Avoiding hives–or worse–when sending your food-allergic tot to preschool

Four-and-a half-year-old Nora Flaherty has a classroom of little PALS at the Dickinson College Children’s Center in Carlisle who help keep her safe from peanuts and tree nuts.

It was two years ago when Nora’s mother, Heather, first had the displeasure of watching her daughter’s face fill out like a helium balloon after she ate Chinese takeout noodles cooked in peanut oil.

The reaction itself ballooned into a total systemic one that also involved a body rash and vomiting. Since then, the elder Flaherty has worked to beef up an already pretty advanced allergy readiness plan at DCCC to help ensure that Nora does not ingest unsafe foods.

Good PALS

Some of Nora’s most zealot allergy advocates are her peers because Flaherty enlisted the help the Protect A Life program espoused by the Food Allergy and Anaphylaxis Network (www.foodallergy.org).

The idea behind PAL is to educate the children around the child with the food allergy on several fronts. They are taught not to take allergies lightly, not to share food with friends with allergies, to always wash hands after eating, to know what their friends’ allergies are and help them avoid them, and to know what to do should a friend start to have an allergic reaction.

The PAL program was widely accepted by administrators at DCCC and deployed by teachers there. To that end Nora’s friends sometimes speak up for her before she does, said Flaherty.  And her PALS are in turn teaching their parents how to deal with Nora’s food allergies so that measures are taken to protect her at play dates and birthday parties outside of school," she said.

The findings of a large-scale study in which researchers surveyed over 40,000 homes with children were released by the Northwestern University’s Feinberg School of Medicine in June 2011. Data shows that 8 percent of American children under the age of 18 have a food allergy.  In sheer numbers that means almost 6 million children are allergic to peanuts (25 percent), milk (21 percent), shellfish (17 percent), tree nuts (13.1 percent), eggs (9.8 percent) and/or an assortment of other triggers.

Do your homework

One in every 13 kids has a food allergy, a ratio that is up from one in 25 in 2008. What’s more, two out of every five children living with a food allergy today exhibit a severe reaction when they inadvertently ingest food they need to avoid.

According to the US Centers for Disease Control, food allergies result in more than 300,000 ambulatory-care visits a year among children under the age of 18.

So it’s no wonder parents of allergy-inflicted offspring are anxious about sending their tots off to preschool where a single oversight can result in a bad reaction.

DCCC Executive Director Gina Van Kirk advises parents to ask pointed questions regarding allergy readiness when scoping out perspective childcare in Pennsylvania as the state does not require anything specific on that front.  She does note that allergy readiness measures do factor into day care quality rating schemes like KeyStone STARS (http://www.pakeys.org/pages/get.aspx?page=Programs_STARS).

Van Kirk advices parents to ask which members of staff have taken pediatric first aide training that encompasses allergy training. She also says that parents should ask to see the form the center uses to help identify students’ allergies. "You can tell a lot about a center’s allergy readiness mindset by the types of questions about your children’s allergy are kept on file," said Van Kirk, who highly recommends the allergy form included in "Caring For Our Children" (http://www.barnesandnoble.com/w/caring-for-our-children-american-academy-of-pediatrics/1101704618 ), a childcare reference book put out by the American Academy of Pediatrics.

A recipe for safety

Once you’ve enrolled your child in a center mothers interviewed say it’s crucial to have an allergy plan of action clearly outlined with both administrators and your child’s teacher. It’s well within a parent’s right to ask for a meeting prior to the first day of school that encompasses an overview of a child’s specific allergies; how publically and widely information about his allergy will be dispensed; protocols for storing foods in communal refrigerators; accommodations for safe eating space; identifying allergic reactions should if unsafe foods are eaten; which medications will be stored on-premise; who can administer those medications; and, how that medication will travel with the child on field trips.

Even young children can be taught to recognize what they can and cannot eat. "When it comes right down to it, it’s your child that chooses what they put in their mouths, so you have to teach them to be their own first and last line of defense," said Kristin Beckett, a mother of four from Berwyn, Chester County, whose 7-year-old son Matthew has had allergies to soy, peanuts, tree nuts and pitted fruits since he was 3. Beckett has drilled Matthew to ask over and over when offered food from anyone, "Is that safe for me?"  It’s become his mantra. 

Matthew is also well-versed in the science of reading labels and can recognize the early signs of his own allergic reaction.

And parents must be persistent in making sure everyone caring for their child knows the plan.

"The most dangerous time for a child with an allergy is when there are two substitutes in the classroom," said Flaherty.  To help alleviate this problem for her daughter, Flaherty worked with teachers to have signs placed at Nora’s designated eating spot that specify that she does not eat the standard morning snack but consumes a special one supplied by Flaherty.

Flaherty keeps a ready supply of banana sun-nut butter bread, mixes of Annie’s Organic crackers and pretzels, and cereal bars in safe flavors in Nora’s classroom for her to eat at snack time.

Beckett said she kept a supply of allergy-free cupcakes in the day car center’s freezer so that Matthew was not forced to sit out the regular birthday celebrations that might have otherwise featured only goodies unsafe for him to consume.

The best piece of allergy coping advice that Maureen Mansfield McHugh got when her then-toddler Molly started exhibiting allergy symptoms several years ago when she was attending the Trinity Lutheran Church preschool program in Camp Hill is stay calm and methodically address the issue day by day.

"We still don’t know the exact triggers for Molly’s allergy, but we know our kid, and we keep a food diary, and we don’t have qualms about switching doctors if they don’t help her," McHugh said.

Flaherty agrees. "You could easily make an allergy the total focus of your child’s life," she said.  Be informed. Be watchful. Be prepared, advised Flaherty. "But you also have to calm down. Don’t get paralyzed by it so that you teach your child to be to be totally fearful of life."

Christine Burns Rudalevige is a classically trained food writer, recipe developer and cooking instructor based in Carlisle. Her two biggest culinary critics are Owen, 13, and Eliza, 10.