An estimated 32 million Americans have food allergies, including 5.6 million children under 18, according to the Food Allergy Research & Education organization (FARE). That equates to about one in 13 kids or roughly two in each classroom.
Between 1997 and 2011, the prevalence of food allergies in children increased by 50 percent. As the number of cases of food allergies has grown, schools have been forced to make modifications to help provide a safer environment for students and to be prepared for the effects of allergic reactions, which can be as minor as slightly itchy skin or severe and life-threatening.
“When a parent or guardian identifies that their child has a food allergy, a process is started to educate the parent/student/staff. We gather information from the parent regarding the history of the allergy and reactions. Based on the information from the allergy history and allergy action plan, we discuss the next steps,” said Kathy Knawa, Flossmoor School District 161 nurse.
Knawa noted that “the Illinois State Board of Education has guidelines for managing life-threatening food allergies. We follow these guidelines, as all schools should.”
At District 161, it is requested that an “Illinois Allergy Action Plan” is completed by the student’s healthcare provider that can then be reviewed by school staff.
“Students with life-threatening allergies should have an emergency action plan, health plan and consideration for a 504 plan,” said Knawa. “The goal is to recognize symptoms, prevent exposure and have an emergency plan in the event of an exposure.”
"Education of staff and communication between staff is pertinent in ensuring that risk is minimized for students with food allergies. Food service staff have an allergy list that is given to us from the school nurse,” said Dana Pries, Food Service Director with Homewood School District 153. “We have to follow the guidelines for the national lunch program. All lunches are calculated for calories, saturated fat, sodium etc., so substitutions for food allergies are only made for milk. We offer lactaid and soy milk for any student that has a dairy allergy.”
There are eight major food allergens: milk, egg, peanut, tree nuts, wheat, soy, fish and crustacean shellfish. Although more than 170 foods have been reported to cause allergic reactions, those eight are responsible for most of the serious food allergy reactions in the United States, according to FARE.
Peanuts are an allergen that can be a cause of severe allergic reactions. At District 153, there is a peanut free table in the cafeteria that students can sit at to reduce risk of reaction.
“Lunchtime is one of the high risk times of the school day,” said Knawa. “If a parent requests special seating for their child due to food allergies, this can be accommodated. We must always weigh the benefits and risks of having students at a separate table from their friends. Other options may be considered such as eating at the end of the table, eating out of their lunch box, etc. It is very difficult for a child to have food allergies.
"Removing them from their friends due to food allergies may not be best for all students.”
Knawa said that special meals can be served for students with food allergies if certain criteria are met and required paperwork is completed. “The food service provider does not serve anything with peanuts,” she said. “Parents should review the menus of the food served. Often times, parents of children with food allergies provide the meals.”
When it comes to birthdays and children bringing in treats to celebrate, Knawa said that parents are encouraged to send in non-edible treats. If an edible treat is sent in to school, it must be off the Allergen Free List. At the start of the school year, parents are also notified if there is a food allergy among the class.
Pries said that at District 153 outside food is not permitted to be brought in to celebrate birthdays or holidays. “Food service supplies snacks needed for celebrations like Halloween or Valentine’s Day along with the ingredient label to parents,” she said.
Knawa said that she does have a stock of EpiPens, filled with epinephrine, a quick-acting medication that can help restore breathing and reduce swelling. The school strongly encourages parents to obtain an order for an EpiPen for their child, which would follow the child on field trips or be available at high risk times. “The stock of EpiPens does not leave the building and is dependent on availability,” she added.
Pries did not have access to information on the nurse’s office procedures as far as EpiPens, but she said all staff are trained to use an EpiPen.
“Food safety is our priority along with serving the students a nutritious meal that they will enjoy,” said Pries.