Kids with allergies can die in school

Like many other parents of kids with allergies, I was very dismayed to see this article, titled, Allergic boy, 7, suffers two heart attacks after teacher hands him chocolate nut in class, last week.   It seems a boy of 7 was accidentally given a chocolate candy containing a hazelnut, to which he is allergic.  After biting into the candy, he realized immediately that he shouldn’t have it and spit it out.  Despite quick treatment with an EpiPen after symptoms started, he ended up in pretty bad shape on life support after suffering a couple of cardiac arrests.

I read with interest the comments that the public left on that article.  As I’ve seen before with other peanut allergy articles (namely those that discuss banning peanuts on airplanes), this issue was very polarizing.  The teacher and child were equally blamed.  People even blamed the mother, who wasn’t even there until right afterward and did exactly what she was supposed to do.

I am almost positive that I would be one of those people saying, “What’s the big deal?  Just don’t eat peanuts” if peanut allergies didn’t affect my life in a huge way – my 4 year old son is severely allergic to peanuts.  He’s had 3 exposures, all accidental.  The last one saw us end up in the Emergency Room needing IV’s, oxygen, and several medications to treat his anaphylactic reaction.

I wanted to take the opportunity to respond to some of the comments I often read and hear.

“Honestly, 7-years-old is old enough to know what products may contain harmful ingredients and his parents should not expect the Big Brother state will always be there to watch over him.”

Yes, a 7 year old boy is probably old enough to know better.  Even my 4 year old knows that he’s allergic to peanuts and needs to avoid them.  But think about it.  The boy is seven.  Who would bet money on a 7 year old having 100% impeccable judgment at all times?  I wouldn’t.  So while they may be aware of their allergy and “know better,” the fact remains that they are just too young to be trusted 100% of the time.  It’s a dichotomy that society as a whole can’t quite agree on and we can’t have it both ways.  Some say that a child of that age should be completely in control of this life-threatening allergy, yet I have heard first-hand about the police being called because a child of the same age was left alone in a locked car while the mom went into the store for a few minutes!

As for not expecting the “Big Brother state to watch over him?”  I would absolutely expect him to be watched over while he was at school!

There are stories about people in their teens who have lived with the same allergy all of their lives die from a reaction.

Some people commented that teachers already have enough on their plate, why do they need to deal with what kid has what allergy?

Because these allergies can be life-threatening, that’s why.  I’m not going to be talking to my son’s kindergarten teacher in the fall to warn her that he might get a tummy ache if he accidentally eats some peanut.  In reality, he might actually die. We send our children to school with the fervent hope that the teachers and staff there will keep them safe.   In reading several online message boards and articles, I have often seen this analogy:  Sending a kid to school or another child’s house where peanuts (or other allergens) are freely available is just like leaving a loaded gun out on the table.

Kids are by nature extremely curious and often want exactly that which they cannot have.  It seems like a dramatic analogy, but the end result is the same as far as I’m concerned.  Playing with a loaded gun or playing with a peanut can leave my child maimed or dead.

It isn’t only peanuts, by the way.  Kids are having anaphylactic reactions to dairy, eggs, and wheat.  Some kids are so sensitive that mere residue left on a toy from someone having eaten a cheddar cracker can send them to the hospital with a reaction.

Most allergic kids have quick access to an Epipen in case of a reaction.  These are not a cure.  For one, they have to be given before the reaction progresses too far otherwise they don’t help.  For another, they only buy you time to get to an Emergency Department.  No one stabs themselves with an Epipen and then thinks, “Whew!  Glad that’s over then!”  It’s not.

I have read some other “helpful” advice: “Just desensitize the child – give them a bunch of eggs, peanuts, milk and they’ll stop reacting to it.”  This is like telling someone allergic to bee stings to put themselves into a locked room with a bunch of bees.  It’s ridiculous.  There are desensitization clinical trials happening around the country, but the amounts they start with are incredibly minute and are given under extremely controlled conditions with emergency equipment immediately available.  People in these experiments have had reactions to a few grains of peanut dust.  It’s just not something you do at home on a Saturday afternoon.

When I was a kid in school, we usually got treats on someone’s birthday:  homemade cookies, store-bought candies.  Doing this now is like walking through a minefield.  So many kids have allergies to so many different foods these days, you’d never find a product that everyone could eat. Why not cut treats out altogether at school?  Provide the children with stickers, coloring books, pencils, little trinkets.  Or at the very least talk to the teacher and make sure you provide a food that everyone in the class can enjoy.

Most importantly, keep this in mind: no parent asked for this.  No pregnant woman ever daydreamed that her daughter would have blue eyes and a life-threatening reaction to eating a peanut.  No expectant father ever hoped that his son would enjoy playing catch and stop breathing after eating an egg.

