Managing allergies at school: a guide for parents
It’s thought that between five and eight per cent of children in the UK suffer from some kind of food allergy. This means that at least 20 per cent of parents are used to checking food for allergens to make sure everything’s safe.
But when they’re at school all day, it’s not so easy to ensure they avoid their allergy triggers.
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Under the Children and Families Act, schools are obliged to provide high quality support for children with medical needs, which includes ensuring they are not excluded from normal school life because of their allergy.
This means that classroom activities, lunchtime arrangements and school trips must all be safe for children with allergies, with adjustments made as necessary.
Testing for allergies in children
If you suspect your child has food allergies, getting them tested can confirm your suspicions. NICE, the National Institute for Health and Care Excellence, recommends that children should be tested if they are showing signs of a food allergy.
Your GP can take your child’s clinical history and refer them to a specialist for testing. This might be:
- A skin prick test: a small amount of an allergen is placed onto the skin. If a small, swollen ‘weal’ appears in 15-20 minutes, it shows the immune system is sensitised to that allergen. The results require careful interpretation by a doctor.
- A blood test: a blood sample is taken and tested for allergenic antibodies to the suspected allergen.
Informing your child’s school about their allergy
It’s vital to tell the school about your child’s allergy. According the Task Force on the Allergic Child at School (TACS), 20 per cent of allergic reactions to food occur at school, so keeping your school informed about your child’s needs can help prevent incidents.
TACS advises taking the following steps:
- Giving the school a written allergy management plan from your child’s GP or specialist.
- Making sure staff know what your child looks like, and the basic details of their allergy.
- Providing the school with any medications your child needs
One way to ensure your child’s school has all the information they need about their allergy is to put together an Individual Healthcare Plan. This is a written document that sets out your child’s medical needs and how they should be handled.
Allergy Action Plans have been introduced to facilitate first-aid treatment of anaphylaxis by someone without first-aid training (student, staff, parent). These need to be completed by a medical professional, printed out and signed.
Food allergies and school dinners
If your child has food allergies, lunchtimes can be an area of high risk, whether they have school dinners or bring a packed lunch.
School caterers are not legally required to provide meals for children with food allergies. For example, they may say that there is a risk of cross-contamination, which could potentially put children at risk. But they should still ensure that children have safe food options.
If the caterer doesn’t believe they can guarantee their meals are free from certain allergens, based on an informed risk assessment, the school can request that children with food allergies bring in a packed lunch. Alternatively, they can try to find an alternative caterer that can provide allergen-free meals.
If the caterer states that it can provide meals for an allergic child, they are legally obliged to give accurate information about 14 key allergens used as ingredients or during processing.
School menus should be shared with parents so that they can view the list of ingredients, which should be clearly labelled.
Food allergies and packed lunches
Many parents of children with food allergies feel it’s safer to provide packed lunches than to take up school dinners. Even so, there’s always a risk of cross-contamination from other children’s lunches, so it’s vital that schools are vigilant.
According to the Anaphylaxis Campaign, schools shouldn’t make children with food allergies sit separately to eat their lunch. Instead, well-trained staff should be aware of which children have allergies, and seek to ensure they’re safe while they’re eating lunch.
Pupils should also be made aware of allergies in an age-appropriate manner, so they understand that some foods aren’t safe for their peers, and not to share food.
Banning allergens in schools
In an effort to keep children with allergies safe, some schools have a blanket ban on certain allergens, specifically peanuts and tree nuts. Children are not allowed to bring food containing the allergen in their lunchbox or as a snack.
In general, though, the Anaphylaxis Campaign doesn’t advocate blanket bans of allergens. This is because no school can guarantee a truly allergen-free environment, and banning allergens could provide a false sense of security.
That said, it’s reasonable to ask parents of Foundation Stage and Key Stage 1 children not to let them take food containing peanuts or tree nuts into school, in order to reduce the risk of cross-contamination for young and vulnerable pupils.
In the case of older children, schools should undertake a thorough risk assessment, and may wish to write to parents to ask for their cooperation in making school life safer for pupils with allergies.
The most important thing is for schools to adopt a culture of allergy awareness and education, and to put measures in place to minimize the risk of a child having an allergic reaction.
Managing medication for allergies at school
The Anaphylaxis Campaign recommends that schools have a core team to work with parents to establish prevention and treatment strategies for children with allergies, including how to administer emergency medication.
Training should typically be arranged by the school nurse so that all staff know how to recognise symptoms of an allergic reaction, how to manage allergens and reduce risks, and what to do in an emergency. It's good practice for schools to have a specific member of staff who is trained in allergy management and who maintains and updates the school allergy policy.
According to the Anaphylaxis Campaign, it’s usual for primary schools to store emergency medication like AAIs in a central location, for example the school office. It’s important that staff know where to find it in case of emergency. Medicine should be stored safely, but not locked away, and it should be labelled clearly with the child's details.
Some children with allergies need an adrenaline auto injector (AAI) such as an EpiPen. Sometimes, it may be advisable for children to carry their own medication. This might happen if the child has a history of immediate, severe reactions, or if the school site is very large and so it would take a considerable time to reach the medication in an emergency.
Parents need to ensure that their child's AAIs haven't expired, but it is also a good idea for schools to check regularly. If the school has been closed for some time (as it was during Covid-19 lockdowns) then it is possible that any medication kept at school will be out of date.
This is something that should be discussed with your child’s school and noted in their Individual Healthcare Plan.
Schools are allowed to keep a spare AAI to treat children who are suffering an anaphylactic reaction. Since 2017, schools have been able to order AAIs without a prescription. They can also keep a spare reliever inhaler, which they can use if a child is having an asthma attack: a common symptom of many allergies.