Summer '08 Edition
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New state guidelines help schools deal with students’ food allergies
By Rita Molloy, R.N.
Imagine that you are enjoying a meal with your toddler. You are introducing new foods, watching your child enjoying new sensations and exploring your child’s tastes. But you notice something peculiar. After just a lick from a spoon used to spread peanut butter on a bagel, that angelic face begins to swell. Your child coughs and develops hives. The eyes water and the nose begins to run. You realize you are witnessing the start of an anaphylactic reaction – an allergic reaction that can be life-threatening.
That swollen face belonged to my son Matt. That event changed eating in my family forever. Every morsel he ingested became subject to scrutiny.
Food accounts for approximately 90 percent of allergic reactions. An estimated 5 to 6 percent of the pediatric population has had an occurrence of a food allergy, and the incidence is increasing rapidly. The most common foods that students are allergic to include peanuts, fish, shellfish, tree nuts (i.e., walnuts, cashews, pecans, etc.), eggs, milk, soy and wheat. Any food can trigger a reaction, as well as substances such as venom from insect stings, exposure to latex and medications.
There is no cure for food allergies, so avoidance is essential to keeping these individuals safe. When children with food allergies come to school, much responsibility falls on the school nurse.
What can your school district do to deal with students’ food allergies? As both the mother of an allergic child and president of the New York State Association of School Nurses, I have some suggestions:
• All allergic students should have a plan of care developed to provide for their safety in the school environment. A policy should be in place to prevent exposures and to respond to emergencies if they occur.
• School districts need to plan not only for students with known allergies, but also those who may experience their first symptoms in school. Standing non-patient specific orders for epinephrine can be written by your school medical director for your school nurse to give in the event of a new onset anaphylactic response, providing a safer environment for all.
• A team approach is necessary to promote an optimal learning environment for those at risk for allergic response. Time should be allotted for the school nurse to train staff, and to prepare student-specific plans of care. It is optimal to have a school nurse (a Registered Professional Nurse) available to assess these students. A Section 504 Plan can be considered to address the need for accommodations that might need to be made for these students.
h_life_threatening_allergies.pdf. I am pleased to have reviewed and given input to this document, which was developed in response to Public Health Law 2500-H*2- Anaphylactic Policy for School Districts, the text of which can be found in the guidance document.
While I was discussing this article with my son Matt, now 22, I asked him what message he would like me to deliver to school board members about his school experiences as a person living with food allergies. He said he wanted you to know that in school he endured threats by other students to expose him to peanuts. He felt the teachers and administrators treated these comments like jokes, but he considered them a form of harassment and bullying. He said the response he got from adults made him feel less willing to report further incidents.
School board members have the responsibility to ensure that students feel protected and secure in the school setting. I hope that sharing my experiences with you will help you to be sensitive to the far-reaching impact felt by those who live with life threatening allergies as you create and adopt policies for your schools. Together, as a school community, we can make a difference for all students.
Rita Molloy is president of the New York State Association of School Nurses. She will lead an educational seminar on food allergies at NYSSBA’s Annual Convention in New York City
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