So when you read about people trying to ban peanuts on planes (and I have never been so amazed as I was while reading comments from people who were adamant against giving up their God given right to eat peanuts at 30,000 feet in the air) or if you get a note sent home from school asking you not to include certain products in your child’s lunchbox, go ahead and be annoyed.  Then take a minute to realize that we are just trying to keep our children alive.  Yes, alive.  It’s truly not just a tummy ache that we’re dealing with here.

“Gina” is an intensive care nurse who blogs at code blog – tales of a nurse.

 

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  • Anne Montgomery, MD

    Thanks for this post. My son, now 20, had anaphylaxis after eating what he was told was a chocolate chip cookie, and turned out to be a peanut butter chocolate chip cookie, when he was 12. At that age he knew what to avoid and always read labels but sometimes even now he gets surprised. And in third grade, despite having 2 peanut-allergic kids in her class, his teacher had the kids make peanut butter sandwiches as an exercise in following directions step by step. He and his classmate were actually punished for refusing to participate and he ended up having an anxiety attack becaus he was afraid he could die. Absolutely schools have a responsibility to keep these kids safe. It’s not that hard to enforce peanut-free zones or ban therm altogether.

    • Holly

      OMG! How could a teacher do that? I sure hope he/she was fired for that “exercise”. My son is almost 11, and is allergic to peanuts, nuts and shellfish. When he was in SK his secret valentine gave him chocolate peanut butter candies—even though they had questioned the teacher about what to give him, given she has a son who’s allergic to peanuts/nuts as well. She came up to me and apologized, but no explanation as to how she managed to mess up so. Before I had a chance to check, he was already eating it, and immediately ran into the kitchen and spit it into the garbage. Fortunately he did not react to that exposure. I can’t imagine how the parent’s of this boy are feeling, and I sure hope he makes a full recovery.

  • Nathan Johnson

    I’m sorry for these unfortunate incidences, but there’s another side to this. From the NY Times:

    “Dr. Christakis notes that while it’s reasonable for schools and parents to take basic precautions, there is no scientific evidence that nut bans are particularly effective at protecting children. But more important, he argues, is that limiting widespread exposure to nuts can make things worse. The “policy of avoidance” means that fewer children are being exposed to nuts, likely increasing their risk for developing an allergy. A 2008 study in The Journal of Allergy and Clinical Immunology of 10,000 British children found that early exposure to peanuts lowers risk of allergy, rather than increasing it.”
    http://well.blogs.nytimes.com/2008/12/15/are-nut-bans-promoting-hysteria/

    • Patti

      Well then those parents can sprinkle nuts all over their non allergic kids beds and keep them healthy. Meanwhile, let me bring my kid to the public school and be safe in a nut free environment. Thanks for sharing your amazing side to the death by peanut story.

      • Anne Montgomery, MD

        I looked at the original study. This was indeed a population study comparing a population of UK jewish kids with a population of Israeli kids. The Israeli kids tended to get peanut in infancy as a weaning food and had less peanut allergy. Great possibility (not proof) in a population. Does not apply to our individual kids who manifested their peanut allergy in infancy. And also doesn’t apply to keeping reasonable restrictions in schools to protect kids with life-threatening allergies.

  • Frank in L.A.

    I am very sympathetic to the plight of those with allergies and that of parents who have to manage their children’s allergy situation.

    But, when I see statements like “Some kids are so sensitive that mere residue left on a toy from someone having eaten a cheddar cracker can send them to the hospital with a reaction” and that we should “ban peanuts on planes,” with nothing but anecdotal evidence to justify them, I become less anxious to change my behavior to support their beliefs. Where is the evidence?

    • Andi

      I have some evidence for you! My 2 year old ended up in the ER with an ANA reaction after touching video games at a restaurant that is known for it’s yummy peanut butter cookies. We were within a foot of her at all times and there was no chunks for even visible crumbs. This was before we were aware of her allergy, we would obviously NOT take her to that restaurant now. All she did was touch the residue and rub her eye and within minutes she was in ANA. So please have some compassion for those of us who have to live with the reality of loosing our child to this awful reality every second of everyday until we (or our precious children) DIE!

      • LaraB

        Another for you… at 7 months of age, my daughter swelled into hives NOT because she ate something with sesame in it but because I had sesame residue on my hands from eating a bagel. Like the poster above, this was BEFORE the allergy diagnosis and a frightening way to learn about it!
        Hmmm…I guess I’m just another ancedote. My child would only be the stat you desire if god-forbid something tragic happened to my her!

