Tips for a Safe Return to School

Tips for the Elementary School Environment

• Meet with child's teacher as early as possible (preferably before school starts) to explain what the child is allergic to; typical symptoms to watch for during a reaction; the emergency treatment plan; if the child carries medication on his/her person/body or where medication will be kept at school, etc.
• Request an allergen-free classroom for kindergarten and the early grades (eg. peanut and nut-free).
• Adult supervision for young children is needed while eating.
• If lunch or snacks are eaten in the classroom, ensure that the desks are properly cleaned after eating.
• Ensure that procedures for proper hand washing are being followed before and after eating.
• A ‘no sharing’ policy for food-allergic children should be enforced.
• Ensure that noon-hour supervisors are aware of children with anaphylaxis and trained to recognize the symptoms and how to use the auto-injector.
• Encourage an allergy-aware school by including appropriate allergen-safe recipes in the school newsletter.
• When a school-wide event is planned and there is food involved, ask parents to cooperate and avoid sending food containing the allergen.
• Encourage student education and discussion about life-threatening allergies.
• Some schools appeal to the community to restrict some food allergens, particularly in the early grades.
• Other schools ask children who bring food containing an allergen to eat at a designated table in the lunchroom.
• Some schools have children with food allergies sit at a table which has been designated “allergy-safe”.
• Some schools have a no-eating rule in the classroom. Children then eat in a designated area.
• Craft activities may need to be adjusted to omit allergens (e.g. peanut butter bird feeders, play dough with peanut butter, egg white icing for gingerbread houses, tempura paints which may contain egg).
• If there are children with bee sting allergies, garbage cans should be kept away from where children have to line up to enter school.
• School communication to parents through newsletter regarding consideration/cooperation in complying with allergen management policies.
• Parents of allergic children should provide non-perishable treats to be kept at school for those days when the class has treats that are unsafe for the allergic child to eat, (e.g.. birthdays and other special event days).
• Talk with the teacher about “Kindercooking” program if applicable. It may need to be altered to omit allergenic foods.

Tips for the Junior High/Middle School and High School Environment

• It is imperative that the junior high/middle school and high school teachers are informed and have an emergency care plan for all students with anaphylaxis. The student’s life may depend upon a quick response by caregivers when a reaction occurs.
• Informing the teachers in these schools is usually handled more discreetly than in elementary school, i.e. student pictures and care plans may be kept in the front of teacher’s day planning books rather than being posted, or there may be a computer red alert system identifying students with anaphylaxis. Students of this age should be encouraged to speak to their teachers about their anaphylaxis. School administrators need the assistance of the allergic student as well as their parents in identifying anaphylactic children.
• Meet with administration to discuss the management and labeling of allergenic foods in the cafeteria. Peanut containing snacks can sometimes be replaced with other foods. But remember that it may be more difficult to deal with other allergens such as milk or egg.
• Encourage a “buddy” system where a friend is taught about the student’s allergy and what to do in an emergency. Schools will often arrange it so that the allergic student and his/her buddy are in the same classes as much as possible. The buddy system can work well for this age group since the student goes from one class to another all day rather than staying with the same teacher.
• Remind students with anaphylaxis to carry their medication with them at all times. It must not be left in their locker.
• If they do not have their auto-injector on their person/body or with them – THEY MUST NOT EAT.
• Remind the student about having their asthma medication with them for physical education class.
• For student education about anaphylaxis there is a video called ‘Taking Control - Watching the Signs: Severe Food Allergies and Youth”. This is good for the junior high/middle school age student and is available from the AAIA.
• Prior to registering in food classes and outdoor education, the student or parent should meet with the teacher to discuss whether the needs of the allergic student can be met.

Tips Re: Auto-Injectors

• When kept at school, auto-injectors must be in a safe but unlocked location.
• As soon as is age-appropriate, students should carry auto-injectors on their person.
• All school personnel must know where to find the allergic students auto-injector and the school supplied auto-injector (if there is one).
• Auto-injectors have expiry dates. Make sure they have not expired.
• The effect of an injection of epinephrine usually lasts from 15 to 20 minutes. A second injection may be needed.
• Auto-injectors will go through light clothing, including jeans but not the seam. Move the seam out of the way.
• Do not inject through a snowsuit.
• Store auto-injectors at room temperature. Do not refrigerate.
• Heat will affect the medication. Do not store auto-injectors in vehicle glove compartments or leave sitting in the sun.
• Do not allow the auto-injector to freeze.
• Posters on how to administer the EpiPen^® or Twinject^® can be displayed alongside the child's emergency care plan and in other key areas. The posters reinforce how to use the auto-injector without identifying the child and are therefore excellent to raise awareness and education throughout the school.

Tips for the Allergic Child

Here are some basic rules that will help to keep your allergic child safe.

• As soon as the child is mature enough, the auto-injector must be carried on his/her person at all times - not in a backpack, school bag, etc. Convenient carrying cases are available.
• Teach your child how to use an auto-injector.
• Ensure that asthma medications are carried at all times.
• Ensure that a second epinephrine injection is available in case there is no relief from the first injection or if there are recurring symptoms.
• Emphasize that “If you do not have your auto-injector on your person/body or with you, you DO NOT EAT.”
• Teach the importance of keeping asthma under control. (Uncontrolled asthma can worsen an allergic reaction.)
• Have child wear a MedicAlert^® bracelet or medical identification.
• The allergic child should tell friends about their allergy and teach them what to do in an emergency.
• Have children wash hands before and after eating.
• Do not allow sharing of food, utensils, straws or containers.
• Place food on a napkin or wax paper rather than in direct contact with a desk or table.
• Avoid the habit of putting the end of pens, pencils, markers or crayons in your mouth, especially if anyone else uses them. (Other students may also have put them in their mouth after eating food containing your child’s allergen.)
• Young children should eat only food which they have brought from home or which has been approved by their parents.
• Always read food labels and avoid high risk foods such as bulk foods and foods which may be easily cross-contaminated.
• Teach children to always ask about the preparation of foods when eating away from home.
• Try new foods at home, not in the school setting.
• If allergic to stinging insects
  • Avoid wearing bright colors
  • Avoid wearing scented products
  • Avoid drinking directly out of cans or glasses when outdoors... use a straw.
• To teach young children in the primary grades about anaphylaxis, excellent storybooks and videos are available to help with education and awareness.

For products and resources mentioned, consult the AAIA Product brochure or call AAIA Ontario.

from Allergy & Asthma News, Issue 3 2006