For families of children with food allergies, returning to school or childcare comes with a much longer list of reminders and to dos. From talking to your child about avoiding lunchtime food swaps to ensuring that their teacher or carer is aware of their allergies, here are some top tips for the return to school and childcare from RCH Director of Allergy and Immunology Professor Mimi Tang:

First steps:

Parents of children with food allergies should make their school or childcare aware of their child’s allergy condition. For example, you can:

• Inform the school or childcare service that your child has a food allergy at the time your child is enrolled or when the diagnosis of food allergy is made by your child’s doctor.

• Work together with staff to develop a risk minimisation plan that is specific for your child.

• Provide the school or childcare service with your child’s up-to-date personal ASCIA emergency action plan (see below) that has been prepared and signed by your child’s doctor. This plan provides important information about how to manage an allergic reaction in the community.

• If your child has been prescribed an adrenaline auto-injector, provide staff with an emergency medical kit for your child that contains the adrenaline auto-injector, as well as any other allergy medications that have been prescribed together with your child’s personal emergency action plan.

• Regularly check the expiry date of your child’s adrenaline auto-injector device and replace the device when it expires.

• Offer information and answer any questions that staff may have regarding your child’s allergies.

• Let staff know as soon as any changes to your child’s allergy status occur and provide a new emergency action plan that has been updated with these changes.

• Work with your school or childcare on an allergy management plan: Each child’s enrolment record should contain an individualised allergy management plan that includes detailed information on the child’s specific allergies, emergency contact details, a risk minimisation plan and a medical ASCIA emergency action plan (see below).

Obtaining an emergency action plan for your child:

Emergency action plans are available on the ASCIA website and should be filled out by your child’s doctor. Several different types of allergy plans are available, depending on whether your child carries an adrenaline auto-injector and, if so, which brand.

Teaching your child’s friends about their allergy:

Children with food allergy can worry about what their friends are going to think. The most important thing to tell your child with food allergy is that she needs to remember that her friend’s prime concern is going to be her safety.

How you inform friends at school is, of course, completely up to you — but it is advised that you enlist the help of your child’s teacher to explain to the class what your child’s allergy is, and some of the simple information about food allergy and the warning signs of anaphylaxis (if relevant).

In Victoria, legislation requires that school and childcare staff are trained in appropriate management of food allergy.

Further ideas and advice:

• Avoid lunchroom food swaps and food fights – asking your child about food swapping is worthwhile, check whether it occurs at their school, and if it does, how they feel about it. If they are feeling left out it may be worth speaking to their teacher.
• Provide healthy yummy snacks that can be kept in the classroom specifically for your child – providing your child with healthy, allergen-free snacks to take to school or childcare is important, these snacks can then be used when food sharing occurs or at times of celebration, such as another student’s birthday.
• Explain to your child that they must ask for help immediately when feeling funny – one of the most important things your child needs to know is when and how to get help if he/she thinks they are having a food allergy reaction. Explain that:
  • Your child should ask for help from the nearest adult if they’re concerned that they might be having any symptoms, no matter how mild. Asking for help when they’re starting to feel funny won’t necessarily activate any intervention but will alert the teacher or carer that there may be a problem. A rash or vomiting in itself isn’t a sign of anaphylaxis but may be one of the early signs.
  • If they are old enough, they should take an active role in assessing the risk of the situation.
  • Any symptoms involving the airway, breathing or the circulation, such as coughing, wheezing, shortness of breath or an impending sense of collapse indicates a serious reaction (anaphylaxis), and should be treated by administration of an adrenaline auto-injector and calling an ambulance.
  • Teach your child the following three important points:
    • Symptoms may differ with each reaction — so your child needs to be aware of all of the potential symptoms.
    • Symptoms usually occur right after eating the food but can occur up to one to two hours later.
    • Your child should seek help immediately in the case of any of these early warning signs:
    1. Itchiness in or around the mouth
    2. Rash
    3. Vomiting
    4. Tightness in the throat or any difficulty breathing
    5. An impending sense of doom — even if your child’s not sure that she has accidentally eaten an allergen, because it’s better to be safe than sorry.

More information can be found in ‘Kids’ Food Allergies for Dummies’ written by RCH paediatric allergist and immunologist Professor Mimi Tang and RCH paediatric gastroenterologist and allergist Professor Katie Allen or on the RCH Allergy and Immunology website.