Managing Food Allergies in Schools

apple and nuts Food allergies in children are on the rise. The American Academy of Allergy, Asthma and Immunology (AAAAI) estimates that about 6 % of children have a diagnosed food allergy and the Center for Disease Control and Prevention (CDC) reports food allergies in children increased 18% between 1997 and 2007.

A food allergy is an immune system response that happens after exposure to a given food. Ninety percent of allergic reactions to food result from exposure to one of the “Big 8”: milk, egg, peanut, tree nut, shellfish, fish, soy and wheat. Diagnosis of food allergies can be challenging. The National Institute of Allergy and Infectious Disease (NIAID) recommends children with a suspected food allergy see a board certified allergist for testing.

Food allergies can have a large impact on a child. They can cause an insufficient intake of nutrients which may lead to slowed growth and nutrient deficiencies.  Food allergies can also lead to changes in eating behaviors and may lead some children to become picky eaters or develop food aversions. Living with a food allergy is difficult and at times stressful, which may cause some children anxiety due to fear of the adverse reaction to food.

Strict avoidance and medications are the current medical management for food allergies. Children must learn to not share food, communicate their allergy to others, never eat unsafe food, ask questions, learn to administer and carry epinephrine (if applicable), read food labels and respond to bullying. When food is prepared for the child, cross-contact must be prevented, proper cleaning techniques must be followed and all labels must be read. The greatest risk for a food allergic child is during activities occurring outside of the school day or building (e.g. field trips).

Schools play an important role in helping manage a child’s food allergy. Some of the best practices for successfully managing food allergies in schools are listed below.

School District Food Service Best Practices

  • Institute standard substitutions (e.g. peanut butter is substituted with sunflower seed butter)
  • Implement point of sale software warnings that alert staff to student food allergies
  • Separate production processes to prevent cross-contact. Cross-contact happens when one food comes into contact with another food and their proteins mix.
  • Incorporate food allergy management procedures into the HACCP plan
  • Collaborate with vendors and distributors to identify allergens in products  
  • Meet with students with allergies and their families to develop a plan and address questions and concerns
  • Train all food service staff on food allergy basics, identifying food allergens, preventing cross-contact (hand washing, preparation and service), emergency procedures and label reading

School District Best Practices

  • Family, school and medical provider should work together to ensure the child’s food allergy is managed while at school
  • Train all school staff on managing food allergies
  • Standardize all forms
  • Implement standardized procedures

Schools play an important role in the management of a child’s food allergy. Schools must be prepared and work with families and children to ensure the school environment is safe for children with food allergies. 

For more resources about managing food allergies in schools click here! 


Contributor

Amanda Mercer, MS, RD, Colorado Department of Education, Office of School Nutrition


Resources

Accommodating Children with Special Dietary Needs in the School Nutrition Programs, Guidance for School Food Service Staff

American Academy of Allergy Asthma and Immunology

Center for Disease Control and Prevention

Food Allergy Research and Education – Resources for Schools  

National Food Service Management Institute Food Allergy Resources

National Institute of Allergy and Infectious Diseases