Food Allergies on the Rise: No Surprise!

How Many EpiPens?

The latest findings published in the June 25, 2012 issue of Pediatrics will come as no surprise to school nurses, teachers, pediatricians and anyone in the food allergy community. "Allergic Reactions to Foods in Preschool-Aged Children" found that reactions among young children are rising. No coincidence that the number of EpiPens in the school nurse's office and the number of school districts adopting food allergy management plans has also been increasing.


The study did indicate several reasons for the rising numbers of reactions:

• lack of vigilance
• misreading ingredient labels
• allergen cross-contact
• non-accidental allergen feeding 
• under-utilization of epinephrine for severe reactions

A few other items of note to me from this study:

• severe reactions were due to ingestion, rather than exposure through skin or inhaling
• there continues to be a hesitancy to administer epinephrine for anaphylaxis. Reasons cited included not being able to identify symptoms as an allergic reaction, unavailability of epinephrine, feeling too afraid to administer epinephrine  and waiting for additional symptoms. 
• 11% of the reactions were as a result of purposeful reintroduction by the family. I've reported on our experiences in reintroducing foods at home. While we've discussed this with our allergist, I can certainly see how frustration with lack of progress and higher medical costs may lead parents to try this at home.

And so we continue reading ingredient labels, maintain vigilance and avoid cross-contact. It's disturbing though that the number of reactions is increasing and yet we still can't find a root cause. It was recently referred to as "an epidemic" and while I agree that we need to continue to raise awareness, we certainly need to annihilate allergies to food once and for all.

Food Allergy Bill is now Food Allergy Law

On Wednesday President Obama signed 35 bills into law. One of them was the Food Allergy and Anaphylaxis Act. This is welcome news for our school children with food allergies.

Forward this to your school board and administrators and offer your assistance in creating a plan that works for your school. Yes, it's a voluntary program, but the federal government will provide the standards and schools can craft a food allergy policy to fit their needs. We need consistency among our schools in the way food allergies are managed. This is a great step toward this so get inolved now!

Food Allergy and 504 Plans at School

As I prepare for our annual 504 meeting with our school later this week, I am reminded about how far we have come. It was only in 2008, that Congress expanded the definition of who is eligible for federal protection. Now, individuals are protected- even if they don't suffer a disability all the time.

Prior to 2008, parents had to fight for any accommodations for their food allergic children at school. It was at the discretion of the school district how food allergy would be handled. When my child with food allergies entered school 5 years ago, we did not have any type of formal written agreement. The school did allow him to carry an EpiPen® (beginning in kendergarten) and a special food allergy table was established in the cafeteria. After a disappointing experience in 2nd grade, where he was excluded from making gingerbread houses with his grade due to his food allergy, we insisted on something more formal. We were offered an IHP, an Individualized Healthcare Plan.

The IHP was a document between us as parents and the school nurse. It was a good start, but not enough, as it didn't include key players within the school system like teachers, bus drivers and even the facilities and maintenance department (they're the only ones who knew the ingredients in the soap in dispensers near school sinks).

Enter last year and our first 504 Plan. We held a group meeting- parents, nurse, principal, guidance counselor, classroom teacher and head of facilities for the school district (also in charge of our bus company contract). Together we completed an individualized document to best meet my son's needs. This year my son will join the meeting and we will all work together to update the 504 Plan as needed.

The 504 Plan makes everything much easier because everyone, including the student, knows what they are responsible for. I like this recent article about 504 Plans for those who aren't familiar with federal protection for food allergic students.

 Are most of you using 504 Plans or do you use other documents or tools at school?

School Districts and Food Allergies

Isn't it wonderful to read things like, "proactive", "district-wide awareness", and "inclusion of all children"?

"Advocating for Allergy Education", published in the Valley News Dispatch, discusses numerous districts in the Pittsburgh PA area and how they handle food allergies.

I like what I'm reading and hope to see more school districts promote education and acceptance when it comes to food allergies. Read it and see what you think. For those of you who don't have a school district that is quite so understanding, use some of the phrases from this article to talk to your school officials.

Food Allergy Guidelines for PA schools

This article is of particular interest to me.

I spent many hours working with our school district so my child could be safe at school. As I've said before, he's carried an Epi-Pen around his waist since his first day of kindergarten. If the school had denied us this right, it would have been a deal breaker resulting in a search for alternative educational opportunities. Every child and every situation is different, but schools and parents need to have some basic understandings and rights when it comes to food allergies.

I fully support State Rep. Tom Murt in his efforts to require Pennsylvania to develop food allergy guidelines for schools. I'm going to write to him right now and see how I can help.

How is your school handling food allergies?

Food Allergy and Anaphylaxis Management Act of 2009

Do you know about the Food Allergy and Anaphylaxis Management Act of 2009? I wrote about it over at Suite 101, so read that article if you want specific info about what it is.

I've written to PA Senators Casey and Specter to request their support of the bill. Feel free to copy all, or part, of my letter to send to your state senators. Check here if you're not sure who your senators are. Pass this letter along to anyone who may be willing to write a letter too.

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Dear Senator Specter,

I am writing to request your support of S456: Food Allergy and Anaphylaxis Management Act of 2009, introduced on February 23, 2009 by Senator Dodd to the Committee on Health, Education, Labor, and Pensions.

As the parent of a child with food allergies, I know first-hand the problems created when schools do not have established plans to manage the risk of food allergy and anaphylaxis. Young students have life-saving medication hidden in backpacks. Teachers feel anxious because they don't have the proper knowledge to handle an allergic reaction. Children feel left out because they can't participate in certain activities because plans were not made in advance.

I have advocated for my son often within our district. They have been very willing to work with us, but I know this is not the case in neighboring schools. This act would open the dialogue, and some funding, to get everyone on a level playing field.

I am also requesting an increase in federal funding for food allergy research. As recommended by the researchers who gathered at Children’s Memorial, an increase from the current amount of about $13M to $50M per year may get us better treatment and finally a cure. Recent research in food allergy is so promising and the researchers need more support.

Please support this act and increased funding for my third grader and the other three million school-aged food allergic children in the U.S. They need us.

Thank you.

Sincerely,

Food Allergies in School

If you have a food allergic child entering school for the first time next fall, you should start thinking now about what you and your child require to keep him/her safe. Children with food allergies are protected under the Americans with Disabilities Act and accommodations must be made by schools. If funding is involved, your child will need a 504 Plan which is typically done with the Special Education Administrator. If there is no funding, a Healthcare Plan may be fine.

Take some time now to write down what you need and then arrange a meeting with the principal, school nurse, and others if necessary. This is your meeting so be prepared with your questions and requests. Some areas I addressed during my meeting:

How are teachers and staff educated to deal with food allergies?
Where will life-saving medications be stored? I also informed the school that my kindergartner would carry his own Epi-Pen in a waist-pack.
How are medications handled on field trips?
What is the procedure for medications in the event of a fire drill? I wanted to know if the nurse took medications out of the building in the event students were kept outside for a long period of time.
How will the bus driver be aware of food allergies and are they trained in how to handle them?
How will classrooms be kept safe? I requested that the principal send a letter home to parents at the beginning of the year informing them that their child has a classmate with food allergies. I also asked that all students in the class wash their hands after lunch and snack.

The school will probably require documentation from your child's allergist as well. Planning ahead will ensure a smooth transition to school next fall.

For more information, go to my website.