FAQ: How Can an Allergist Help with School Plans for Your Child with Food Allergies?
by Beth Puliti
Make the grade by making time for an allergist this school year
Before they hit the books, make sure your food allergic children
are adequately prepared for school this fall by setting up
a meeting with their allergist. Open communication between
parents and allergists is critical in guaranteeing a safe school
KFA spoke with pediatric allergist Michael Pistiner, MD,
MMSC, a pediatric allergist and instructor of pediatrics at Boston Children’s Hospital about the role of an
allergist in back to school preparation.
KFA: As an allergist and parent of a child with a food
allergy, what should parents discuss with their allergist to
prepare for a child going to school?
The way I approach food allergies in
general, and you can apply it to any setting, is by dividing
management into avoidance and preparedness. Parents should know exactly what foods their children are allergic to and be
prepared to discuss and participate in the implementation of
avoidance strategies in their children's schools. They should be
aware of basic food allergy facts and avoidance strategies and
work with the school nurse and teachers. In addition, parents
should ensure that their allergist develops an allergy action
plan, and contact their allergist when there is any uncertainty
on the part of the parent or the school.
KFA: What specific questions should parents ask their
As far as the emergency care plan, the
specific question would be “When should we give what medication?” It's important for the emergency care plan to clearly
delineate what symptoms should be considered anaphylaxis
(severe, life-threatening allergic reactions). This is a written
documentation that clearly lays out what to do in the event
of a reaction.
If the criteria are met, the plan should state that the child
needs to be treated with injectable epinephrine, 911 should
be immediately dialed and your child must go to the hospital
in an ambulance. If the child has asthma, it should be stated
because asthma is a risk factor for more severe reactions.
Food Allergy Research and Education (FARE) has a downloadable
emergency care plan in English and Spanish that
displays a picture demonstrating how to give injectable
KFA: Are there specific issues an allergist would want a
family to do to prepare to send their child off to school?
One of the most important things parents
can do is to get their children involved in a developmentally
appropriate way in their own care. Children need to learn
how to say no if somebody offers them food, learn not to
share food, learn not to take sips from someone else's drink,
know to report symptoms to teachers and feel comfortable
reporting an accidental ingestion to teachers. As children get
older, they can start playing a more active role by practicing
to read labels, participating in appropriate food selection and
carrying their own injectable epinephrine.
KFA: What types of things should a parent want to work
out with a teacher and not leave to chance?
In general having open communication
with staff who are responsible for the care of their children
in school is important. I recommend letting these people
know up front that you (the parent) would like to know when
any new situation involving food (e.g., field trips or parties)
comes up so that if necessary new avoidance strategies can be
KFA: Do you have any other suggestions for parents
preparing to send their children off to school?
Know specifically what your child is
allergic to and communicate that clearly with the school.
Also, make sure the injectable epinephrine is up to date and
will not expire until after the end of the school year. It's
also a good idea to have two doses of injectable epinephrine
available as some children need more than one dose for it to
be effective. Find out if the school trains the teachers and staff
or if you will need to teach them how to use the device.
Have an open line of communication with the school nurse
and your child's allergist. In many cases, the parent is going to
be the go-between. It's important to have a clear and up-to-date
allergy action plan that the school nurse feels comfortable
with. Show the school nurse the allergy action plan and ask if
she is comfortable with it. If the school nurse says she doesn't
understand a certain part, take the plan back to the allergist
and explain the situation so the plan can be altered. Plans
should be updated each time there is a new reaction, a new
allergy or at least every year.
Beth Puliti is a professional writer for a national healthcare
Dr. Michael Pistiner is a member of KFA's Medical Advisory Team.
Approved by KFA Medical Advisory Team August 2008. Updated August 2009 and September 2013.
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