        • Frank in L.A.

          Andi and LaraB

          It is easy to provide anecdotes (as both of you have done so colorfully), but you have not provided the evidence.

          There seems to be no real evidence justifying the type of assertions made by Andi and LaraB. If there were, why can no one cite it?

          • Anne Montgomery, MD

            No one is going to deliberately expose allergic kids to allergen so there won’t be any clinical trials of this particular phenomenon. There will only be case reports–you can call it “anecdote” but when it happens repeatedly to many different kids it does take on scientific significance.

            There is plenty of evidence about the increasing incidence and severity of peanut allergy. Here’s one article. Not hard to find more.

            Ann Allergy Asthma Immunol. 2008 Oct;101(4):387-93.
            Increasing anaphylaxis hospitalizations in the first 2 decades of life: New York State, 1990 -2006.
            Lin RY, Anderson AS, Shah SN, Nurruzzaman F.
            Department of Medicine, St Vincent’s Hospital-Manhattan-SVCMC, New York, New York 10011, USA. robert_lin@nymc.edu
            Abstract
            Background: Although an increase in the occurrence of anaphylaxis has been reported in several parts of the world, this phenomenon has not been described in the United States.
            OBJECTIVE: To characterize anaphylaxis hospitalizations in New York State in patients younger than 20 years.
            METHODS: Using a statewide administrative database, hospital admissions of patients with an allergic disease (anaphylaxis, angioedema, urticaria, and allergy unspecified) as the primary diagnosis were analyzed from 1990 through 2006 in New York State. Admission rates were calculated for the allergic disease groups, as were hospitalization characteristics. Statistical modeling and group comparisons were performed with the use of negative binomial distribution analysis.
            RESULTS: For patients younger than 20 years, the anaphylaxis hospitalization rate increased by more than 4-fold during the study period and by 2002 exceeded the combined hospitalization rates for urticaria, angioedema, and unspecified allergy. After the widespread adoption of food anaphylaxis codes in 1994, food anaphylaxis predominated hospitalizations for anaphylaxis. Peanut was the most common food allergen in food anaphylaxis admissions. The anaphylaxis hospitalization rate for males was significantly greater than that of females (risk ratio, 1.45; 95% confidence interval, 1.26-1.66). Blacks were not disproportionately hospitalized for anaphylaxis. An overall bimodal age distribution showed peaks in the very young and in teens.
            CONCLUSION: These data demonstrate that in a populous Northeastern state in the United States, anaphylaxis requiring hospitalization is increasing in the age group younger than 20 years.
            PMID: 18939727 [PubMed - indexed for MEDLINE]

  • Anne Montgomery, MD

    That may be true in populations, but my son had his first severe reaction to peanuts from the crumb of someone’s peanut butter sandwich he accidentally picked up at day care when he was <6 months old and still exclusively breastfed. We assume he was sensitized either prenatally or through breastmilk. Neither his father nor I have food allergies so I did not avoid any foods and in fact ate quite a few peanuts, so "early exposure" definitely did not help him avoid it.

    After the peanut butter sandwich lesson fiasco, we were able to persuade our school to ban peanuts from formal lesson plans and to set up "peanut free" zones in the cafeteria. This was not to quarantine our kids, any of their friends could sit with them as long as they ate school lunch (which became peanut-free) or brought lunch with no peanuts. Other kids were still welcome to have their peanut butter sandwiches but they were no longer allowed to tease our kids by holding them under their noses. (This latter practice constitutes harassment as far as I am concerned, much like pointing a gun at someone; if you are 8 years old and have been told repeatedly that peanuts can kill you, a peanut butter sandwich looks just as deadly as a gun and causes pretty significant anxiety.)

    I never advocated for a ban, just for common sense, reasonable caution, and sensitivity.

  • Jim ( UK )

    I haven`t eaten potatoes in 40 years ( now 63 ) because they would trigger a migraine . ( Even potato chips ) . And if I go out to dinner , I would let my host/ess know .

  • http://www.kidswithfoodallergies.org Lynda Mitchell

    The problem with residue left on toys or surfaces with young children is that their hands often go into their mouths after touching contaminated surfaces. Once that happens, it’s considered an ingestion and it can trigger a systemic allergic reaction.

    It’s important to have an age-appropriate safety net around a child with food allergies. Little children need more of a safety net than older children, but even children in their early elementary years are not mature enough to fully manage their own food allergies.

    Those of us raising kids with food allergies are slowly teaching our children to self-manage but even so, we look to responsible adults to work with us to keep our kids safe, healthy and included. And to forgo that occasional bag of peanuts just to keep our kids safe.

