I’ve spent the summer researching a feature article on Starting School with Allergies, so I thought I’d share some of what I’ve learned here.
Anyone who has a child with allergies probably heard about the recent inquest into the death of 16-year-old Sydney student Raymond Cho, who died after eating a biscuit containing nuts at school. The biscuit was given to Raymond by other students who had baked it in a school cooking class. Hearing about this incident was a huge wake-up call to me, but it also demonstrates the huge responsibility teachers now face looking after children at risk of anaphylaxis. Thankfully deaths of school students with allergies are extremely rare, but they do happen every few years, so everybody who is part of a school community needs to be aware of allergies and the challenge they present to parents, teachers and students.
So what needs to happen when a child with allergies is starting school for the first time?
Since the death of Raymond Cho, the Department of Education and Communities has released some updated Procedures for public schools. They’re very new, but there are now some clear things that must happen if a school has a child enrolled with severe allergies. They must train their staff in anaphylaxis and emergency care, they must keep a spare EpiPen in their first aid kit that can be given to any child, even one who has not been previously diagnosed with an allergy, and they can and should use another child’s EpiPen if they think a child is having a life-threatening allergic reaction. So check that your school has implemented those things so you can be confident that your child will receive proper emergency care if the worst happens. You should also check with school staff that your child will be given a second EpiPen if needed.
Secondly, every parent should get a face-to-face meeting with a school representative to work out a unique health care plan for their child. This is now mandatory. When my daughter enrolled, we just handed in the paperwork and that was that. What should happen is that you should sit down with the school and together work out some strategies that will reduce the risk of your child having an allergic reaction at school. Those strategies will be different depending on the child and the specific allergy. So that might mean sending a note home to the other class parents to tell them about your child’s allergy. You might need to request that they don’t send certain foods to school, like peanut butter sandwiches. Don’t just assume the school will be nut-free or peanut-free, many schools aren’t. You might want to speak to the class, and show them a video or read them a book to teach them about allergies. You might instigate something like making sure the children wash their hands before and after eating, or that they eat lunch supervised in the classroom for ten minutes before heading out to play. Or you could get a sticker made up for the children’s lunchboxes that says, “Please don’t share food.” My experience is that even though kids know they’re not supposed to share food, they still do it all the time, so you need to keep pushing that message. Whatever strategies you decide on, the parents and the school should work it out together to make sure the solutions are workable, both for the child with allergies and for the rest of the school community.
What about the school canteen – is it safe to use?
Parents of children with allergies have to just work out for themselves whether or not they think the canteen is okay for their child. Personally I’ve decided not to let my daughter use the canteen, because our school uses a huge roster of volunteers, some of whom help out as little as once a month. With so many people on the roster, it’s inevitable that some of them won’t be clued up on allergies and that mistakes could be made. Caillie has already been sold products containing traces of nuts from the canteen because the packaging wasn’t checked thoroughly enough. So again, don’t just assume the canteen will be safe because they say it’s a nut-free canteen. Find out how it actually operates and then decide if it’s safe. It only takes one time that they run out of tomato sauce, somebody runs across to Woolies and buys a different brand than usual and suddenly the sauce has traces of peanuts or dairy.
What do parents need to teach the child with allergies so that they can keep themselves safe?
According to Dr Elizabeth Pickford from RPAH Allergy Clinic there are four main things children need to know before starting school
1) You need to make sure the child knows what they are allergic to and what foods are likely to contain that allergen. That sounds obvious, but as I go around pre-schools a lot of kids don’t know their own allergies.
2) They need to know to always ask a trusted adult if foods contain their allergen and that if there is any doubt they should just say ‘no’. As they get older they should be taught how to read the ingredients themselves.
3) They and all their friends need to be continually reminded not to share food with other children
4) If they feel sick, they need to tell the teacher immediately because the teacher can help them.
I also think kids need to know that they shouldn’t be ashamed of their allergies. Kids who feel different or ashamed are much less likely to speak up when they need to and for children with allergies speaking up is a survival skill.
In all of this, the main thing is ongoing communication, so keep talking to your teacher, the other parents and your child. And if you have an instinct that things aren’t quite right, then make sure you speak up. You can’t be shy if your child has a serious allergy.
You can read the new Anaphylaxis Procedures for NSW Schools here
Australasian Society of Clinical Immunology and Allergy (including free online training)
My children’s book Marty’s Nut-Free Party is a great resource for the classroom
Trigger Food Allergy Awareness Video, also a great resource for teachers.