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Going to School

Sending Children with Allergies to School

eating lunchAllergies affect approximately 50 million of Americans, causing reactions from the minor to the life-threatening. According to the latest statistics, 8 percent of children under age 18 have a food allergy, which translates to about 1 to 2 per classroom, says Michael Pistiner, pediatric allergist for Harvard Vanguard Medical Associates in Boston. The American Academy of Allergy, Asthma and Immunology (AAAAI) reports that allergic rhinitis (or hay fever) affects as many as 40 percent of children.

Whether your child suffers from eczema, asthma, hay fever, or an allergy to food, bee stings, dust or pollen, she may face extra hurdles in the school environment. You may feel confident taking care of your child at home, but it’s important to work closely with the school to help manage your child’s allergy care, especially when she has experienced severe reactions like anaphylaxis.

“Basic food allergy management strategies are a very doable thing,” Pistiner says. “Schools can pull it off, but it takes a coordinated effort and partnership between the family and the school.”

Here are some tips on how to establish a safe experience for your child with allergies.

Do Your Homework
Thirteen states have guidelines for managing food allergies in schools, which is great news if you live in one of those states. Look up the guidelines and your school’s policy to find out what you can expect for your child’s accommodations. If your state does not have guidelines, ask your pediatrician or allergist what schools in your state or district have done in the past and can be expected to do to protect children. Beyond food allergies, consider what your child will need to think about to avoid allergens. Does the school have class pets in every room? Does it use chalkboards that can stir up dust, or dry-erase boards?

Prepare Early
The summer is busy with vacations, camp and family gatherings, but it’s also the time to start planning for the school year. Find time to meet with your pediatrician or allergist and determine what your child will need in the fall. If you wait too long to start planning, you will be rushing to make accommodations, which could lead to errors. Make an appointment to tour the school and meet the staff.

Meet the School Staff
Get to know the principal, school nurse, teacher and any other staff members who need to know about your child’s allergy or allergies. You and your child need to know who can be relied on in case of an emergency.

“Anybody in the school who has interaction with children should be aware of the allergy. When you think about a school, there are many different places, circumstances and people who will interact with kids. Everyone plays a role,” says Pistiner, who wrote the children’s book “Everyday Cool with Food Allergies” to teach young children about allergy management. Depending on your child’s age, you may want to include her in the meeting, so she knows the people involved in managing her allergies.

Create a Plan
“Ideally, any parent who has a child with food or other severe allergies has an allergist. That allergist writes a letter to the school and lists the accommodations that will be necessary,” says Nicole Smith, founder of

Your child may need an allergen-free zone in the classroom or in the lunchroom. She may not be allowed to touch certain allergens, such as the class pet. Children with dust allergies may need to sit away from the blackboard to avoid chalk dust, and children with asthma may need to have an inhaler on hand at all times.

Use the allergist’s recommendations to create a written set of instructions that the school can use to help prevent and treat an allergic reaction. The school should have a copy of the written plan as well as a supply of any medications necessary. Find out who is trained with an EpiPen in case the school nurse is not available.

Keep in mind that the plan and accommodations will depend on what type of school your child is attending. “All schools are different. If my child goes to a school that is preschool through eighth grade and they share many of the same rooms and they share eating spaces, that’s a different environment than if my kid goes to high school. The school that has little ones, they are still exploring with their hands, and cross contact becomes more of an issue,” Pistiner says. Also consider the resources and manpower that your school has, and work within those limits. Keep the focus on finding ways for your child to be included in as much of the school day as possible. Is there an activity the teacher usually does with food that could be done without it?

Educate Your Child
Don’t expect a young child to be able to manage her allergies herself, but start teaching her now what to avoid and how to ask for help. Preschoolers and even grade-school children cannot be relied on to say “No” every time to certain allergens, but they can start learning to identify hazards, even if you use pictures of allergens or a children’s book discussing food allergies.

“Not only does the school need to understand food allergies, accommodations, EpiPen training and allergic reactions, but a child on an age-appropriate level needs to understand what their food allergies are, who they can tell if they are feeling poorly. Most kids by kindergarten age who have life-threatening food allergies know enough to say, ‘I’ve got a problem,'” Smith says.

Teach your child with food allergies to ask a teacher if a food is safe before eating it. Along with that, make sure you provide a stockpile of safe foods for your child, so there is always an option for her.

Maintain Communication
Check in with your child’s teacher or school nurse throughout the year to see how the plan is working. “Your child will likely be at that school for several years, so it’s best to set him up for success by working together with the school to keep your child safe and included in activities,” says Lynda Mitchell, president of the Kids with Food Allergies Foundation.

Present yourself as a resource, not as a watchdog. Offer to be a volunteer in the classroom or cafeteria, not only to spend time with your child but also to help guide your child and be a resource for the teacher and/or staff who may have questions.

Handle Social Issues
If necessary, ask your principal or administrator to notify the parents of other students that there is a child in the classroom or school who has certain allergies. There is no need to single out a child by name, however. If parents or children complain to you about the allergen-free zone or other accommodations, defer to the school administration to handle any conflict, since it is ultimately a school issue.

“When problems arise, it’s best to work directly with the school, in a matter-of-fact, unemotional way, to resolve the problem amicably, if possible,” Mitchell says. “Schools are more aware now than ever about bullying—whether it’s by other students or by adults—and how this type of unacceptable behavior needs to be dealt with swiftly.”

In many cases, parents of children with allergies say that many classmates will actually offer to look out for an allergic child, especially with the growing prevalence of food allergies. With the help of state guidelines, parents’ and allergists’ guidance, and increased awareness among school staff, students and fellow parents, the school can help keep its students safe and active participants in school life.

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