Food AllergiesThere are three students in your class with a peanut and tree nut food allergy. You are concerned that the other students might bring in snacks that contain peanuts or tree nuts. A parent informed you she is making brownies to bring into class for her child’s birthday celebration. There is a holiday party coming up.  You are aware many children in the lunch room eat peanut butter sandwiches. Students with food allergies want to buy lunch in the cafeteria.  A field trip is being planned. How do you ensure that the snacks and lunches are appropriate for these students? How do you keep students with food allergies safe in the school?

It’s critical that everyone work together to keep children safe. A collaborative partnership between school and family is the best way to prevent exposure to specific allergens and to help children make the transition between a safe home environment and school.  

As a school nurse of 19 years, in an elementary school (pre-K to fourth grade), I work hard to ensure that students with food allergies are safe. Every student with an allergy has a Food Allergy Action Plan (www.foodallergy.org) or an emergency care plan that provides the necessary information on how to handle an emergency and prevent anaphylaxis. Parents need the reassurance that the school is able to handle their child’s allergy, and they need to feel confident that the school takes allergies seriously. Thanks to the 2010 anti-bullying law, schools are required to address the bullying of students with food allergies.

The certified school nurses in my district, with the support of administration, formulated and implemented “Food Allergy Guidelines,” which can be found at www.hillsdaleschools.com. These guidelines assist both teachers and parents in establishing a safe environment for our students with food allergies.

Notifications and awareness

Advanced notice is important. Teachers are informed before the end of the school year if they will be having a “peanut/tree nut classroom” the following school year. In August, parents are informed if their children will be in a peanut/tree nut classroom so they can bring in appropriate snacks. Parents of allergic students can meet with the teacher and school nurse prior to September if necessary.

At the beginning of the school year, I visit every peanut/tree nut classroom to educate the students about what this means. I read to these students a book I wrote, Nurse Teddy Bear Learns about Food Allergies. I wrote it because I felt it filled a gap about how food allergies are handled in schools and I wasn’t excited about the books that were available. I involve the kindergarteners in a project in which they take home a Nurse Teddy Bear and teach her about an aspect of health, so telling the story for my book from the Teddy Bear's perspective seemed to make sense. Through this activity, students learn what snacks they can bring in, as well as sensitivity toward students with food allergies.

I also make teachers and parents aware of the following guidelines:

  • Daily snacks cannot contain peanuts, tree nuts (almonds, pecans, walnuts, cashews, pistachios, etc.) or their oils. Products labeled as “may contain nuts” or “produced in a facility that processes nuts” are not acceptable.
  • For classroom celebrations, all foods need to be in their original containers with the nutrition labels intact. All food needs to be approved by the school nurse prior to entering the classroom. Some schools are totally eliminating all foods for celebrations.
  • Parents of students with food allergies are encouraged to send in a supply of safe snacks for their children.
  • Students with food allergies may not eat any homemade food items.
  • If parents or teachers choose to distribute goody bags, they must contain non-edible items.
  • Students are advised to wash their hands before and after consuming food.
  • Students are not allowed to share or swap food.
  • All classroom activities and holiday projects must use non-edible items.

A day in the life of a student with food allergies

When a student with allergies arrives at school each morning, his/her lunch is placed in a separate crate labeled peanut/tree nut free, and then that crate is transported to the cafeteria. Students in a “peanut/tree nut classroom” place their snacks on their desks, and the teacher checks that the snack is safe . (If a student brings in an inappropriate snack, the school nurse always has appropriate snacks to offer.)

Students without allergies—but with safe lunches--volunteer or are chosen to sit at the peanut/tree nut-free table. Student with allergies never sit at the table by themselves. The tables are washed before and after eating. Other students who eat peanut butter or tree nut products use a hand wipe after eating. If a teacher has any concerns about a student with food allergies, (hives), the student is sent to the school nurse for assessment. In an emergency, the nurse is available to administer epinephrine if needed. At the end of a typical day, students leave the school safe and parents feel secure.

The role of school staff

A teacher who has never had a student with an allergy in his/her classroom may worry that this adds yet another responsibility to an already long list of things to do. But if the school nurse, teachers, support professionals and parents work together, employing these guidelines will quickly become a regular practice.

My colleague Claudia Gibney, a first-grade teacher, has had a peanut/tree nut-free classroom for five years. “Checking snacks has become routine,” Gibney notes. “Students place the snack on the corner of their desks, and once it is checked, the students put the snacks in a special crate. With the help of a teacher’s aide, it takes less than five minutes. Students become aware of what they can bring in, and parents become better about writing down the ingredients. It just becomes a daily routine and everyone is aware of what they can eat.”

Paula Onderdonk and Janice Bender are teacher aides that have been checking snacks for over six years. “My first year, I was nervous because of the responsibility,” says Onderdonk.

I check the ingredients on the snack foods that I think are safe just to be sure,” adds Bender. “It makes me feel secure to add that extra step.”

Third-grade teacher June Dano has had a peanut/tree nut classroom for three years and does not have a teacher’s aide. She explains: “I implemented a routine right away--students know they can’t interrupt me while I am checking snacks. The hard part is when food does not have labels; the easy part is kids eat the same snack every day. Parents help by sending me the ingredients; sometimes they photocopy them or send a picture of ingredients with their phone.

“Having a peanut/tree nut classroom does add one more step, but it doesn’t take as long as I thought it would. It is not a big intrusion, but I am mindful of it,” Dano adds.

Of course, cafeteria personnel must follow these guidelines:

  • All foods served in the school cafeteria are free of peanuts and tree nuts.
  • An allergen-free table will be an available option for all allergic students.
  • Students are not allowed to share or swap food.
  • Students are advised to wash their hands before and after consuming food.
  • If there is a need for a peanut/tree nut-free table and a student without food allergies is invited to sit there, he or she must have a peanut/tree nut-free lunch on that day.
  • Students who had a peanut/tree nut lunch in the cafeteria should be offered a hand wipe afterwards.

Trish Poggiogalle, who has been a lunch aide for six years, is responsible for the peanut/tree nut lunch table. “It is an added responsibility,” says Poggiogalle. “But I enjoy it because I really get to know the students.

Poggiogalle doesn’t worry about the students with allergies feeling isolated. “They always have friends with them,” she notes, “and as an added benefit to sitting at the allergen-free table, their buddies can cut the lunch line!”

Finally, there is the issue of field trips. Our policy is that a school nurse or trained epinephrine delegate will be available during all school-sponsored field trips. In addition, eating on the bus is strongly discouraged.

Although students with allergies sometimes tell me they wish they could eat whatever they want, they also appreciate all we do to keep them safe. That sentiment makes all of our extra effort worthwhile.     

Ann Lempert Deutsch, RN, MSN, CPNP, NJCSN, works at Meadowbrook School in Hillsdale. She can be reached at annlempertdeutsch@gmail.com. To purchase copies of Nurse Teddy Bear Learns about Food Allergies, go to www.createspace.com/3681306.

More information on food allergies