The recent tragic death of teenager Natasha Ednan-Laperouse, who died after suffering an allergic reaction to a baguette, highlights the dangers that people who suffer with severe allergies face on a daily basis. For some, everyday food choices are a ‘life and death’ decision.
Thankfully, most of us can enjoy food without suffering any adverse reaction, but the prevalence of allergies in the UK has increased significantly in recent years. The Association of UK Dietitians (BDA) estimates that up to 10% of the population have a food hypersensitivity. Food allergies in young children are a particular cause for concern. Estimates suggest 1 in 40 children will develop a peanut allergy, and 1 in 20 will develop an egg allergy, according to the British Society for Allergy & Clinical Immunology (BSACI) in a 2011 report.
What are food allergies?
A food allergy is when the body’s immune system reacts unusually to specific foods. The most common food allergies are celery, cereals containing gluten, (e.g. wheat), crustaceans, eggs, fish, lupin, milk, molluscs, mustard, tree nuts, peanuts, sesame seeds, soya and sulphites.
Symptoms of food allergies
An allergic reaction typically triggers symptoms in the respiratory system, the skin or the stomach. Allergies can also exacerbate the symptoms of asthma. In the most serious cases, a life-threatening reaction called anaphylaxis can occur.
The main symptoms include:
It’s unlikely that a child will have all the above symptoms at once, but you should talk to the child’s parents to identify the most common symptoms for each particular child.
What is anaphylaxis and how is it treated?
Anaphylaxis is the term given to a severe, allergic reaction that occurs rapidly. In some cases, anaphylaxis can be life-threatening. Anaphylaxis can be managed with planning and care, but it must be treated quickly.
Treatments can be over-the-counter or prescribed medications such as antihistamines (often used for hay fever), or pre-loaded, adrenaline injection devices such as EpiPen®, Emerade® or Jext®.
Managing allergies in your setting
Since prevention is better than cure, there are number of things you can do to ensure your staff are well-informed and well-prepared if children in the setting have food, or indeed other, allergies.
Good communication is vital
Before a child starts at your setting, parents should be asked about any allergies the child has. This information should be given in writing and placed on the child’s file including:
You may need to ban certain foods from your setting
Many settings have a policy which bans certain foods to avoid contact with potential allergens. Nuts and products containing nuts are often excluded from menus and lunch boxes for just this reason – it’s better to be safe than sorry! You should communicate this to parents and staff and remind everyone when there are external trips or special events planned such as parties or cooking demonstrations. Where food may be provided by outside agencies or parents, extra care should be taken.
Write a care plan for each child with allergies
Studies show that children who have care plans to help manage their allergies, are less likely to have severe reactions. The care plan should be made available to staff so that they know what to do in the event of an allergic reaction. This should be written in consultation with the parents and the child’s doctor and shared with all staff.
Very young children will not be able to administer their own medication, so your setting needs a written policy regarding the management and administration of medicines. Talk to parents to ensure that the child always has their medicine on them. Best practice would also involve keeping a spare emergency kit in your setting (stored securely and at the right temperature).
Remember that medicines have a shelf-life like other consumables, so check medicines regularly. You could add a calendar reminder or diary entry to help you remember.
Another good tip is to have a clear, simple-to-follow, set of instructions stored with the medicine, including the child’s photograph and their contact details. This will save time in the event of an incident.
Staff must be properly informed and properly trained regarding allergies. It may not be necessary for each member of staff to be trained to administer the medication, as long as there are sufficient members of staff available each day, who are trained. Training may well be available through a community nurse or health scheme or you could ask a local doctor’s surgery to help.
However, ALL staff really need to be trained in prevention and how to avoid letting affected children come into contact with allergens, as well as how to recognise the symptoms of anaphylaxis.
The European Academy of Allergy and Clinical Immunology (EAACI) published guidelines aimed at early years and school settings which can be accessed here.
For more information see: anaphylaxis.org.uk