How to Manage Food Allergies in Children

Nov. 29, 2010 -- Pediatricians play a key role in preventing and treating food-related allergic reactions among school-aged children, and can help implement plans concerning the way food allergies are managed in the school setting, according to a clinical report published by the American Academy of Pediatrics.

Food allergies are estimated to affect about one in 25 school-aged children. Research suggests that as many as 18% of children with food allergies experience a reaction while in school, indicating that the school environment is an important place to help prevent and treat allergic responses. Food allergy is also a common trigger of anaphylaxis, a possibly life-threatening reaction to a particular food.

Published in the December issue of Pediatrics, the journal of the American Academy of Pediatrics, the report includes:

• Advice for pediatricians on diagnosing and documenting any potential life-threatening food allergies, including identifying any food that might truly be life-threatening.
• Developing and writing down age-appropriate management and emergency response plans and including children, parents, and school officials in the planning process.
•  Determining whether a health care professional, such as a nurse, is available to help the child in the event of a reaction at school.
• Prescribing self-injectable epinephrine and, if schools permit and if age-appropriate, allowing children to carry their own epinephrine in the event of an emergency, such as outside of the school cafeteria, because delays in treatments have been linked to fatalities.
• Teaching children and their families how to use and store medication properly.
• Informing children, families, and schools how to identify signs of anaphylaxis and how to best respond to expedite treatment.
• Understanding the school’s anaphylaxis response protocols. The report notes that 25% of anaphylaxis cases that occur in schools are among children without a previous diagnosis of food allergy.

Building Partnerships

“Partnerships with students, families, school nurses, school physicians, and school staff are important for individualizing effective and practical care plans,” the authors write.

The report did not include infants, toddlers, and preschool age children, since these children are cared for in a variety of settings and would require their own set of prevention and treatment guidelines.

According to the Food Allergy and Anaphylaxis Network, an advocacy group, an estimated 3 million children have food allergies. Eight foods account for 90% of all food allergies in the U.S.: milk, eggs, peanuts, tree nuts (such as almonds and walnuts), wheat, soy, fish, and shellfish. Food allergies account for more than 300,000 ambulatory care visits per year among children.