Reducing risk of allergic reactions in schools

Food allergy is common – on average, most school classes in the UK will have one or two children with food allergy.

Children with food allergies need to avoid the food they are allergic too. However, accidental reactions are common: most younger children have at least one accidental reaction every 2-3 years. Fortunately, most reactions present with mild-moderate symptoms, and do not progress to anaphylaxis – even in children who have had anaphylaxis before.

Schools need to consider how to reduce the risk of an allergic reaction, in line with the statutory guidance Supporting pupils at school with medical conditions. Parents need to work with the school in trying to reduce the potential risks:

• Bottles, other drinks and lunch boxes should be clearly labelled with the name of the child for whom they are intended.
• If food is purchased from the school canteen, parents should check the appropriateness of foods by speaking directly to the catering manager.
• Parents should teach their children how to check with staff and read ingredients labels before buying food. Many children of primary school age are able to do this. One way to help your child learn is to take them shopping with you, and ask them to read ingredients labels to spot the foods they are allergic too.
• The Food Standards Agency (FSA) has provided useful guidance for caterers which parents may find useful.
• Food should not be given to food-allergic children in primary schools without parental engagement and permission (e.g. birthday parties, food treats).
• Schools should have policies to avoid trading and sharing of food, food utensils or food containers.
• Use of food in crafts, cooking classes, science experiments and special events (e.g. fêtes, assemblies, cultural events) needs to be considered and may need to be restricted, depending on the allergies of particular children and their age.
• When planning out-of-school activities such as sporting events, excursions (e.g. restaurants and food processing plants), school outings or camps, think early about the catering requirements for food-allergic children, and emergency planning (including access to emergency medication and medical care).

Food bans

Many parents and schools try to implement a ‘ban’ certain foods (such as nuts) from school premises. However, schools and parents should consider:

• Banning a particular food does not stop the risk of accidental exposure, and are very difficult to enforce.
• There is no evidence that food bans help reduce the risk of accident exposures, and may result in a false sense of security.
• Food bans often focus on nuts: however many food allergies are caused by other foods such as cow’s milk or wheat. In the UK, more fatal reactions in children are caused by milk than peanut.
• Food restrictions (as opposed to food bans) may be useful in primary schools, where children are less able to check for themselves what a food might contain, and sharing toys is more common.
• Unlabelled food poses a greater risk of allergen exposure than prepacked foods with precautionary “may contain” labels.
• Children should be taught to check foods themselves as soon as they are able to do so.
• Many schools have successfully made “food allergy” an example of how children can “look after” their classmates.
• It is far safer for a school to be “allergen-aware” than “allergen-free”.

If a school does decide to implement a nut ban, it should never claim to be “peanut or nut free”. Evidence suggests this may lead to a false sense of security about the risk of accidental exposure to peanuts or nuts. A recent editorial in an allergy journal discussing this can be accessed here. Allergy & Anaphylaxis Australia have also produced a useful factsheet which may be interest.