It’s back-to-school time again, and if you’re the parent of a child who suffers with allergies or asthma, it can also be a stressful time.
Food allergies affect approximately one in 13 kids. That means that in the average classroom, there are about two students who are coping with some form of food allergy. Of these students, nearly 40 percent have a history of severe allergic reactions or anaphylaxis. Parents, teachers, and school officials need to be aware of the potentially life-threatening situations that can arise and be ready to handle them should they strike.
Here, our board-certified allergists offer advice and resources for allergy- and asthma-sensitive kids and back-to-school preparedness.
Request a meeting with the school nurse.
Often, the nurse is the most experienced and best-trained staff member when it comes to medical emergencies. Your school’s nurse is the food allergy “champion” in your school, and the nurse should be your connection for developing a coordinated effort to ensure an all-inclusive approach to managing your child’s food allergy and asthma management in the school setting. This is why one of the first things we recommend parents to do is meet with the nurse and explain all of your child’s allergy or asthma symptoms.
Speak to the school counselor to discuss whether a 504 Plan is appropriate.
Under federal law, a food allergy may be considered a disability. In those instances your child may qualify for educational services under Section 504 of the Rehabilitation Act of 1973. 504 plans outline appropriate accommodations, aids or services that a student with a disability needs to be able to fully participate in a free and appropriate public education environment. A 504 plan allows you to create, in collaboration with your child and the school, a written management plan outlining how the school will your child’s food allergies. It will also allow your child to participate safely and equally alongside their peers in all normal facets of the school day.
Disclaimer: We are not experts on 504 Plans—if you believe your child would qualify for a Section 504 Plan, please discuss this with your child’s counselor or the Special Education/504 Plan liaison at your student’s school.
Share your emergency care plan.
In conjunction with the nurse and teachers, share the emergency care plan you use for your family. Make sure all staff who works with your child is aware of this plan. This emergency care plan outlines the treatments recommended in case your child experiences an allergic reaction, the form is great for including emergency contact numbers and can be signed by your physician, pediatrician, and allergist.
Share pictures of typical reactions your child has.
If your child’s teacher has not cared for kids with severe allergies, it could be helpful to share pictures of what typical allergic reactions look like. If you have pictures of your student’s reactions that would probably be the best option, but even just directing staff to websites with allergic reaction pictures.
Ask your child to describe to his/her teacher what they’re symptoms feel like.
Children explain things in their own special way. They have a way of describing their experiences that are vastly different than the way adults describe things—and their way of describing allergic reactions are no exception. Knowing how a student experiences their reactions will help the adults around them save precious time when needing to recognize a reaction that is happening. Some kids, especially little kids, will place their hands to their mouth or pull and scratch their tongues in response to an allergic reaction. Additionally a children’s voice may change in response to a reaction (they may become hoarse or squeaky), and they could begin slurring their words.
Here are some examples of what a child may say to describe their allergic reaction:
- “My tongue is hot/on fire/burning…”
- “It feels like something’s poking my tongue.”
- “My tongue/mouth/lips is tingling…”
- “My throat itches…”
- “My mouth/tongue feels funny…”
- “It feels like there is something stuck in my throat…”
- “My tongue feels fat/heavy…”
- “My lips hurt…”
- “It feels like something/bugs are in my ears…” (to describe itchy ears)
- “It feels like my skin is burning…”
- “I feel bumps on the back of my tongue/throat…”
Speak with school lunch staff.
Most schools have electronic systems for tracking lunch purchases. Ask that a notification or alert be included on your child’s profile. This notifies lunch personnel of your child’s allergy status and helps ensure he or she isn’t accidentally served foods he or she reacts to. In some instances, if your child has a very severe reaction to certain foods—especially if just being in close proximity to the food can cause a reaction—staff should be able to ensure a safe area in the lunch room or a safe eating area for your child.
Keep an epinephrine injector at school.
For parents in Florida, schools can keep non-student specific epinephrine pens stocked for children who suffer from anaphylactic reactions at school. However, every child with a severe food or insect venom allergy (i.e. to bees, wasps, fire ant, etc…) should have their own prescription for an auto injector that can be kept on hand at school. We recommend EpiPen, Auvi-Q or Adrenaclick (generic). You can also check out our patient education page for info on proper use of EpiPens.
Use safety tattoos for notifying staff.
You probably don’t need these for long-term use, but for the beginning of the school year (or other times when your child will be with new care providers), these safety tattoos can be extremely helpful in making sure people are aware of your child’s allergies.
Have your child wear a medical alert bracelet.
Especially for children at risk for severe allergic reactions, this is a better option than the safety tattoos. They are also helpful for EMTs who might respond in case of a medical emergency. Also, for your fashion-conscious kids, medical bracelets can be made like stylish jewelry.
