Food allergies are on the rise nationally. As a pediatrician, I am experiencing this phenomenon in the clinic; but I am also living with it. My child has significant anaphylactic food allergies, so I understand this problem on a personal level.
The range of reactions that may occur along the allergy spectrum creates a lot of confusion among people. One person may exhibit a mild rash or gastrointestinal symptoms, while another may manifest significant airway swelling that restricts airflow and can be life threatening in a very short amount of time; this is anaphylaxis.
Other hurdles arise when there is a lack of understanding regarding what anaphylaxis looks like. Many health care providers, including physicians, may not have witnessed anaphylaxis first hand to recognize its presentation.
In addition, many people are avoiding foods for a variety of health reasons. Some examples include celiac disease, which is gluten sensitivity; or perhaps, a healthcare provider has recommended a restrictive diet for behavioral or developmental concerns. This further clouds and confuses those who might be caring for or interacting with your child.
As a result, a parent must be their child’s best advocate in the school setting. Schools do have a responsibility to make your child’s school experience as risk free as possible. Parents should request that epinephrine be placed where it may be needed: the cafeteria, classroom and nurse’s office. Providers and teachers in these areas should be trained to recognize anaphylaxis and they should know how to administer an Epipen. It is not realistic to expect young students to alert an adult when in distress or administer an epinephrine shot to themselves.
Parents can advocate for food free or food restricted classrooms. Children do not have to be rewarded with food (as an aside – we are living in a societal epidemic of obesity). In addition, cafeterias can have food allergy tables, where more care and observation can happen for this at risk population. A trained adult should monitor this table.
Remember the squeaky wheel gets the grease. You are your child’s best advocate. Be safe…
David Kleiner, MD, FAAP
