut-free policies? Should the decision be based on factors like school size, layout, personnel and composition of students? Should nut-free policies be abandoned altogether?
Here are some important points about nut allergies and nut-free schools:
— In one study of 1,960 Massachusetts schools, rates of epinephrine use were higher in schools with nut-free policies compared with those without. Rates were lower in schools with nut-free tables in the cafeteria.
— There are no randomized controlled studies (gold-standard for research) that have evaluated rates of food allergy reactions in schools with nut-free policies. More research is clearly needed.
— Epinephrine is the only effective treatment for anaphylaxis — a rapidly progressing and severely allergic reaction involving more than one organ system, such as hives and difficulty breathing.
— Deaths from food allergy are very rare, and almost always due to lack of access to, or delayed use of, epinephrine.
— 16 to 18 percent of children with food allergies have had a reaction at school.
— 25 percent of food allergy reactions at school occur in a student without a known food allergy.
— Food allergy symptoms happen immediately after eating a food, happen every time the food is eaten and with the same symptoms.
— Typical symptoms can include itchy red hives, swelling, trouble breathing, difficulty swallowing and vomiting.
— Symptoms may get worse with each reaction or over time, and may vary from one child to the next.
— It is extremely rare for any exposure other than eating or drinking to cause a severe life-threatening reaction.
— Removing food from a prepared dish (picking a nut off a brownie) is not safe and can still result in a reaction.
— Soap and water or cleaning wipes do a good job of removing food allergens from surfaces and food preparation equipment. Hand sanitizers do not remove allergens.
Did that first point state that food allergy reactions are actually higher in schools with nut-free policies? According to one study, yes. School nurses and administrators say strict enforcement of nut-free policies is almost impossible. It requires scrutiny of every snack and meal brought into school by every student, every day. It is also possible that school staff let their guard down if a nut-free policy is in place. This may inadvertently cause staff to ease up on their focus and monitoring.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
So should schools adopt nut-free policies? For some schools, this is absolutely the best tactic. Other schools may choose a different approach. This is a decision that should be based on each school, including a careful assessment of resources, student population and discussions with concerned parents. Regardless of a school’s decision to go nut-free, given the growing number of food allergies among children, schools should conduct an annual training for all staff to ensure proper understanding of food allergy management.
Debate will probably continue regarding the merits of nut-free policies in schools. But no one can argue that what matters most is that children with food allergies be able to attend school with their peers. They should not be excluded from any activities, and they should learn in a safe environment while minimizing risk of accidentally eating a known food allergen.
Resources for schools: In 2013, the Centers for Disease Control published “Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs.” This is available online for free and offers an excellent review of essential strategies for schools to implement to help protect their food allergic students.
[See: 7 Lifestyle Tips to Manage Your Asthma.]
More from U.S. News
10 Concerns Parents Have About Their Kids’ Health
How to Survive Ragweed Allergy Season
Is it Healthy to Sleep With Your Pets?
Nut-Free Schools: Points to Ponder originally appeared on usnews.com