  • http://fiestabeth.blogspot.com Beth

    Thanks for the article. I recently blogged about this same issue: http://fiestabeth.blogspot.com/2011/01/not-easy-to-share.html.

    Frank, are you looking for evidence such as dead kids? Already it’s been determined that upwards of 200,000 trips to the ER are taken annually because of food allergies. If they don’t die does it not count?

  • http://www.codeblog.com Gina

    Nathan – I’m actually not advocating a peanut ban in schools. I believe it would cause a false sense of security. Vigilance is necessary. Peanut free tables are a good compromise I think. My son also has an egg allergy that he seems to be outgrowing… we were encouraged by our allergist to give him small amounts of egg every week and he’s tolerating that well, so not removing the allergen altogether makes sense. Unfortunately my son’s peanut allergy cannot be managed that way because of his history of anaphylaxis. His reactions have gotten increasingly worse.

    Frank in LA – I believe my son’s first exposure was from playing with (sharing toys) a friend who had eaten peanut butter before they played together. Seeing his 1 year old body covered in hives was all the evidence I needed. It may be anecdotal, but I lived it, and that’s good enough for me.

    As for banning peanuts on planes… What’s more inconvenient: forgoing peanuts for a few hours or making an emergency landing in a city you don’t want to be in to let off the kid who had a bad reaction to peanut dust in the air or residue on the armrests or tray table. Feel free to Google “Allergic reaction peanut reside” if you need more information.

  • http://www.healthybalancedlife.com Ann Becker-Schutte

    Thank you for this thoughtful article. We have been fortunate enough not to have food allergies in our home, but I have several friends who live daily with the fear that serious food allergies cause.

    This seems pretty simple to me. If a child can die from exposure to easily avoided foods, then there should be a clear safety net to protect them from these foods. My daughter’s pre-school is nut-free. There is a list of “safe foods” provided at the beginning of the year. Parents who want to send birthday snacks can choose from that list. I was initially a bit disappointed not to be able to make a fun home-made treat. I got over it. We made a fun cake at home, I took a treat that wouldn’t put any of my daughter’s classmates at risk. She still got to wear the birthday crown. She was not deprived of her “special day” experience. And kids were _safe_. It just blows my mind that this wouldn’t be the bottom line. For all parents.

  • http://www.AllerDine.com Steve Rose

    As a parent of children with severe allergies, reading this blog was very difficult. It reminds us of how vulnerable we are and that at any moment we could be in “Emergency Response” mode. Unfortunately, there are a few people in the general population that don’t understand food allergies and associate our community as being high maintenance and over exaggerating our concerns. This is truly only a small percentage, however a vocal group that are generally not happy with most of their daily life. We, as parents of allergic kids or allergic ourselves MUST keep pushing our politicians and organizations through reasonable approaches to minimize the risk of exposure. I have been working with airlines for over 3 years and totally agree that most of the airlines DON’T get it. I have heard that Southwest is now changing and starting to understand, but cannot confirm. One Canadian airline WestJet is the only airline I’ve seen that has formally taken all nuts off planes and asks everyone on board to not eat the allergen. Why do they do this? They don’t have a “business class section”. Most airlines like to protect their business and first class customers and seem to think they MUST have their nuts on planes. If you ask most folks in these premiere seats, they are more than happy not to eat nuts to prevent someone in coach from dying!!!

    As for daily life…more and more businesses are starting to recognize the power of accommodating our community. We have found many restaurants that are now willing to adjust their processes to ensure a safe dining experience. We started AllerDine.com two years ago to share this information in our community.

    With Schools, every school is different and can be very frustrating to break through their administration. Be “in their face” as much as you can. These are our children’s lives they are playing with…they MUST understand. Make them understand with the use of statistics, videos from FAAN and unfortunately two very recent cases of school related attacks.

    Stay safe…enjoy the SuperBowl – please check where they are ordering food from or the ingredients they are using for food. Read every label and if not sure, don’t eat it. Bring back up food or check for a restaurant that can accommodate your needs.

    Steve Rose
    Founder of AllerDine.com

  • Anne Montgomery, MD

    Alaska and Horizon airlines do not serve peanuts. (I remember when my son was little getting down on my hands and knees looking for dropped peanuts in our row on the plane. If I didn’t find them, he certainly would have.)

    Appreciate Steve’s last paragraph above–that’s what life is like. Don’t eat anything homemade/without a label unless you made it yourself or watched it being made. Oh, and be sure you always have an EpiPen handy just in case.

  • http://www.codeblog.com Gina

    Southwest was very accomodating last time we flew in October. I called the airline after buying our tickets online, explained the situation, and they were fantastic. We just had to tell the ticket agent when we arrived and they sent a message to the gate agent and that was all that was needed. They could not promise that others wouldn’t bring peanuts, but they didn’t serve them.

