Allergy/Asthma Information Association

Food for Thought

By Elaine Pollard, AAIA member, St. Albert, Alberta

Last school year, another parent and I advocated for our children by addressing School Council in an attempt to raise awareness about milk allergy and to ask for critical thinking about the use of food in school. The first mother has two children who are anaphylactic to eggs, milk and nuts (ground nuts and tree nuts); one child also has asthma. My child is anaphylactic to milk and milk products.

I consider a severe allergy to be, in my terms, a Condition Requiring Community Response (CRCR). A child with haemophilia, for example, must have playmates who ensure that the child does not receive bruises during their time together. His teachers must recognize and act appropriately if the child appears to be bleeding internally. As such, the non-allergy community has a role to play in safeguarding children with allergies. But what is that role and how much is expected of them?

Parents of a child with a severe allergy start their own and their child's education regarding the allergy the minute they receive the diagnosis. As with all such parents, I have raised my child to be allergy aware; he has, for example, learned how to read labels for milk products as developmentally appropriate. As he enters grade four, I feel confident that he will try to avoid a situation where his food might be cross-contaminated with a dairy product, even if it means separating himself from certain individuals at a play date.

However, in a setting where I cannot always be present and where he is continually surrounded by food, I require a community response to assist with my child's well-being. At school, I must say that many of the parents of my child's friends have been very accommodating of his special needs, especially at birthday parties. And yet, I was met with an altogether different reaction at the School Council presentation.

One mother told me that she is aware of allergies and she is scrupulous about reading labels for nuts when she shops. A few moments later, she told me that I should request a pizza without cheese for my milk allergy child when the school throws a pizza party. She was sadly unaware of the dangers of accidental cross-contamination for anyone except for the child with the nut allergy. It was at this point that I recognized the phenomenon of allergy fatigue, a term coined by another AAIA member. I realized that the school community had agreed to be allergy aware by being a nut-free school. They knew how to read labels for traces of nuts, but now they were unwilling to go beyond that one trigger of anaphylaxis.

Those lobbying on behalf of nut allergic children in our school have been telling other parents what their children could and couldn't eat for breakfast. So many reminders about peanut/nut allergies have gone out that some teachers have given up on class parties. So the reasons for the allergy fatigue became more apparent to me as the year progressed.

Now, I would like to suggest that we (AAIA members) ask the non-allergic community to do less regarding peanut /nut allergies. Ironically, by doing this we will end up doing more for the larger allergy community and ultimately the whole community. First and foremost, instead of asking them to read labels for allergens, we should let the non-allergic community pack lunches with whatever they deem necessary for their children's nutritional needs (peanut butter and cheese included). After all, the recent study “Relevance of casual contact with peanut butter in children with peanut allergy” suggests that a child with a nut allergy sitting next to a child eating a peanut butter sandwich is not in a life-threatening situation. Instead of advocating for a ban of one trigger for anaphylaxis, we should invite the non-allergic community to request more hand-washing in schools and to insist on better cleaning of their children's classrooms. We should ask the non-allergic community to think critically about the use of all foods in schools for fundraising and rewards. (Why do we need all those pizza parties in schools?).

In this age of awareness of obesity and diabetes, of SARS and flu, of mysterious infections and mutating viruses, of individual rights and community protection, we would be asking the non-allergic community to do these things for themselves and also to help the more global allergy community. With over 200 foods identified as allergens, the banning of nuts in schools sets an impossible precedent and creates an ineffective means of allergy awareness. Some paediatric allergists do not agree with the banning of foods. Let's ask for allergy aware schools, not allergy free schools.

My child suffered with hives at school this past year for a five day period because of the viscosity of the hot cheese dip brought in for a lunch time fund-raiser. Better hand-washing and desk-washing could have prevented his unfortunate, but minor, reaction. At least it wasn't anaphylactic shock. This cleanliness routine could also alleviate the spread of infections among all children.

Allergies are a CRCR. Yes, the non-allergic community must know what allergies are present at a school; they must know what cross-contamination is; and they must know how to recognize and to respond to an allergic and an anaphylactic reaction. Let's make schools safer and cleaner for all children.

from Allergy & Asthma News, Issue 3 2005

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