Create a “safe food box.”
It’s common for classrooms to have snacks that may cause issues for your child. Create a safe food box that can be kept with the teacher to substitute for your child with severe allergic reactions. If safe food boxes are not encouraged, you can also offer up a safe food list for your child’s teacher to ensure that reactionary foods are not in the classroom.
Ask for a list of birthday party dates.
If your child’s classroom celebrates birthdays, it is possible to ask for celebration dates in advance and whether there will be dangerous treats available. Nowadays most treats have allergen-free alternatives that can be substituted for your child to ensure they don’t feel left out.
If you have the flexibility, consider being a “classroom parent.”
This would give you a little more advance notice on events going on in the school and classroom. Also, volunteering in the PTA and on field trips can help you monitor your child (and other children that might have allergies). Additionally, many schools are in dire need of volunteers and assistance—so you’ll be helping your child and your community school.
Ask school administrators to limit or not use your child’s classroom for after school activities.
Sometimes schools have to use rooms for after-school activities or to support outside groups. Ask that your child’s room not be used for these activities. While there is no guarantee the administration can honor your request, it could help to limit allergens brought into your child’s classroom.
Find out your school’s procedures for limiting allergens on buses and transportation vehicles.
Determine if the policies and procedures are appropriate for your child. In some instances, you might be best served by transporting your child to and from school yourself. Most districts have a “no food” policy on their buses unless medically necessary (i.e., a diabetic child with low blood sugar). Some policies might include having an adult on the bus who is trained in administering epinephrine or ensuring special seating arrangements.
Request advance notice of all field trips.
This should be standard procedure for your school and student’s teacher, but don’t just assume they will give you a lot of notice for the field trips. Your child’s allergies needn’t prevent him or her from attending educational and fun field trips. But asking staff to provide you with as much advance notice as possible gives you a chance to prepare and address any allergy concerns.
Ask to speak with the kids in your child’s class.
Unfortunately, bullying occurs for all sorts of things, and kids with allergies aren’t immune to bullies. Ask your child’s teacher and principal if you can address your child’s class to help them understand what allergies are and what happens to your child if he or she has a reaction. This won’t prevent all bullying, but it’s a good way to address issues ahead of time. If speaking to the class isn’t possible, allow the teacher to address the class about your child’s allergies (without giving too much personal information). For younger classes, a great little video to share is Binky Goes Nuts — check with your child’s school or local public library to see if it’s available.
Don’t forget to address recess, physical education classes, and sports.
Recess is probably the most enjoyable part of the day for kids — but if your child suffers from allergies or asthma, it can be easily turn into the worst part of the day.
For kids with allergic rhinitis (hay fever), parents can sign up for National Allergy Bureau pollen count alerts. When pollen count levels are expected to be high, you’ll be able to plan accordingly. If your child takes medication to control their symptoms you’ll be able to be ready for days when they’ll be highly affected. You may also ask your child’s teachers and school staff to do their best to keep windows closed to keep as much pollen out as possible.
Children with exercise-induced bronchoconstriction or general asthma may find participating in physical activities difficult. However, it is very important for children to be active and participate with their classmates. Parents should work with the school staff determine the best strategies to keep your child as symptom-free as possible while allowing them to participate in recess and exercise.
Some strategies may include:
- Using short-acting inhaler 15 minutes before gym or recess
- Ensuring they drink plenty of liquids before, during and after exercise
- Sometimes it may be necessary to limit what sports and exercise kids can participate in to lessen the chances of triggering their symptoms and an attack.
Another issue that can affect kids during playtimes and gym are insect bites. Insect bites can cause severe allergic reactions in kids with an insect allergy. Make sure the school nurse, school staff, and your children’s teachers are aware of their insect allergy and its symptoms and ensure your child always has an autoinjectable epinephrine at the school (or with them if allowable).
Work with your child on how to self manage his or her allergies.
Older kids need to learn how to manage their allergies and advocate for themselves. When you feel it’s age appropriate, make sure your child knows to carry their medicine at all times and how to self-administer epinephrine if appropriate.
The good news for parents is that schools are becoming more aware of kids with severe food allergies and the actions to take to keep them safe. But it’s still important for you to be your child’s number-one advocate. Follow these tips to make sure you, your child and his or her school are ready for the coming school year!
If you suspect your child has allergies or asthma and would like to have him or her tested for food allergies, contact us to schedule an appointment with one of our board-certified allergy and asthma specialists. We have four convenient allergy clinics in Jacksonville.
Each school district may have different policies regarding school nurse staffing and student health policies. For our patients in Northeast Florida, please visit your school district’s website for more information: