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FAQ: How Can an Allergist Help with School Plans for Your Child with Food Allergies?

September 2013

by Beth Puliti

Allergist Allergist ABCs's
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 year.

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?

Dr. Pistiner: 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 child's allergist?

Dr. Pistiner: 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 epinephrine.

KFA: Are there specific issues an allergist would want a family to do to prepare to send their child off to school?

Dr. Pistiner: 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?

Dr. Pistiner: 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 implemented.

KFA: Do you have any other suggestions for parents preparing to send their children off to school?

Dr. Pistiner: 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 trade magazine.
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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Page last updated 7/29/2012

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