  • Melissa Gensch

    I have a husband and son with life threatening food allergies. Its amazing to me that people are still so ignorant. This is a very true article. To those who left comments wondering where the evidence is…its everywhere!! These things have been proven over and over again and people die from these very real things. We don’t care if you understand why it happens…..just suck it up and help us keep our family members alive despite your own ignorance.
    I’m really sick of stupidity standing in the way of food allergy management. FYI….the NY times had it all wrong….proven many times over! Believing everything you read is another sign of ignorance…

  • Robin Tryloff

    I would like to second many of the excellent comments above in support of those with allergies. I was born with many allergies. I had nine years of desensitizing shots to minimize them, but the doctor said that my peanut allergy is so severe, I cannot even tolerate the small amount in the shots. For those who think four-year-olds should be able to manage their allergies, I am over 50 and still run into people who think “I am allergic” means “I don’t like.” I cannot tell you how many times I have informed an adult of my allergies, they have assured me the food they made is OK, I have take one bite and tasted peanut butter. Countless times they have responded, “You didn’t say you were allergic to peanut butter!” I wonder what they think peanut butter is made from? I try to only eat food I make — eating in restaurants only when absolutely unavoidable (i.e. for business). Just last week my sister made my mother’s recipe for chocolate cake, which I have been eating my entire life. When I had a reaction, she had to walk through her steps in making it to figure out how she had contaminated the cake. Banning peanuts is just a small step. Do people really rely on schools to provide their children exposure to foods so they will not develop allergies? As human beings, we need food to survive; please think about the quality of life we face as the very thing we need to live and thrive can kill us. Not only is eating (anything not prepared by myself) not a pleasure, it’s frightening. I am so envious of those who read a restaurant menu just to see what they are in the mood for, while I read it to see what, if anything I can eat, and then put my life in the hands of a server who may or may not understand or care about my allergies. For those who do not understand, I often use this analogy. When you say to me, there may have been nuts or cross-contamination in the kitchen, but I’m pretty sure nothing you are allergic to is in the food. I suggest they substitute the words “rat poison” for nuts, and think whether they would eat that food.

    • @BollywoodBlonde

      So well said Robin. Thank you for posting it.

  • Rosie

    Thank you for this article. I am an adult that’s lived with a peanut allergy since my youth that even my own relatives do not take seriously, no matter how many times I’ve been in the ER after accidental digestion. It’s very disheartening that regardless of how it’s stressed to people, they don’t seem to take the fact that food allergies could in fact lead to death, and even seem exasperated by the inconvenience it might pose to them.

  • Ruth

    My husband has severe allergies to eggs, milk, soy, and shellfish. This makes eating fast food and most pre-packaged snacks impossible. Peanuts are actually one of the few safe snacks he can eat while traveling! However, we have gone without eating on long flights to keep other allergic passengers safe (the flight attendants announced that for the passenger’s safety, no one could eat outside food brought on board; they then served a snack mix with a cheese coating).

    It would be great if the public were educated with true facts about allergies, rather than relying on conflicting anecdotes. Most people just don’t understand the difference between allergy and intolerance, or the range of severity of allergic reactions.

    I’m interested in the long term psychological impact that can occur from having such severe allergies at a young age. Even these comments show hints of anxiety and panic attacks.

  • just a patient

    I’m allergic to soy & certain types of shellfish (crab,shrimp & calamari, but not lobster or bivalves). My 4-year-old nephew is allergic to tree nuts. We both have Epi Pens.

    I can control what I eat. I’ve been taking allergy shots for 3 years to desensitize me to other allergens. I’m the poster child for what allergiests want to have happen when someone does the shot regimine. They have worked. I can eat small amounts of tofu & shrimp without reacting, a first in my life.

    My nephew? He’s had multiple anaphylactic reactions in the last 2 years. The first time he ever ate a pecan, his face swelled & he stopped breathing. Only the fact that my brother is a pharmacist who recognized the signs and got him to an ER within a few minutes saved him (there was a 3-day hospital stay afterwards to stabilize him). He doesn’t eat anything that his parents or his grandparents haven’t given him. When I make desserts for family dinners, they have to be homemade (no box cakes, since all of them are produced in factories that are also used to produce items that contain nuts), and they can’t contain any nut products, including nut oils.

