Student Well-Being

Food Allergies Are on the Rise. Are Schools Prepared?

Many severe reactions occur in school setting
By Evie Blad — November 14, 2017 5 min read
EpiPens, or epinephrine injectors, have become commonplace in American schools as the numbers of children with food allergies rises. New research shows that peanut allergies in children have increased 21 percent since 2010, and that overall, nearly 2.5 percent of U.S. children may have an allergy to peanuts.
  • Save to favorites
  • Print

When Abbe Large’s daughter was a toddler, she was diagnosed with a peanut allergy so severe that the skin on her cheek reacted to a kiss from her father hours after he’d eaten peanuts.

With two daughters with multiple food allergies, Large worked with an allergy consultant to figure out how to eat, how to store food, and how to control her children’s exposure to the allergens that could send them into anaphylaxis.

Large was anxious when it was time to send them to their Connecticut elementary school. Peanut protein is difficult to clean from skin and surfaces, which would leave her younger daughter, now 10, vulnerable to a reaction even if peanut-eating classmates didn’t have the nuts at school.

“I would put her to bed at night and really fear for her life,” Large said.

School-based health providers and education leaders say they’ve seen a major uptick in allergies to peanuts and other foods, sometimes creating logistical challenges for teachers, food service workers, and school nurses.

“I’ve been a school nurse for 24 years, and the number of students presenting with risk of anaphylaxis related to food has grown exponentially,” said Laurie Combe, the president-elect of the National Association of School Nurses. “When I started, I had one student with an EpiPen, and now I will go into schools and they will have 20 to 30.”

And new research backs up the assertion that the number of children with food allergies is growing.

Peanut allergies in children have increased 21 percent since 2010, and nearly 2.5 percent of U.S. children may have an allergy to peanuts, according to preliminary research presented by Ruchi Gupta, a professor of pediatric medicine at Northwestern University.

BRIC ARCHIVE

Gupta presented her findings, derived from a survey of 58,000 U.S. households, at the American College of Allergy, Asthma and Immunology’s annual scientific meeting in Boston last month. Her findings also showed rising rates of child allergies to tree nuts, shellfish, fin fish, and sesame during the same time period.

Scientists have suggested that a lack of early exposure to allergens may have contributed to an increase in children with allergies.

Growing rates of food allergies should concern schools, advocates say, because many children who have not been diagnosed with an allergy have their first allergic reactions in a school setting.

Between 20 and 25 percent of epinephrine injections administered to counter severe allergic reactions at school are given to students who’ve not yet been diagnosed with an allergy, according to Food Allergy Research & Education, an advocacy group for people with allergies.

FARE advocates for policies that allow schools to carry epinephrine injectors that aren’t prescribed for use by a specific student so that they can react quickly in the event of an allergic reaction.

States have responded to growing allergy concerns in recent years. Every state but Hawaii has a policy that allows or requires schools to stock epinephrine, according to a FARE legislation tracker. And most states require training for teachers and administrators in how to use the devices.

Those state policies come after a 2013 federal law that prioritizes some federal grants to states that stock epinephrine injectors in schools. Mylan, a leading distributor of epinephrine injectors, pushed for the federal law. Some policymakers have said requiring schools to stock the injectors, rather than merely allowing them to do so, creates a financial burden because of the cost of training staff and maintaining drug supplies.

Groups like the National Association of School Nurses have also pressed for a nurse in every school, noting that relatively common diagnoses like allergies can quickly become serious health risks.

Parents like Large say that, as more schools adopt clear policies related to things like food in the classroom and allowing for broader use of epinephrine injectors, they are more comfortable sending their children to school.

Schools Need Broad Policies

FARE pushes for parents of children with allergies to secure “504 plans” that outline how their schools will limit exposure to allergens and respond if they have reactions, said Jennifer Jobrack, the organization’s national advocacy director.

But schools shouldn’t address allergies as merely issues for individual students, Jobrack said. Rather, they should implement broader policies that reduce allergen exposure for all students, even those who have not yet been diagnosed.

“Food-free classrooms,” where teachers avoid using things like M&M candies for counting exercises and egg cartons for craft products would be one example, Jobrack said.

Schools should also limit use of products like peanut butter in cafeterias, provide special tables for highly allergic students in the lunchroom, and require classroom snacks that include listed ingredients so parents can screen for allergens, she said.

Such policies, applied across an entire school, can help reduce the stigma for individual children with severe allergies.

“You never want to single out a child and make other children feel that because of Johnny’s allergy, we can’t have M&M’s in our classroom,” Jobrack said.

