The Problem
So, your child has been diagnosed with a severe peanut or tree nut allergy. What do you do now? Well, if you’re like most of us, you’ll be forever vigilant whenever you are with your child, to prevent him or her from having an allergic reaction. But, what about the times when you can’t watch over your child? Specifically, what happens at school? How will you keep him/her from accidental exposure to nuts? And, if your child is exposed, how can you ensure that he/she will receive prompt, appropriate treatment? My wife and I struggled with this issue, when our younger daughter (at age 2) was diagnosed with a severe, airborne, peanut and nut allergy. After exhaustive research, and consultation with many experts, we came up with the following plan.
Prevention is Paramount
As with any allergy, food or otherwise, the most desirable situation is removal of the allergen from the environment. With the allergen gone, there is no chance of the allergic individual having a reaction. In the case of peanut and nut allergic children, this would entail making their school nut free. This is a concept that is fairly common in Ontario, Canada (my wife’s original home), but is almost unknown in the United States. We were fortunate to convince the administration of our daughter’s school to eliminate nuts from the school campus, making the environment as safe as possible for her. If making the school nut-free isn’t an option, many schools will designate “peanut free” areas in the school cafeteria. While this is not as comprehensive as an entirely nut free environment, it is better than nothing.
Have a Treatment Plan Rehearsed and Ready
In dealing with a highly allergic child, preparedness is essential. A parent of the allergic child should, in conjunction with his/her doctor, devise a comprehensive anaphylaxis treatment plan for the child. The protocol should include plans for administration of medications, activation of emergency medical services, and notification of the child’s parents. In addition, several faculty members should be trained to administer adrenaline, via an automatic injector (Epipen), if the child has a severe reaction. Training the school nurse alone isn’t enough – valuable time can be lost searching for the nurse in an emergency. Additionally, all of the child’s teachers (art, phys. ed., etc) should be aware of the child’s allergies, and should be prepared to intervene if necessary. Finally, the child should always carry a dose of adrenaline with him/her, to prevent time lost searching for medications in an emergency.
Be Aware of Hidden Dangers
The school cafeteria isn’t the only dangerous place for a peanut allergic child. The classroom can be dangerous too. For example, children may be exposed to nuts and nut products in art class (for example, making a bird feeder with a pine cone and peanut butter), or on field trips (nut remnants may be present on buses, or may be included in museum displays). It is essential that the parents of the allergic child be aware of the itinerary for field trips, as well as the classroom curriculum, to prevent exposure to nuts, and subsequent reaction. Prevention is the key to safety for allergic children, and vigilance plays a vital role in prevention.
