Re: Something that happened at school w/ my peanut allergic son

May 5, 2010

I first just want to say Thank God your baby is OK!!! I do not have a child

with allergies so perhaps others have better or more accurate advice in this

area as to you and your childâ€™s rights in the situation that happened. From a

quick glance it appears you may have rights above and beyond what I am going to

mention here quickly but am covering what I would do in any situation where I

felt my childâ€™s safety was violated in any way. In addition to stating my

childâ€™s rights in this area, I would raise awareness about the seriousness of

the situation and let the teacher and all in the school know that a bullet was

just dodged.. So just off the top this is what I would do immediately.

I would document this situation in full as you know it in writing to the teacher

and copy on the letter the school nurse, the principal of the school and the

superintendent of the school. I would mention that based on what happened it

appears that either the teacher is not aware of the life threatening dangers of

peanut allergies, and or the teacher is not aware of school policy on peanut

allergies, and/ or there is not a strict enough school policy in place to

protect your childâ€™s life from the ignorance surrounding peanut allergies in

this particular school. It should not be assumed that if your child is seen

with a peanut butter sandwich that you gave it to him; clearly he is a 3 year

old child in a room full of other preschool children, it is well known that

children share food and pick up things they should not be eating, so that could

be a fatal assumption.

I recall in one of my son Dakota's classes during elementary school years there

was a note that went home to the parents that said one of the children in his

class that year had a severe peanut allergy (did not mention the child's name)

and requested I not send Dakota to school with anything that contained peanuts

or peanut butter and did not bring anything with peanuts to any bake sale or

school party. I didn't think that was too much to ask.

Speaking of school policy I would request a copy of the school policy on peanut

allergies and share this one as an example

http://www.doe.mass.edu/cnp/allergy.pdf

I would schedule an IEP meeting specifically to make sure that strategies to

protect my child from a mistake like this or any other due to his peanut allergy

are added to his IEP.

I would bring a copy of the book The Peanut Allergy Answer Book to the IEP

meeting and write on the inside that this book is to protect the LIFE of (my

sonâ€™s name)

http://www.amazon.com/Peanut-Allergy-Answer-Book-2nd/dp/1592332331

And here is a quick sheet on 'School Peanut Allergy Safety' from the author of

this book which probably covers far more than what I can as again neither of my

boys have allergies so I do not have firsthand knowledge in this area on the

best ways to advocate. I hope others can share more and again I'm thankful for

you that your child is OK!!:

School Peanut Allergy Safety

The author of The Peanut Allergy Answer Book explains how to keep kids with

peanut allergies safe in the classroom and lunchroom at school.

By C. Young, MD

School Peanut Safety Guidelines

The Peanut Allergy Answer Book

Enlarge Image

Q. How can my peanut-allergic child be kept safe at school?

A. Consider the following facts: Food allergies affect 8 percent of children

under 3, and 6 to 8 percent of school-age children. Eighty-five percent of

children outgrow milk and egg allergies by age 5, but only 20 percent outgrow

peanut allergy by age 6. The prevalence of peanut and tree nut allergies in

children has doubled in the past five years. Peanut-allergic patients have

accidental exposures and reactions every three years. Seventy-five percent of

peanut-allergic reactions occur on the first known exposure. Twenty-five percent

of epinephrine administrations in schools are for people who have never had food

allergy or anaphylaxis. In the U.S., fatal food anaphylaxis occurs in 150 people

each year, 90 percent from peanut and nut allergies. Fatal anaphylaxis occurs

most often outside the home, in schools and restaurants. Given these statistics,

every school needs to be prepared to deal with the problem of food anaphylaxis,

especially from peanut allergy.

In 2001, following the death of a peanut-allergic student in Massachusetts, the

Massachusetts Department of Education convened a Food Anaphylaxis Task Force, of

which I was privileged to be a part. We discussed the growing problem of

life-threatening food allergies in schools, the importance of making all schools

aware of this problem, and the importance of having ways to prevent and manage

anaphylaxis in schools. After meeting over the course of a year, in 2002 the

task force published " Managing Life Threatening Food Allergies in Schools, " a

76-page set of guidelines for all schools in Massachusetts. This detailed

document addresses all aspects of managing food allergies in schools, including

the action plan and recommendations for the classroom, cafeteria, school sports,

playgrounds, extracurricular activities, school trips, and school buses. You can

adapt sections from these guidelines for your child's action plan for school.

You can view or download this document from the Web site of the Massachusetts

Department of Education at www.doe.mass.edu/cnp. Many states and even schools

from other countries have used these guidelines as a template for their own

school policies.

Setting School Peanut Safety Guidelines

The key points of the guidelines are to:

1. Identify the student with the food allergy to the school;

2. Have a written emergency action plan in place for managing an anaphylactic

reaction;

3. Have a written individual healthcare plan in place for the prevention and

proactive management for the student in all the different school environments he

or she may be in, from the classroom to the cafeteria to the bus to field trips.

The emergency action plan is formulated by your physician with your input, based

on your child's history, and specifies what symptoms to look for and what

treatments are to be given, as well as contact information and directions for

disposition following the reaction. The school nurse usually is responsible for

implementing this plan in the event of an actual emergency. This is discussed in

greater detail in the section on the school's responsibility to you.

The general principles of the preventive plan usually include the following:

1. The general principles of avoidance followed at home should be applied to

the classroom, cafeteria, and all areas where the student may be. Nineteen

percent of anaphylactic reactions in Massachusetts schoolchildren occurred

outside the school building, on the playground, on the school bus to and from

school, and on field trips.

