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Food allergies are more and more prevalent in children and can have serious consequences. Find out how to manage this risk at school.

What does a food allergy consist of?

A food allergy is an abnormal reaction by the body to food or to a substance in the food that was ingested or to which an individual came into contact with. Therefore, the food or substance in question is referred to by the term "allergen". We speak of a food allergy when the reaction is caused by an immune system dysfunction that overreacts and attempts to protect the body against the food or substance, which it perceives as a threat.

The defensive reaction that ensues can be very strong and manifests itself by a series of symptoms. Sometimes, the mere presence of traces of the allergen is enough to trigger a reaction. Paradoxically, some of these symptoms can pose an even greater threat to the individual with the allergy, especially in the case of an "anaphylactic" reaction.

What is an anaphylactic reaction?

An anaphylactic reaction or anaphylaxis is an acute, serious allergic reaction that can cause death. The severity of an allergic reaction and the nature of the symptoms that it induces may vary from one person to the next and from one episode to the next. The symptoms of an anaphylactic reaction include, among others:

• swelling of the throat, lips, and tongue
• difficulty breathing or swallowing
• choking sensation
• hot flashes
• itching or overall redness of the skin
• increased pulse rate
• blood pressure drop
• pallor
• sudden weakness, and
• loss of consciousness

Why is it important to have an action plan?

When living with a food allergy, constant vigilance is important because the allergen can be found almost anywhere. At school, it may be more difficult to control the environment to keep the allergen out. So, if an allergic reaction occurs and the people who are there are unprepared, this can be very dangerous. Therefore, it's important to establish a structured and rigorous action plan and to inform both the child and the people in his/her environment about it.

Your child's doctor is undoubtedly the best person to help you develop an action plan. You must give this plan to everyone who is likely to help your child in the event of a serious allergic reaction—teachers, child care service or cafeteria workers, school principal and secretary, and so on.

To make things easier, you can write up your action plan using a pre-existing form and adapting it to your needs. You can find this type of form at: http://foodallergycanada.ca/wp-content/uploads/AnaphylaxisEmergencyPlanwithEpiPen.pdf

What should the action plan include?

It's important to have an effective action plan, in other words, it should include all the pertinent information in a concise and precise manner. The following is an example of the information it should contain:

• your child's name and a photograph
• the allergen in question (peanuts, eggs, soybean, etc.)
• the name of the epinephrine auto-injector to be used in the case of an allergic reaction
• the places where the epinephrine auto-injectors are kept
• a description of the allergy symptoms that may occur
• a description of the steps to follow in the case of an allergic reaction
• usage instructions (ideally with an illustration) for the epinephrine injection
• a list of people to contact in case of an emergency

Pharmacists can also help you develop an action plan and provide information on how to use the auto-injector safely and optimally. Did you know that they can also prescribe this type of device? Additionally, you can use the preauthorized refill service to have your pharmacist call you when it’s time to replace your auto-injector when it expires.

You will likely have to fill out and sign an authorization form for the administration of the drug by school staff. Ask the responsible staff members what you need to do.

A few additional tips for parents

Here are a few tips for parents with a child suffering from a food allergy:

• Prepare all of your child's meals and snacks yourself.
• Tell your child not to eat any foods offered to him/her by friends or classmates.
• Make sure your child wears his or her auto-injector at all times, for example, around the waist. If you think your child is too young to keep the device, discuss the best option with the school team.
• Ensure your child wears medical alert identification (i.e. MedicAlert bracelet) at all times.
• Give the school an adequate number of rescue epinephrine auto-injectors that will be stored in strategic places known to key personnel.
• Replace epinephrine auto-injectors before the expiry date.
• Review the steps to administer epinephrine often and encourage family members and the people in your child's environment to do the same. You will find a demonstration on how to use the auto-injector (via images or a video brief) on the manufacturer's internet site.
• Visit the website of the manufacturer of the auto-injector for information, such as posters that provide explanations that can be placed in strategic areas at school.

Speak to your pharmacist for additional information about food allergies and their treatment.