  • Lindalou

    Thank you for you post and for those with positive and understanding replies. I do get tired of those who act as though they’ll die if they cant eat peanuts on a plane. Sometimes I wish the most negative would wake up with a food allergy someday just to experience what it’s like. It can happen you know. I know someone who, out of the blue, in his late 20′s, was all of the sudden allergic to all nuts. Quite a lesson to learn. Even my father wanted to argue about my sons allergy. Not sure why he thought he knew more than the highly respected allergist we were seeing. It is a crazy an difficult life. I constantly battle everyone about how careless they can be with my sons life, even his father.

  • http://www.BocaConciergeDoc.com Steven Reznick MD

    My wife is a pre school teacher in a Hebrew Day School. The class is peanut free. When they had a child with egg allergies the school went egg free. This included not having hard boiled eggs served at the traditional seder meal . It is an adjustment for health and life.
    My objection is the school , while private , has no school nurse. Parents
    send in epi pens, medications to be mixed for nebulizers, medications for subcutaneous injection, and expect the non medically trained teachers to administer the medications when appropriate . The teachers take a CPR course and are certified. My wife would do anything to save the life of one of her students but at what point is it unfair to ask the teacher to take on this responsibility?

    • Andi

      Are you blaming the parents for having her take on the responsibility or the school for not providing a full time nurse?

      • http://www.BocaConciergeDoc.com Steven Reznick MD

        I am blaming both. These are young kids 3 years old. I blame the school for not having a school nurse. I blame the parents for not demanding that they hire one and for making the decision to send their children to a school with no nurse. Yes, if you have a child who has a life threatening medical condition, I think putting them in a classroom and asking a teacher to administer medications with little or no training is irresponsible and dangerous. Teachers did not train to be nurses or paramedics.

        • Holly

          I don’t know where you live, but in Canada none of the three schools that my children have attended have school nurses anymore. Their primary school was too small, my daughter’s middle school was larger, and had a nurse’s office, but no nurse was ever there. She is now in a large (1800+) high school that also does not have a school nurse. The fact is that when a person has an anaphylactic reaction the epi-pen has to be administered a.s.a.p., that means that if the child is too young to do so themselves, the adult has to take responsibility. In Canada (at least in Toronto where we live) teachers are specifically trained for just such an event.

          • http://www.BocaConciergeDoc.com Steven Reznick MD

            This is a private pre school in a relatively affluent area of South Florida. There are multiple other pre schools that have a nut free policy and have a school nurse. I believe teachers who wish to go into Special Education programs receive medical training beyond CPR but generally an elementary school teacher in our state does not. There are liability considerations as well for the teacher and her family that may not exist in Canada.
            Every parent who has a child with a particular problem that is special and unique wants to mainstream their child. In most cases the funding does not exist ( due to taxpayor elected school boards not allocating the funds) to address every individuals special needs. There is an inherent risk in sending your child to a mainstream classroom if the child is unable to distinguish potentially fatal foods or situations and the staff does not have the experience and training to recognize the problem quickly and treat it. Parents of mainstreaming seem to accept this risk until there is a bad outcome.

        • Andi

          So just wondering those of us who have no other option financially but to put our child in the public school to which they are assigned and that school has no nurse what should we do??????? Assuming that home school is also financially of the table.

    • http://www.kidswithfoodallergies.org Lynda Mitchell

      The Department of Justice vs. La Petite Academy case from 1998 put the responsibility for this issue squarely on the shoulders of the preschool or daycare, not the parents. http://www.ada.gov/childq%26a.htm (see q. 19 and 26). Having said that, q. 2 indicates that Title III of the ADA doesn’t apply to religious schools.

  • Frank in L.A.

    Despite the 30+ comments on this thread, no one still has provided anything more than some anecdotes concerning statements like “Some kids are so sensitive that mere residue left on a toy from someone having eaten a cheddar cracker can send them to the hospital with a reaction” and that we should “ban peanuts on planes”

    If it is so clear that the “cheddar cracker” incident and the fear of other people eating peanuts on airplanes represent actual hazards, why is it that no one has any evidence other than their anecdotes?

    We do not approve/disapprove new drugs on the basis of anecdotes posted on the internet, so why should we adopt policies about snacks on airplanes on the basis of anecdotes posted on the internet?

    • Anne Montgomery, MD

      OK, Frank, here’s one specifically about airplanes. Again the minimal residue issue will NOT be a clinical trial. No one will deliberately expose people with allergy to even tiny amounts of an allergen to “see what happens”. That study would never pass an institutional review board for protection of research subjects. We will only have case-report data for that issue. Given what we know about allergy, it is plausible that a minute amount of allergen could cause a significant reaction in some very sensitive individuals.

