Food Allergies

by SKHC Editor on July 21, 2006

Greetings from Twyla,

The summer months have flown by and in a few, short weeks it’s time to go back to school.  Students will arrive with school supplies in their backpacks.  Their lunchboxes will contain their favorite foods, or they will purchase them from the cafeteria.  Some students, however, will return to school with more than school supplies.  They will present with severe food allergies and for them and their caregivers, the return to school may bring anxiety and fear.Consider the data.  About 6-8% of school-age children in the United States have food allergies.  Eight foods account for 90% of all food-allergic reactions: milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soy.  In a 2001 study of fatal food allergy-induced reactions, more than half (53%) were aged 18 and younger.  There is no cure for food allergies and strict avoidance of the offending food is the only way to prevent a reaction.

Given that information, management of students with food allergies in the school setting is one of the tougher challenges that school nurses face, as the numbers are on the rise.  We have to address accommodations in the classroom, cafeteria and on field trips.  Education of the student, family, school staff and the community is critical.  We need to inform classroom teachers, special area teachers, paraprofessionals, food service staff and bus drivers of students with food allergies.

Care planning includes formalizing the steps to be taken in an anaphylactic emergency, securing health care provider orders for medication and training staff to administer it.  And those are just a few of the considerations!

Luckily, School Nurses have a wealth of resources available to assist them with providing care for these students.  The National Association of School Nurses (NASN) has a position statement entitled, “The Role of the School Nurse in Allergy/Anaphylaxis Management”.  It can be found on the NASN web site,  The new book SCHOOL NURSING: A Comprehensive Text contains guidelines for managing students with food allergies.  The Food Allergy and Anaphylaxis Network ( has extensive information on the subject.  There are a myriad of other resources, as well.

It also helps to know what is going on in the political arena, as it can have an impact on your practice.  The House of Representatives introduced a bill in October, 2005, HR 4063, which would direct the Secretary of Health and Human Services to develop a policy for managing the risk of food allergy and anaphylaxis in schools.  If school nurses want to have input into legislation that affects children and our practice, then we must work through our professional organization to have a strong, unified voice.

What have you learned from your experiences with families of food allergic students?  What worked/hasn’t worked for you?  Perhaps you have some tips for those of us who are new to or veterans of school nursing.  School Kids Healthcare is providing us with a forum to discuss this issue.  Let us know what you think.

Twyla Lato, RN, BSN, NCSN is a School District Nurse for a suburban community in southeast Wisconsin, and a past president of the Wisconsin Association of School Nurses.             


{ 1 comment }

Sarah September 9, 2008 at 10:53 am

Learn all about food allergies by taking this new online course for FREE! Follow one of the links below to – Children’s Health Education Center to check it out. (educators)

OR (parents and caregivers)

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