For the first time, federal health officials are giving schools recommendations on how to handle food allergies in students.
The guidelines, released Wednesday by the Centers for Disease Control and Prevention, are voluntary but they could make schools safer for millions of children, advocates say. They also could mean more classrooms will ban food rewards, snacks and party treats made with nuts, milk, eggs and other common allergens - changes kids without allergies are sure to notice, too.
Fifteen states and many school districts already have guidelines in place, but the CDC recommendations "are now the gold standard," says John Lehr, chief executive officer of Food Allergy Research & Education, an advocacy group based in McLean, Va. The group was among those who worked on the guidelines with federal health officials.
CDC estimates that 4% to 6% of children have food allergies and that 88% of schools have at least one student with a food allergy.
"When allergic reactions occur, they can be severe and can mean a child takes an ambulance ride or even dies," says Wayne Giles, director of the CDC division of population health. "These guidelines are about preventing those events."
Parents can play a crucial role by letting schools know when children are diagnosed with food allergies, Giles says. Parents and schools can then work together on management plans.
CDC says schools should:
Avoid using foods identified as allergens in class projects, parties, snacks, science experiments and cooking exercises in allergic children's classrooms.
- Train staff to use injecting devices for the medication epinephrine (such as Epi-Pens) when students have severe allergic reactions - known as anaphylaxis.
- Make sure children who can use their own injectors can get to them quickly.
- Make sure children with food allergies are not excluded from field trips, extracurricular activities, physical education or recess.
- Consider designating food-free zones or allergen-safe zones.
Use non-food incentives for prizes, gifts and awards.
"We want all kids to be safe and included," Lehr says. "If the kid next to you gets a candy bar as a reward but you get a pat on the head or a sticker, you feel bad. But when everybody gets a sticker, you feel good about getting a sticker."
While the changes can affect children without allergies, most school communities are willing to make them "when they are made aware of how serious food allergies are," says Sally Schoessler, director of nursing education for the National Association of School Nurses in Silver Spring, Md., which also worked on the guidelines.
She notes that many children who have never been diagnosed with a food allergy have a first allergic reaction at school, and the guidelines will help schools respond to those emergencies. "We are working to keep all of the children safe all the time," she says.