      We are talking about potentially LIFE-THREATENING reactions on an airplane, vs the inconvenience of people not eating peanuts for a couple of hours. I am a physician and have attended (as a volunteer) to people having serious medical issues on airplanes. It’s pretty scary for the person, and for the crew, and for the people trying to help. As I said in another post, I used to get down and find dropped peanuts under my seat. I almost always found some. So even if I chose to not accept any peanuts, my peanut-allergic toddler might have had a good chance of accidentally discovering a peanut on the airplane if I hadn’t been so vigilant.

      No, we can’t protect every allergic kid from every possible exposure. But we can and should take REASONABLE precautions and when a young kid is known to be allergic, his/her environment should be cleared of that allergen to whatever reasonable extent the adults around him/her are able to do so.

      Ann Allergy Asthma Immunol. 2008 Jul;101(1):51-6.
      Allergic reactions to peanuts, tree nuts, and seeds aboard commercial airliners.
      Comstock SS, DeMera R, Vega LC, Boren EJ, Deane S, Haapanen LA, Teuber SS.
      Division of Rheumatology, Allergy, and Clinical Immunology, Department of Internal Medicine, University of California, Davis, School of Medicine, Davis, California, USA.
      Comment in:
      Ann Allergy Asthma Immunol. 2008 Nov;101(5):556-7.
      Abstract
      BACKGROUND: Minimal data exist on the prevalence and characteristics of in-flight reactions to foods.
      OBJECTIVES: To characterize reactions to foods experienced by passengers aboard commercial airplanes and to examine information about flying with a food allergy available from airlines.
      METHODS: Telephone questionnaires were administered to individuals in a peanut, tree nut, and seed allergy database who self-reported reactions aboard aircraft. Airlines were contacted to obtain information on food allergy policies.
      RESULTS: Forty-one of 471 individuals reported allergic reactions to food while on airplanes, including 4 reporting more than 1 reaction. Peanuts accounted for most of the reactions. Twenty-one individuals (51%) treated their reactions during flight. Only 12 individuals (29%) reported the reaction to a flight attendant. Six individuals went to an emergency department after landing, including 1 after a flight diversion. Airline personnel were notified of only 3 of these severe reactions. Comparison of information given to 3 different investigators by airline customer service representatives showed that inconsistencies regarding important information occurred, such as whether the airline regularly serves peanuts.
      CONCLUSIONS: In this group of mainly adults with severe nut/seed allergy, approximately 9% reported experiencing an allergic reaction to food while on board an airplane. Some reactions were serious and potentially life-threatening. Individuals commonly did not inform airline personnel about their experiences. In addition, the quality of information about flying with food allergies available from customer service departments is highly variable and, in some cases, incomplete or inaccurate.
      PMID: 18681085 [PubMed - indexed for MEDLINE]

    • Andria

      How would you get any “evidence” as you call it there would NEVER be a trial set up using children as guinea pigs to prove they can be harmed by touching residue. What parent would let their child participate? And that type of test would never be approved in the first place. It is not testing a drug or treatment, it would only be a test that tortured children. We don’t do tests on people just to prove a point.

    • Anonymous

      Frank-
      If you saw anaphylaxis from residue, you would understand. I watched in horror as my 18month old broke out in large red rashes, followed by asthma as she used the tray table on the airline to play. Because we had large doses of antihistamine and prednison with us, we were able to stop the reaction from progressing.  had we not medicated and washed the residue off of her immediately, that plane would have been forced to make an emergency landing.  With 100′s of choices for snacks, it should not be an issue for  planes to switch to a non life-threatening food option.  

  • http://nycpokerchick.blogspot.com Poker Chick

    As a mother to a 6-year old with multiple food allergies, THANK YOU for posting this. Your comments were right on.

    • Frank in L.A.

      You’re welcome.

  • http://www.BocaConciergeDoc.com Steven Reznick MD

    I saw an article from the Duke University College of Medicine Department of Allergy and Immunology from 2007 presented by David Nash MD at the American Academy of Allergy and Immunology meetings describing successful prevention of Peanut allergy with oral immunotherapy. They fed children small amounts of peanut material and slowly and gradually increased the amount. They had very good results. I am neither a pediatrician or allergist. Do any of you physicians or parents know if there is a followup to this study and if it was so successful why isnt it used more often?

    • Andi

      I have looked into this issue extensively. Unfortunately my child is NOT a candidate for 2 reasons: 1) she is only 2 years old, children must be over 7. 2) Some childrens allergies (like my daughter’s) are too severe to participate. So it is not the magic cure it has been made out to be. Also the treatment is NEVER complete it is daily a maintenance issue.

