Food allergies are a rising concern that affect about 8% of children in the United States.1 That statistic equates to roughly 1 in 13 children per classroom.1 It is important for you to know how to keep students with food allergies safe in your classroom to prevent a potential life-threatening reaction.
What is a Food Allergy?
A food allergy occurs when the body mistakenly identifies a food as harmful and causes an immune response. Symptoms and severity of reactions in response to a food allergy will vary among children, ranging from mild to severe. Anaphylaxis is a severe and potentially fatal allergic reaction in which the body triggers an immune response. Strict avoidance of a food allergen is the only way to prevent a reaction. If a reaction does occur, treatment with an epinephrine auto-injector must be given promptly to reverse life-threatening symptoms.
Food Allergy vs. Food Intolerance2
As stated above, a food allergy is a potentially life-threatening response to a food triggered by the body’s immune system. With a food allergy, the body is reacting to proteins present in the food. A food intolerance is an adverse reaction to food that typically affects the digestive system. With a food intolerance, the body is reacting to the inability to digest sugars present in the food. Food intolerances often cause symptoms like bloating, diarrhea, or gas, and will not progress to a life-threatening reaction.
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The Most Common Food Allergens
A child could be allergic to any food, but there are 8 foods that account for the majority of allergic reactions. They are:
- Tree nuts (almonds, cashews, pine nuts, walnuts, pecans, etc.)
- Shellfish (shrimp, lobster, oysters, scallops, etc.)
Signs of an Allergic Reaction
There are a wide variety of symptoms that may indicate a child is having an allergic reaction. Symptoms may occur within minutes of exposure to the allergen, or up to 2 hours later.
Common symptoms include:
- Swelling of the mouth, tongue, face or throat
- Itching of the skin, ears, eyes or mouth
- Hives, rash or eczema
- Difficulty breathing; wheezing; coughing
- Congestion, hoarseness
- Stomach pain
- Nausea, vomiting or diarrhea
- Dizziness; confusion
Young children may communicate their symptoms in the following ways3:
- “My tongue (or mouth) is tingling (or burning).”
- “My tongue (or mouth) itches.”
- “My mouth feels funny.”
- “There’s something stuck in my throat.”
- “My lips feel tight.”
- “It feels like there are bugs in my ear.”
Being aware of these symptoms and how they may be communicated by students can help you to respond promptly if a reaction does occur in your classroom.
Tips for Preventing Allergic Reactions in the Classroom3
- Follow school rules and practices for dealing with food allergies
- Review food rules with students and parents
- Avoid using food in classroom activities
- Use non-food items for celebrations, rewards or incentives
- Ensure a safe and supervised eating environment for students
- Enforce hand washing before and after eating
- Clean surfaces with warm soapy water or an all-purpose cleaning agent when food is served in the classroom
- Do not allow students to share food
- Work with the school nurse to identify students with allergies and their Anaphylaxis Emergency Care Plans
- Identify school personnel who have been trained and permitted to administer the epinephrine auto-injector
- Work with the school nurse, parents and other school personnel to determine if classroom modifications need to be made for any students
- Inform parents and the school nurse before including food or known allergens in classroom activities
What Do I Do If a Student Has an Allergic Reaction in My Classroom?
The treatment for anaphylaxis is prompt use of an injectable medication called epinephrine.
If you suspect a student is having an allergic reaction, take immediate action. At minimum, this should include the following:
- Activate the student’s Anaphylaxis Emergency Care Plan and ensure prompt administration of the epinephrine auto-injector by a trained staff member. Do not leave the student unattended!
- Call 911 immediately after administering the epinephrine auto-injector
- Immediately call the school nurse and school administrator
It is important to review your school’s emergency response plan so that you know the specific actions you should take if a child has an allergic reaction in your classroom.
When in doubt, it is better to give an epinephrine auto-injector and seek medical attention.
Withholding epinephrine increases the risk for fatality.
The Emotional Impact on Children with Food Allergies2
Studies have shown that having food allergies significantly affects children’s psychological well-being. Children may be scared of having a severe allergic reaction or of being a burden to others because of their allergies. They may also be the target of teasing, taunting or bullying by peers, teachers or adults. Teachers should ensure that students feel safe in their classroom, both physically and emotionally. Bullying or harassment of students with food allergies should not be tolerated and should be handled accordingly.
It is also important for students with food allergies to be able to socialize during meal and snack periods. Make sure that students do not sit alone whenever they are eating in an allergy-friendly area. This seating area should be open to any child who is eating foods free of identified allergens.
For more information on food allergies in schools, check out these additional resources:
- Food allergies. CDC Health Schools website. https://www.cdc.gov/healthyschools/foodallergies/index.htm#:~:text=Food%20allergies%20are%20a%20growing,children%20in%20the%20United%20States.&text=That’s%201%20in%2013%20children,immune%20response%20to%20certain%20foods. Updated June 8, 2020. Accessed December 21, 2020.
- Managing life threatening allergies in schools. The John C. Stalker Institute of Food and Nutrition website. https://johnstalkerinstitute.org/wp-content/uploads/2020/06/Mng-Allergies.pdf. Published May 2016. Accessed December 21, 2020.
- Managing food allergies in schools: the role of school teachers and paraeducators. CDC Healthy Schools website. https://www.cdc.gov/healthyschools/foodallergies/pdf/teachers_508_tagged.pdf. Accessed December 21, 2020.