ARTICLES

By Mary Allen, Quebec Regional Coordinator
AAIA News - October 2001

Trace amounts of peanut can cause severe reactions. In an effort to reduce the risk of peanut reactions, the CSACI (Canadian Society of Allergy and Clinical Immunology) in their paper Anaphylaxis in School and Other Child Care Settings, has recommended that peanut be restricted in day cares and in early grades when a child in the classroom is peanut allergic.

Many schools restrict peanuts and nuts in classrooms, particularly when children eat lunch and snacks in the classroom. A few schools have a "no peanut or not" policy for the entire school. How important are restrictions? Is the school-wide approach necessary? Opinions differ and there are many heated debates about this issue.

Classroom or school-wide restrictions on milk, egg or any allergens other than peanut are seldom suggested despite the fact that children can have anaphylactic reactions to these foods. Parents of children who have these food allergies sometimes resent the lack of attention paid to their child's allergies. Parents of non-allergic children may also resent being told that their children cannot have favourite foods at school.

Rules restricting peanut or other foods, may not only allow an allergic child to feel more secure, but also reduces the amount of the allergenic food present in the classroom or school, which should lessen the risk of a reaction. However, food restrictions can be difficult to enforce. Often, this can take the focus away from educating and preparing the allergic child, his caregivers and peers on allergen avoidance.

Restrictions or not, it can never be assumed that the environment is 100% safe, since complete compliance cannot be guaranteed. Indeed, children who love peanut butter may be more likely to eat it at breakfast if they can't take it for lunch and may bring trace amounts to school on their hands, books and clothes. Therefore, whether or not food restrictions are in effect, simple measures such as frequent hand washing are extremely important.

Some schools have rules that are stricter than others. Assuming that a school has decided to prohibit peanut/nut products from a classroom or from a lunchroom, how far should the ban extend? Some parents of allergic children are content, correctly or incorrectly so, if only peanut butter and all products that actually contain peanuts are eliminated. Others want everything that says "may contain" to be eliminated. The latter means that all non-allergic children are forced to shop and eat with the same stringent constraints as an allergic person even though the risk of peanut/nut being in the "may contain" products is often low depending on the product. (However this is not always the case, the risk may be quite high for contamination with nuts if for example, the chocolates are made in Eastern Europe). The risk that the allergic child would share food with others should be very low, because anaphylactic children should always be trained never to trade any foods. As parents, when deciding what restrictions or risk you are prepared to enforce or take for your child, remember that we as parents must assume the role of advocate for our child or children.

There are no easy answers to these situations. Risk and responsibilities have to be weighed. Solutions will differ for different age groups and school situations. An "allergy committee" at school, composed of parents of both allergic and non-allergic children, may be a good idea. Policies can be developed for field trips, bake sales and other special events and the committee can take the time to examine the impact of the various alternatives, with an emphasis on cooperation, education and safety. While nothing will totally alleviate the anxiety felt by the parents of allergic children, it is usually possible to find workable solutions and, as the child gets older, he or she will assume more and more responsibility.

Don't assume….
In many school districts, snack time, lunch time and after-school programs may not be staffed by the School Board. It may be set up and managed by a Home & School Group, Parent Volunteers, Grade 6 students or other entity. Find out who is legally responsible. Do not assume that these caregivers are covered by school protocols and training programs. They may not receive information that you send to school, unless you send a separate copy specifically addressed to them. Ensure that these caregivers receive all of the pertinent information:
§ What the child is allergic to
§ How to recognize symptoms
§ Location of medications and how to use them
§ Emergency phone numbers
§ How to avoid allergens and "accidental" contamination.

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This article courtesy of the Allergy/Asthma Information Association at www.aaia.ca and the Calgary Allergy Network web site at www.calgaryallergy.ca. May be reproduced for educational, non-profit purposes with proper attribution.
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