    • @BollywoodBlonde

      Does “peanut allergy prevention” imply there was no peanut allergy diagnosis but a relative with a peanut allergy and they were trying to prevent it?
      I know of food allergy desensitization trials. Our child is too allergic to participate and the results I think more work than don’t. Some kids come out of it more sensitive but I think most kids came out of it more desensitized to their allergy and as long as a minimum amount of the thing they were previously extremely allergic to is ingested daily that keeps up their lack of immune response to it.
      My information and research was done in the summer of 2010 and I was most interested in the baked milk (20 min at 350F) allergy study which would have let my child have pizza but not dairy milk… which did not work out for us.

  • James

    Frank in LA…….

    Out of curiosity can you please explain to the group two things?

    1. your educational background? Do you have any back ground in biology or science? You keep asking for empirical data and dispelling anecdotal evidence yet I wonder how much you are actually able to decipher a scientific journal article? Can you truly decipher the statistical significance of a P value of .05 or .01?

    2. Do you have any financial interest in the food industry? In scientific journals of which you speak there is a disclosure of interests along with the data. Can you tell us if you work or represent a source of common allergy producing food products?

    The only reason I can imagine opposition to an effort to improve the qulaity of life for others is a monetary interest or that you are personally a stakeholder in this outcome.

    So please Frank in LA, enlighten us as to why you chose this battle…..

    Thanks,

    James
    RN, BSN, CCRN, PHRN, Mobile Intensive Care Paramedic
    Student Registered Nurse Anesthetist.

  • @BollywoodBlonde

    I don’t understand how anyone can trust anyone outside their own home when it comes to highly sensitive allergies. My child was once age 7 and in school and we have 2 rules.
    1. don’t eat anything you haven’t taken from home.
    2. if you would like to make an exception to the rule call my cell with an ingredient list

    We have not had an issue nor do I expect us to… we will see what the teen years bring as my child gains more independence. I, in preparation, subscribe to Allergic Living magazine (the best food allergy magazine in my opinion) and I read my child the article son how peer pressure may impact his decisions as he gets older and honestly talk about what to expect from his life and his future so he is aware and can make decisions or hear my opinion on how to be safe and still have fun.
    My kid at age 7 did meet up with a teacher or two trying to be kind who offered him food. He brought them home every time and just said thank you and that he had to check with his mom.
    I wish I could protect all food allergy kids from anaphylaxis. XO
    Huge hugs.

  • Anne Renda

    Great article! My friend works in a pre-school and frequently talks about the concerns related to allergies.
    Allergies and cancers were so infrequent in the 1950′s and are so currently abundant that I have to believe GM food additives and other environmental changes are related to this change.
    I hope the medical community can get behind requiring more and better research in these areas.

  • Tom

    My son was in 6th grade when he answered a question correctly – who said “there is nothing to fear but fear itself”. His teacher gave him a candy bar as a prize – she said it wasma mocha rocha. Turned outmto be an Almond Roca and he is very allergic to almonds. He ended up in the emergency room and scaring incredibly. Teachersmdo need to know their kids – that really is not optional. And they need to understand allergies – my son knew he was allergic to almonds

  • http://informationhighwaycardandgiftshop.com Lou Barba@informationhighwaycardandgiftshop.com

    Hi Gina,

    One of the things I do is drive school busses. A few years ago, the district recognized the dangers of food allergies and implemented a no peanut zone plan. And on the busses, kids are not allowed to eat or drink at all, unless they are diabetics. Like all plans, it requires a lot of cooperation. You can imagine the impossibility of enforcing the ban on the bus. I hope never to have a child have a problem when it could take a half hour bfore help could arrive.

    Lou

  • Anonymous

    IIRC, food allergies are NOT like pollen allergies – there are no shots or drops that can desensitize a person (although research is being done). I don’t think people understand this when they suggest that you just feed the kid the allergenic food till he gets over it.

  • Anonymous

    I would like someone to demonstrate how food in the classroom enhances learning? More specifically, how did that chocolate hazelnut add to a little boys’ education?  A Simple solution of avoiding food in the classroom would eliminate the controversy of safety and inclusion.  Avoiding food breaks gives kids and teachers back valuable time they need to teach.  Do we really need to break for 25 birthday and 4-8 holiday celebrations in the classroom with sweet treats? (That is usually on top of every special event during and after school that also involve baked goods and sweets). School districts need to give serious consideration to the rising number of diabetic children (now 33%-?), and what we know about sugar, trans-fats and white flour in addition to life threatening food allergies.  Could we celebrate with charitable activities once a month to honor those birthday children or holiday? Could our children uses that treat time to get extra recess, a special trip once each quarter or other special event?  Why is it so hard for our school districts to change their old ways? Let’s be creative and bring our thinking up to modern day.  

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