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Going back to school with Food Allergies

Going back to school with Food Allergies

Food allergies are a growing food safety and public health concern that affect an estimated 4%–6% of children in the United States according to the Centers for Disease Control. Allergic reactions to foods have become the most common cause of anaphylaxis in community health settings. In the United States, 90% of serious allergic reactions come from the following foods: milk, eggs, fin fish, crustacean shellfish, wheat, soy, peanuts, and tree nuts, but any food could potentially cause an allergic reaction.

What can your school or care program do to help?

One of the best ways to help support a child with food allergies is by training all staff and care providers to improve their understanding of food allergies, their ability to help children prevent exposure to food allergens, and their ability to respond to food allergy emergencies (including administration of epinephrine). Every school or childcare program should create a plan for preventing an allergic reaction and responding to a food allergy emergency. Children with food allergies should be well known by all teachers and care providers so that everyone is aware and can help support that child. They should also be prepared to respond effectively to the emergency needs of children who are not known to have food allergies but who exhibit allergic signs and symptoms. Studies show that 16%–18% of children with food allergies have had a reaction from accidentally eating food allergens while at school. In addition, 25% of the severe and potentially life-threatening reactions (anaphylaxis) reported at schools happened in children with no previous diagnosis of food allergy.

What are the Symptoms of an allergic reaction?

So what are the types of allergic reactions you can experience from ingesting a food you are allergic too?

Mild Symptoms

Mild allergic reaction symptoms include itchy/ runny nose, sneezing, itchy mouth, mild itch, few hives, mild nausea, mild abdominal discomfort. For mild symptoms from a single system, antihistamines such as Benadryl may be given with very close monitoring. If there are mild symptoms from more than one system (example hives and nausea) then Epinephrine should be given and immediately call 911. Closely monitoring is crucial in reducing risk of fatality since early anaphylaxis reactions can present as mild reactions and escalate quickly. Have Epinephrine available if needed.

Severe Symptoms

Symptoms of breathing difficulty, voice hoarseness, or faintness associated with change in mood or alertness or rapid progression of symptoms that involve a combination of the skin, gastrointestinal tract, or cardiovascular symptoms signal a more severe allergic reaction (anaphylaxis) and require immediately calling 911 and administering Epinephrine. They may need a Bronchodilator such as Albuterol if wheezing is present.

What should you do if someone is experiencing an allergic reaction?

Signs and symptoms can become evident within a few minutes or up to 1–2 hours after ingestion of the allergen, and rarely, several hours after ingestion. Remember that acting quickly can reduce the risk of fatality. Most allergic reactions resolve easily but not all.

If someone has an allergic reaction, have someone call 911, lay the person flat, raise legs and keep warm. If vomiting or breathing difficulty lay them on their side or have them sit up. Alert emergency contacts, stay with the person and watch them closely for changes. If symptoms worsen can give Epinephrine and can be repeated in 5-10 minutes if the symptoms do not improve.

The single best thing you can do is educate yourself to what an allergic reaction could look like, and what you need to do to help them safely get the emergency care needed. is an amazing website full of resources. Another very important issue is to help a child with food allergies learn to be proactive to take responsibility for what they are ingesting by asking what is in prepared foods and reading food labels. Remember that children with food allergies often feel “different” than their peers and it is our responsibility to help support and nurture them be successful in navigating healthy alternatives.


Dr. Michelle Walker DNP


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