For School Professionals: Better Than Bans, Schools Should be “Allergy Aware”

It’s that time of year again – back-to-school! As school professionals and parents prepare for students to return to their studies, many are also focused on safety. For those managing food allergies, it can be a time of stress, with many questions about how to protect children with food allergies while managing the needs of a diverse student population. When it comes to peanut foods, some kids practically live on peanut butter. It can be a life-saver when a child has issues with food textures and self-restricts many foods. Peanut butter also represents an affordable food for many families who may struggle to feed their families, even though they don’t qualify for free or reduced-price school meals. At the same, children with peanut allergies need safeguards in place.

[Download “Instead of ‘Peanut Free’…Be ‘Allergen Aware’” handout]

We know that school professionals don’t want peanut bans because they know that peanuts and peanut butter are nutritious, affordable and delicious foods that students love, and families depend on. But concerned parents of peanut allergic students may request accommodations that include banning peanuts from schools. The good news is 98% of children can enjoy peanuts without restrictions. Here are five surprising facts that can help you avoid being labeled “peanut free” while moving your school toward being “allergen aware” and helping keep the 2% who can’t enjoy peanut foods safer.

Research shows that casual contact presents a low risk for anaphylaxis. A study of 30 peanut-allergic children who smelled peanut butter for 10 minutes resulted in zero reactions. Skin contact in this study also resulted in zero life-threatening reactions; redness and irritation occurred for some where the peanut butter touched the skin. (Simonte S, 2003) Further research supports that people with peanut allergies are highly unlikely to have serious reactions as the result of casual contact, and that soap and water on hands and common household cleaners on surfaces can remove peanut proteins. (Perry T, 2004)

Banning peanuts from schools doesn’t decrease the risk of food allergy reactions. In a study of 567 food allergy reactions in a Canadian pediatric cohort, 4.9% of reactions occurred in “peanut free” schools compared to 3% in schools that allow peanuts. Study authors specifically warned about a false sense of security when foods are banned. (Cherkaoui S, 2015)

Banning peanuts doesn’t reduce the use of epinephrine in schools. According to a study of schools in Massachusetts, schools with policies that restricted peanut foods from being brought from home, served in the school cafeteria or in the classroom did not reduce the use of epinephrine to treat food allergy reactions compared to schools that did not have peanut-free policies. (Bartnikas L, 2017)

Experts don’t recommend bans as a means to manage food allergies. According to guidance on the role of the allergist in the management of food allergies in schools, there is no evidence that supports bans as a way to reduce the risk of reactions. They can also increase the burden on schools and students, while creating a false sense of security. Finally, they are impractical when multiple allergenic foods are banned. (Wang J, 2018)

Bans may seem like the easy solution to managing food allergies, but in reality they are impossible to enforce and have been shown to be ineffective at preventing food allergy reactions. Instead, schools need to employ a more comprehensive approach to food allergies. Here are five ways to do that:

  1. Start with the Experts – refer to the CDC’s Voluntary Guidelines for Managing Food Allergies in Schools and Early Child Education.
  2. Focus on Training – everyone who provides oversight, care and services for a food allergic student should be trained on identifying symptoms of a reaction and how to respond. That means foodservice, teachers, bus drivers, and after school staff, plus any that we’ve missed.
  3. Be Prepared for Reactions – as the evidence proves, nothing completely prevents reactions from happening. Be sure every food allergic student has an emergency anaphylaxis plan, access to emergency medication, and that everyone knows what to do in case of an emergency.
  4. Create a Supportive Community – communicate your food allergy management plans early and often with parents and stakeholders. Let them know you take allergies seriously and that you’re “allergy aware”.
  5. Consider allergen-safe tables in cafeterias, since they did reduce the risk of epinephrine use in one study. (Bartnikas L, 2017)

For more information on managing food allergies in schools, visit:

Bibliography

Bartnikas L, H. M. (2017). Impact of school peanut-free policies on epinephrine administration. J Allergy Clin Immunol, 467-473.

Cherkaoui S, B.-S. M. (2015). Accidental exposures to peanut in a large cohort of Canadian children with peanut allergy. Clinical and Translational Allergy.

Mustafa S, R. A. (2018). Parent perspectives on school food allergy policy. BMC Pediatrics, 164.

Perry T, e. a. (2004). Distribution of peanut allergen in the environment. J of Clin Immunology, 973-976.

Simonte S, M. S. (2003). Relevance of casual contact with peanut butter in children with peanut allergy. J Allergy Clin Immunology, 180–182.

University of Michigan S.S. Mott Children’s Hospital. (2014). National Poll on Children’s Health: Nut Free Lunch? Parents Speak Out. Retrieved from Mott Children’s Hospital: mottnpch.org/sites/default/files/documents/03172014_FoodAllergies.pdf

Wang J, B. T. (2018). The Allergist’s Role in Anaphylaxis and Food Allergy Management in the School and Childcare Setting. JACI-In Practice, 427–435.

Peanuts and peanut butter are low glycemic foods, which do not cause blood sugar to rise sharply. Here is our previously approved content on peanuts/PB related to diabetes: https://www.nationalpeanutboard.org/wellness/diabetes-and-peanuts.htm

Mustafa https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5948763/

University of Michigan https://mottpoll.org/sites/default/files/documents/03172014_FoodAllergies.pdf