Tips for Patients with Food Allergies at School and at University

FOOD ALLERGIES IN THE SCHOOL SITUATION

Starting school, moving to a new school or starting high school can be a daunting time for food allergy sufferers and their caregivers.

More and more schools are starting to understand the severity of allergies, yet there are still many shortcomings in the school systems in keeping the allergic child safe and socially included.

UNDER ALL CIRCUMSTANCES, WHETHER ALLERGEN-FREE OR ALLERGEN-SAFE, THE FOLLOWING STEPS NEED TO BE TAKEN IF THERE ARE FOOD-ALLERGIC CHILDREN IN SCHOOL :

• Awareness of the child’s allergies. Each school should have a form capturing medical conditions, including allergies and chronic medications, to be completed by parents/guardians at the beginning of each year.
• Eliciting the support of co-learners, their families and school staff to limit the presence of specified food allergens on the school premises, in tuckshops, and at after-class activities, parties, trips and school events.
• In the case of a severely allergic child, a letter written by the child’s doctor/allergist to the parents/caregivers in the class explaining the need for allergen awareness will go a long way in educating learners and parents, and in gaining their support.
• Avoiding use of common food allergens in classroom projects or activities, as rewards or incentives if there is a food allergic child in the class. Suitable “safe treat” options can be discussed with the child’s parents or doctor.
• Vigilance around meal times and a designated routine for meal times are imperative, especially for the younger children.
• There should be absolutely no lunch box sharing in the case of an allergic child.
• A general habit that children wash their hands before and after meal times to reduce the carriage of allergen.
• The allergic child must have an official emergency treatment plan for accidental ingestion of allergens. This includes identifying a reaction and the action that should take place. We suggest that this action plan be kept in the child’s classroom, as well as in the school secretary’s office. The action plan should include a photo of the child and should state where the child’s emergency kit is kept.
• Schools should be encouraged to form a small “allergy action committee” (or a chronic illness committee) consisting of staff members who are well versed in identifying and treating allergic reactions. Online training courses are available for school staff. For schools checklist see here>>

Your allergist can assist you with action plans and letters to the school. For more downloadable forms and info click here>>

FOOD ALLERGIES IN THE UNIVERSITY SETTING

Starting university is a challenging time for most, but especially those with food allergies, as they “go out into the big world” on their own. Adolescents will be well versed with their food allergies by this stage, knowing how to label-read and knowing which types of food potentially contain the food allergen they are allergic to. However, adolescence and early adulthood is typically a “danger time” for more severe food allergic reactions in view of greater risk -taking behaviour, coupled with the desire of fitting in with their peers at meal times and at restaurants. Below are some tips  on how to navigate your way safely through university if you have food allergies:

Before starting University:

• Liaise with the student accommodation as to whether their catered accommodation will take into account food allergic students in their meal preparation, or whether self-catered accommodation may be the safer option.
• Either way, consider keeping a small refrigerator in the allergic student’s room to keep a stash of foods which are safe and free of contamination.
• Have an updated allergy emergency action plan available.
• Have your complete and up-to-date emergency kit available including an in-date adrenaline autoinjector.
• Strongly consider wearing a medical alert bracelet or jewellery.
• Find a nearby doctor who can become familiar with your allergies, and who is prepared to provide adrenaline autoinjector prescriptions and other prescriptions (for example asthma medications) on a regular basis. Visit this doctor before starting university to discuss your allergies.
• Also be aware of campus doctors, their location and their opening hours in case of an emergency
• Be aware of the local ambulance numbers, and the nearest emergency facility in case of an accidental exposure and reaction.

Once at University:

• Carry your emergency back containing an antihistamine, action plan, adrenaline autoinjector and in some cases asthma pump with you at all times.
• Store your adrenaline autoinjector in a cool dry place under 25 degrees Celcius in its light-protective container. Do not refrigerate or freeze. Regularly check the expiry date.
• Tell your friends, lecturers and housemates about your allergies and what to do in the event of a severe reaction. Show them how to use your adrenaline autoinjector. It is a good idea to have a trainer pen available to demonstrate this to your friends.
• Let your friends know where you keep your emergency pack.
• When eating at a cafeteria, always read the labels on pre-packaged foods, and always inform the caterer of your allergies every time you are dishing up or buying food there.
• When shopping, label read on every occasion, even if you have eaten the particular brand before. Labelling laws in South Africa and many countries abroad stipulate that the most common food allergens are clearly labelled on the packaging.
• When eating out, it is a good idea to contact the restaurant beforehand to check out their menu and narrow down your “safe” options. When at the restaurant, tell the waiter and chef about your allergies, and also make sure those going with you know about your allergies and the whereabouts of your emergency pack.
• Shared desks, computers or working spaces in lecture halls and libraries can host allergens. Wet wipes can be used to clear away allergens on the working surface.

What factors could increase the chances of an allergic reaction?

• Alcohol can increase the severity of an allergic reaction.
• Alcohol and recreational drugs may cloud the student’s judgement making them more likely to eat “forbidden” foods, and less likely to spot the early signs of a reaction and take the necessary emergency steps to prevent progression.
• Certain medications such as non-steroidal anti-inflammatories can increase the severity of a reaction.
• Illness such as colds or flu can put you at risk of a severe allergic reaction.
• Stress and sleepless nights can make you more susceptible to a severe allergic reaction.
• Smoking is likely to make asthma worse, which in turn makes allergic reactions more dangerous.

“Close encounters”

• Remember that allergens can stay in the saliva for several hours so kissing presents an unintended chance of reacting if your partner has recently eaten an allergen which you are allergic to (even if they have brushed their teeth!).
• Latex and milk can be found in condoms, which may be an issue for some allergy sufferers. Ask the manufacturer’s advice on allergens used in the production and identify safe brands for use.

For more support

• Join Food Allergy Support South Africa