Only 16 states require their schools to have food-allergy policies. But many schools in states without such mandates have adopted them on their own, using guidelines like those from the National Association of School Nurses and the National School Boards Association.

Parent Anxiety

Such policies can help schools reassure parents that their child will be safe, said Combe, of the nurses association.

“When a parent is bringing a child with food allergy to school for the first time, they are terrified,” she said. “They’ve lived in this protective environment of their home, and now they’re sending them off to school to people they don’t know.”

Combe told the story of an elementary student whose mother wanted her to carry an epinephrine injector with her everywhere. While most allergy-affected children stored their injectors in the nurse’s office, administrators allowed the girl to carry hers in a “fairy purse” on her shoulder until her mother grew more confident in the school’s preparedness.

“You have to meet parents where their level of anxiety is, and then you can build trust,” Combe said.

Large, the Connecticut mother, channeled her concern into a mission to boost the level of allergy education in her children’s schools. She went school-by-school to meet with principals, parent-teacher association members, and parents of affected children to put policies in place related to food and allergen exposure.

She convinced schools to switch from peanut butter to sunflower butter in cafeteria foods, and she developed informational features about allergies that could be included in parent newsletters.

“At the end of the day, nobody wants to put a child in harm’s way,” Large said. “Nobody does it intentionally. It’s all about education.”

A version of this article appeared in the November 15, 2017 edition of Education Week as Rising Food Allergies a Challenge for Schools

Events

This content is provided by our sponsor. It is not written by and does not necessarily reflect the views of Education Week's editorial staff.
Sponsor
Reading & Literacy Webinar
The Future of the Science of Reading
Join us for a discussion on the future of the Science of Reading and how to support every student’s path to literacy.
Content provided by HMH
This content is provided by our sponsor. It is not written by and does not necessarily reflect the views of Education Week's editorial staff.
Sponsor
College & Workforce Readiness Webinar
From Classrooms to Careers: How Schools and Districts Can Prepare Students for a Changing Workforce
Real careers start in school. Learn how Alton High built student-centered, job-aligned pathways.
Content provided by TNTP
Student Well-Being Live Online Discussion A Seat at the Table: The Power of Emotion Regulation to Drive K-12 Academic Performance and Wellbeing
Wish you could handle emotions better? Learn practical strategies with researcher Marc Brackett and host Peter DeWitt.

EdWeek Top School Jobs

Teacher Jobs
Search over ten thousand teaching jobs nationwide — elementary, middle, high school and more.
View Jobs
Principal Jobs
Find hundreds of jobs for principals, assistant principals, and other school leadership roles.
View Jobs
Administrator Jobs
Over a thousand district-level jobs: superintendents, directors, more.
View Jobs
Support Staff Jobs
Search thousands of jobs, from paraprofessionals to counselors and more.
View Jobs

Read Next

Student Well-Being How Old Kids Are When They Get Their First Phone, According to a New Survey
The survey collected insights on smartphone use, social media habits, cyberbullying, and more among 11- to 13-year-olds.
3 min read
Photo collage of teenage girl using social media on cellphone.
Georgijevic / E+
Student Well-Being Why RFK Jr.'s Vaccine Views Matter for Schools
This year could bring significant changes to how school-age kids are protected from many viruses.
7 min read
Angela Hayes, a nurse practitioner with Jefferson County Public Schools, prepares vaccines for students at Newcomer Academy in Louisville, Ky., on Aug. 8, 2024.
Angela Hayes, a nurse practitioner with the Jefferson County public schools, prepares vaccines for students at Newcomer Academy in Louisville, Ky., on Aug. 8, 2024.
Mary Conlon/AP
Student Well-Being A State Chief's Order to Schools: Provide Free Meals for All—With No New Funding
Oklahoma's state superintendent told districts to fully cover student meal costs. Districts say the mandate is costly and unenforceable.
6 min read
Cafeteria workers serve student lunches at Firebaugh High School in Lynwood, Calif. on Wednesday, April 3, 2024.
Cafeteria workers serve student lunches at Firebaugh High School in Lynwood, Calif. on April 3, 2024. Demand for school lunches has increased after California guaranteed free meals to all students regardless of their family's income. Now, in Oklahoma, state Superintendent Ryan Walters is mandating that districts provide free meals to all students, although no state law requiring them has passed and the state hasn't set aside additional money.
Richard Vogel/AP
Student Well-Being The Online Behaviors Most Harmful to Kids’ Mental Health, According to a New Survey
A new survey asked 11- to 13-year-olds how they felt when they engaged in certain behaviors online.
5 min read
Photo of teen girl using cellphone.
Georgijevic / E+