Helping Families Manage Food Allergy in Schools

Tips and Tools for the Allergist and Nonallergist

Matthew J. Greenhawt, MD, MBA

Disclosures

July 25, 2011

In This Article

The Growing Problem of Food Allergy

Food allergy is a growing epidemic in the United States. The Centers for Disease Control and Prevention estimate that nearly 3 million children younger than 18 years are affected by food allergy; over the past 10 years, the number of new cases of food allergy has increased 10-fold.[1] Food allergy can have a wide-ranging, negative effect on children and their families, affecting not only life at home but also work, education, vacation, and entertainment. Virtually no life activity remains unaffected by the presence of a potentially fatal allergy.[2] Recognizing that there is no known cure or proven treatment, the number of cases of food allergy is expected to increase. Studies have also suggested that many food allergies persist longer than was once previously assumed.[3] The chances are high that an individual parent or child will interact with a food-allergic person every day. Although much work has been accomplished in spreading the message that food allergens can potentially be life-threatening, a clear lack of understanding about this issue in many persons without food allergy remains.[4] The main management strategy for food allergy -- avoidance -- is difficult to implement, a fact often underappreciated by unaffected individuals. Food allergy has become a global social issue, and protecting the health and self-esteem of affected children as well as the quality of life of the family, is a responsibility that must be shared by the entire community.

Sending a food-allergic child to school, camp, or child care can be a daunting task for a parent and may be associated with much anxiety. Increasingly, allergists and nonallergists are being asked to help prepare students and their families to make a safe transition. This involvement consists of ensuring the following:

  • Each student has a self-injectable epinephrine device;

  • The family and child (if age-appropriate) know how and when to use the device;

  • The family can train others to use the device; and

  • The student has an emergency action plan for the facility to follow in case of a reaction.

Often, more detailed involvement is requested in guiding classroom and/or facility-wide policies, such as the establishment of section 504 plans or other individualized health plans that afford protection and services for food-allergic children at school. Understanding real vs perceived risks of a potential food-induced reaction at school or child care can be helpful in planning.

Let's review the published evidence to gain a better understanding of this situation.

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