Although it’s still summertime, schools across the country are well on their way to preparing for the 2018-2019 school year. Just in time to help, parents of food-allergic students have weighed in with their thoughts on what schools are doing right and how they can improve in food allergy management on campus via a survey conducted by researchers from Northwestern University, published in BMC Pediatrics in May.
Let’s start with the good news from the survey – most parents feel confident in their school’s handling of food allergies. In fact, of the 289 responding parents of food allergic K-12 students, 72.6% believe their child’s school is a safe place for them. Still, more than a quarter felt it was unsafe or were unsure about the safety, which means there is still work to do. In addition, 82% said their child had never experienced a severe reaction at school. This points to the fact that school professionals are doing a good job in the majority of cases when it comes to meeting parental expectations and keeping students safer.
According to Dr. Shahzad Mustafa, the paper’s primary author and lead physician in allergy and immunology at Rochester Regional Health, “Although the majority of parents felt their children were safe at school, a significant percentage had concerns. The overwhelming majority desired stock epinephrine, lunch menus with allergen information, ingredient labels on food items, and direct food allergy education for students.” More than half of the schools permit students (primarily older children) to self-carry their emergency medications and epinephrine is readily available about half of the time. In addition, just over half said that non-student specific (aka “stock”) epinephrine is available at their child’s school. Yet this also means that nearly half of schools have the opportunity to improve in the vital area of epinephrine access. Moreover, epinephrine was not reported to be as available during key risky situations such as field trips, during after-school programs or when students travel off-site to events after school. Because epinephrine is the only treatment for life-threatening anaphylaxis, it is essential that it is available, and quickly, when it is needed.
There are several more opportunities for improvement that can lead to safer situations for these students. Although 63.4% of respondents said there are policies for allowing students to sit in designated areas in the lunchroom and more than half reported clear cleaning policies for managing food allergens in the cafeteria, only about a third reported having access to menus including allergen information and just 12.5% said that food items were clearly labeled. Fewer than 10% reported that concessions had allergen information readily available. In order for students to make informed choices about food and avoid their allergen, it should be very clear what ingredients are in the foods being served. Likewise, there were deficiencies in the area of training and education of school staff and students. Only 37.2% said that an adult on their child’s bus was trained to administer epinephrine and far fewer students were provided food allergy education. Very few reported food allergy education materials available in the lunchroom or in the classroom.
The survey revealed that many parents are uncertain or unaware of food allergy-related efforts being made by schools. This may indicate a real opportunity for schools to improve in their communications to students and parents with regard to their school’s policies around food allergy management. There are some weaknesses to this survey, including the potential for bias due to errors in recall or social desirability, as well as the fact that respondents were mostly Caucasian, college-educated and high-income. In addition, the survey was only distributed in English and online, which would have excluded those non-English speaking parents without access to the internet.
Dr. Mustafa says, “In my opinion, the most important strategy starts with improved education of families, students, and school staff.” Here are some key takeaways for schools from this survey (and links to resources to help):
- Be sure the school/district has a comprehensive food allergy management policy and plan to that include all pertinent members of the school community. Start with the CDC’s Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs. Listen to Episode 091 (Food Allergies at School – Sherry Coleman Collins) of the Sound Bites Podcast with Melissa Joy Dobbins to hear some practical advice on managing food allergies at school.
- Ensure that the food allergy policy and plans are clearly communicated to all stakeholders, including staff, students, and parents.
- Provide staff food allergy training on an annual basis. The School Nutrition Association has a Food Allergy Resources for School Nutrition Professionals, including links to a variety of on-demand training webinars.
- Help teach students about food allergies to raise awareness and to help reduce bullying behavior. FAACT’S Food Allergy Curricula Programs are one great resource to help.
- Clearly indicate what allergens are being served on school menus and on the serving line, as well as in other places such as concessions and vending.
- Plan for how to manage epinephrine in your school in a way that ensures quick access and safe administration if needed.
Learn more about managing food allergens in schools at PeanutAllergyFacts.org.