2. For areas where food is consumed, hand washing, no food sharing, and the

routine cleaning of surfaces where food is prepared and consumed to avoid cross

contamination are practices that students and school staff need to learn and

use.

3. For the classroom, students and staff need to become familiar with the

concept of " hidden " peanut ingredients, not only in foods and but also in

nonfood items that may be used in classroom projects in arts and crafts, math,

and science. Reading the ingredient labels of foods, as well as other items such

as bird feeders and pet feed, becomes an additional responsibility of the school

teacher and staff.

4. There should ideally be a full-time nurse in any school where there are

students with life-threatening allergies. If the school nurse is unable to be on

site, she should be able to train a designated staff member in the management of

anaphylaxis and the use of epinephrine.

5. Every student with life-threatening allergies needs to have an epinephrine

autoinjector in the school. The epinephrine autoinjector needs to be accessible

for quick access within several minutes of a reaction and kept in a secure but

unlocked location.

6. Emergency communications between all the student's locations (classroom,

cafeteria, gym, playground, etc.) and the school nurse and/or principal's office

should be available. Students, families, teachers, and school staff should all

be educated on food allergies, anaphylaxis, and general avoidance principles.

The Food Allergy & Anaphylaxis Network is an excellent resource for educational

programs for schools and provides many age-specific materials, including videos

for children and a very useful kit for school staff and personnel.

Banning Peanuts in Schools

Q. Should peanuts be banned from schools?

A. Consider this real-life scenario:

Mark, age 5, is severely allergic to peanuts and has already had three episodes

of anaphylaxis, one requiring hospitalization. He has been kept out of preschool

because the family could not find a school that satisfied their stringent

requirements. They are now about to enroll Mark in kindergarten and are

requesting a letter of medical necessity from me and the pediatrician to order

that his school prohibit peanuts and peanut products from Mark's classroom, as

well as from the school cafeteria.

The social and legal aspects of this question are very similar to those of

airline peanut exposure. Many preschools and some schools have in fact banned

peanuts from the classrooms and cafeterias. Whether they do so largely depends

on the number of students affected in the school and community, parents'

efforts, and the willingness of the school system and community to make

accommodations.

There are good arguments for both sides. Peanut allergy is a potentially

life-threatening condition; it would make sense to eliminate any possibility of

exposure in a setting with young children who cannot be expected to understand

all the problems of management, let alone the implications of having a

life-threatening reaction. On the other hand, without foolproof methods of

guaranteeing peanut detection 100 percent of the time, there is no way to

enforce a true " peanut-free " school. It would be difficult to do detailed

inspections of all food brought into school by other students, assuming that

everything had an ingredient label, and most families would not be expected to

have adequate knowledge of peanut allergy to be able to make school lunches

peanut-free -- nor could they be expected to have that motivation. As with

peanut-free flights, some also argue that a " false sense of security " results

from a school that claims to be peanut-free, resulting in decreased vigilance

and monitoring over time.

Another problem is that older children who never have to face dealing with

" real-life " situations of hidden exposures, such as cross contamination, because

they have been in peanut-free environments at home and at school, may be at a

disadvantage when they go to college and eventually are on their own. In

addition, there is the consideration of the children with other life-threatening

food allergies. Do we also ban milk, eggs, wheat, soy, tree nuts, seafood, etc.,

from schools to accommodate these other students? These are by no means easy

questions to answer and are the subject of many debates in local communities.

Fortunately, most schools and families usually are able to agree on very

practical school plans.

Preventative Measures

In most cases, compromise solutions are reached, such as having a peanut-free

table in the cafeteria or a peanut-free room. Some schools have a designated

peanut table or area where all the peanut products are eaten, leaving the rest

of the cafeteria peanut free. These zone approaches are generally quite

satisfactory because the actual risk in a dining hall with good ventilation and

no exposure to the actual cooking fumes is very low, particularly for

anaphylaxis. Of course, every effort needs to be made to minimize your child's

sense of isolation; he or she should be able to pick several friends to sit at

the peanut-free table.

In addition to cafeteria precautions, students are given age-appropriate

education in allergy and what the consequences of anaphylaxis are. The dangers

of sharing foods and snacks must be discussed. This education often must begin

with the school nurse explaining these issues to administrative staff. For

preschools and lower grade classes with very young, difficult-to-monitor

children and classes with multiple peanut-allergic students, a peanut-free

classroom might end up being an easier approach for teachers and staff.

The key to the success of any preventive plan is access to and availability of

epinephrine. This can not be overstated. Without easy access to epinephrine in

areas where food and eating occur, potential disaster awaits. This can be a

problem, particularly for children who, because of their age, do not have

permission to carry their epinephrine with them and are therefore dependent on

the school nurse for their epinephrine.

Many schools have to share one nurse, so an individual school may only have the

nurse there a few days each week. In this common situation, the nurse has the

ability and legal authority in many states to train a designee in the use and

administration of epinephrine. This designee can be a teacher, principal,

secretary, or any individual in the school able and available to perform this

crucial function in the absence of the school nurse. You need to know exactly

what the school nurse's weekly schedule is and to whom she has designated the

responsibility for administering epinephrine on the days she is not present in

the school. You should have this plan in writing from the school nurse and

principal.

=====

May 5, 2010

Does that teacher know how to use the epipen? Wow sounds like she would have

to!! Glad to know your son is fine after that. Kate

>

> I first just want to say Thank God your baby is OK!!! I do not have a child