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Ask Dr. Doug: Food Allergies & School

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Q: My child has a severe peanut allergy, and I’m nervous about leaving her with caregivers, like her teachers when she starts kindergarten next year. Can you offer any suggestions for talking with people about how to deal with it if she goes into anaphylactic shock?

A: Your big 5-year-old grinning on her first day of school is such a bittersweet moment — how did she get so big? Unfortunately for parents of children with food allergies, this milestone often comes with added worry. Food allergies are common and have been on the rise over the past 20 years. Around 8 percent of children have one, so your daughter likely won’t be the only student with a food allergy. However, there are still plenty of misunderstandings around food allergies, which is why your communication with her school is so important.

I would recommend starting with teaching your daughter, calmly and matter-of-factly, that she needs to only eat the foods you give her, and to ask “Does this have nuts in it?” if any snacks are distributed in school. If you are reassuring and calm while discussing this you can help ward off the natural anxieties she may have around school and food.

Next, call the school and ask to talk to the administrator regarding their food-allergy policies. Do they have allergen-free rooms or areas? How are staff trained to use epinephrine autoinjectors and is the training current? Educating caretakers how to handle an exposure or a reaction — even before the first day of school — is important so they can take the time to feel fully prepared before they are in charge of caring for your daughter.

In order to plan for an accidental exposure, I would highly recommend you fill out an allergy action plan with input from your pediatrician or allergist. This is a specific plan on how to recognize symptoms of a reaction and how to treat them. The best version is from FARE (Food Allergy Research and Education), found at foodallergy.org. Remember: when in doubt, give epinephrine. Antihistamines like diphenhydramine (Benadryl) only treat itching or hives and will not stop anaphylaxis. A quick poke to save a life is worth it.

View this transition as an opportunity for education and growth. Be prepared, but don’t forget to tell yourself (and your daughter!) that you can handle this. Hug her tight the first day of school — she will be graduating from high school before you know it!