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.

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
Law & Courts Webinar
The Future of Criminal Justice Reform: A Sphere Education Initiative Conversation
America’s criminal justice system is in crisis and calls for reform are dominating the national debate. Join Cato’s Sphere Education Initiative and Education Week for a webinar on criminal justice and policing featuring the nation’s
Content provided by Cato Institute
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
Student Well-Being Webinar
Equity, Care and Connection: New SEL Tools and Practices to Support Students and Adults
As school districts plan to welcome students back into buildings for the upcoming school year, this is the perfect time to take a hard look at both our practices and our systems to build a
Content provided by Panorama Education
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
Classroom Technology Webinar
Here to Stay – Pandemic Lessons for EdTech in Future Development
What technology is needed in a post pandemic district? Learn how changes in education will impact development of new technologies.
Content provided by AWS

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 Opinion Where Does Social-Emotional Learning Go Next?
Teachers, students, and parents all want more social-emotional and service learning in schools. The pandemic has only heightened that need.
John M. Bridgeland & Francie Richards
4 min read
Friendly group of people stand and support each other.
IULIIA/iStock/Getty Images Plus
Student Well-Being What the Research Says Masks, Tracking, Desk Shields: How Much Do School Measures Reduce Families' COVID-19 Risk?
A new study pinpoints the most effective mitigation measures and suggests that the more of them schools use, the better.
5 min read
Jennifer Becker, right, Science Teacher at the Sinaloa Middle School, talks to one of her students in Novato, Calif. on March 2, 2021.
Jennifer Becker, right, a teacher at Sinaloa Middle School, wears a mask to stem the spread of coronavirus as she talks with a student earlier this year in Novato, Calif.
Haven Daily/AP
Student Well-Being Opinion The One Thing Teachers Do That Hurts Student Motivation
When adults take over on a challenging task, kids are more likely to quit sooner on the next one. Here’s what to do instead.
Julia Leonard
1 min read
Images shows a stylized artistic landscape with soothing colors.
Getty
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
Student Well-Being Whitepaper
The Complete Guide to SEL
This guide illustrates why SEL is more important now and what you should look for when implementing a social-emotional curriculum.
Content provided by Navigate360