Archive for January, 2007

Melanie’s general round up on anaphylaxis in schools

Another of our newsletter subscribers Renee from Brisbane has asked a fantastic set of questions.

Basically Renee has just found out that one of her twin boys has anaphylaxis to nuts, and she is having greif with her child care centre that the boys go to, and adjusting to the new lifestyle that we find ourselves in. I won’t post the email, because it was quite personal, but….

Here is what Melanie had to say about it.

Keep in mind that Melanie hasn’t blogged for a very long time, since she gets so emotional when writing about allergies. Which is one of the main reasons why her book has taken so long.

Hi Renee,

Our thoughts are with you during this very stressful and overwhelming phase of life with anaphylaxis. I hope you were able to enjoy Christmas. It is a very challenging time!!

I’m glad you have been able to get an appointment with Jane so quickly, her waiting list is usually over 18 months.

Unfortunatley there is no way of telling how sensitive they will be to the trigger, other than by experiencing different scenarios. Tests only reveal the severity of a potential reaction, not how they can be triggered. Fortunatley, contact reactions are mostly kept to localised skin irritation (eg hives, dermatitis) and don’t usually progress further to an anaphylactic reaction….EXCEPT if the allergen is in contact with the mouth or eyes. This could potentially progress very rapidly. The incidence of anaphylactic reactions through smell is very, very small (yet possible). My son is anaphylactic to dairy products, and has had a major reaction from touching a small droplet of milk and unwittingly rubbing his eye, yet does not react from milk boiling on the stove (not ours….at the shops) nor being surrounded by the endless sources of dairy all around him on a daily basis…….thankfully!!!! An old preschool friend reacts moderately to her allergen just by being near it. It is unfortunately just by trial and error, and being equipped at all times to deal with it if it happens.

Be very wary of “nut free zones”, or any “free zones” for that matter. There is no such thing. For many reasons they are incredibly dangerous. To name a few:
– You can’t rely on other people’s ability to read labels correctly (staff or parents);
– it breeds apathy from the teachers as they can assume that all lunches are friendly, and not check who they are sitting next to, or be looking out for reaction symptoms;
– some people couldn’t really care about other kid’s issues and will simply defy the “ban”.
“free zones” are not usually advocated by anaphylaxis groups. “Awareness zones” is a more realistic option.

We tried to change preschools when we moved 2 years ago. Both were a c&K center. At our first place there where were no bans in place (could you imagine banning dairy products and eggs from a kindy?) and we never had any reactions as there were procedures in place. Nearly every child had milk at lunch, not to mention the butter on their sandwhiches, yoghurt and cheese……aaaaagh! But, the teachers had all the kids wash their hands after every meal, and there were no problems. At the second place they already had a child with anaphylaxis there, so we thought it would be an easy transition. Wrong. It was a “nut free zone”. The kids lunches were never checked, the other allergic child was given a cake brought in for a birthday, which they later realised he wasn’t meant to eat, the teachers snacked on peanut cluster biscuits after home time which they kept in the fridge with the kids lunches! Upon seeing all of this, we had no faith in their ability to look out for our son with a product that wasn’t “banned”. It isn’t taken seriously by all people. You really have to trust your gut feeling. After 2 weeks of spending every lunchtime at the center and crying myself to sleep at night, we changed him back to his old center and spent a fortune on petrol to keep him safe. Sometimes you can’t change the system, as people are just people. “free zones” really only offer a false sense of security for the parent of the allergic child, and the staff.

All staff needs to be informed of your son’s anaphylaxis, relief or otherwise, by the director or teacher in charge. AND the medicine must follow him, without a doubt. These are two fundamental things that ensure the safety of your child. It sounds like very bad management. The fact that they hadn’t even put the action plans up would really concern me, making me think that the safety of my child was not a priority of theirs.

Craft boxes are notorious for containing things our kids wouldn’t be able to use. We got around that by having his own craft box with things we brought in, or had been checked by us before going in his box.

You definately need to research schools thoroughly. The potential for problems is so much greater than in a confined room where the kids are closely monitored all day. I have written about our experience with our school search as a blog entry. Again trust that gut feeling. You can usually tell from the interview how it will be handled. We found the state system did not offer anything that we felt comfortable with……they tuned out when they realised it was dairy they would be dealing with, along with peanuts, eggs…….. We have found a private school within 10 mins from home that have been awesome. Not one anaphylactic reaction all year (touch wood). We never thought we would be able to send him to school. He completed grade 1 last year, grade 2 in 2007! However, the jitters are starting at the thought of having to deal with a different teacher this year.

I hope I have helped….. even if only a little.

Take care,
Melanie

Does having anaphylaxis make you the food police?

I’ve been getting some great questions from our newsletter subscribers so keep them coming.

I thought I’d start answering them on the blog, since they will most likely help others as well.

Jody of Canada writes this:

I have a seven year old daughter who has a severe peanut allergy. Is there any breakthrough news I should be aware of regarding this allergy? Also, the school which my daughter attends is “peanut Aware” not “peanut free”…is there anyway to change this and make it manditory for the school to make sure lunches are checked? For my daughter as well as another little boy in her class, someone bringing a peanut product to school is like bringing a gun and pointing it directly at her/him. It really is scary.

Yes it’s scary but you are thinking about this from the wrong direction. My son has dairy anaphylaxis and is therefore at more risk because more food contains dairy.

They are both as deadly as each other, just one has more exposure. Banning foods does not work. Period. You need to work on putting risk reduction measures in place at the childrens schools instead, and a solid action plan should something happen.

And something will happen, it always does, no matter careful everyone is.

We do not advocate banning any substance. This is the stance of the Anaphylaxis Australia, and most likley the Food Allergy and Anaphylaxis Network (FAAN) and Anaphylaxis Canada as well (but I’m only guessing on that last two). Someone from America and Canada can confirm that for me.

Declan has been through 3 years of schooling now with Anaphylaxis to dairy, and every day we hope that he doesn’t have a trip in the ambulance to the hospital or worse come home in a body bag.

We train the staff yearly, and have a solid action plan in place. The children in the class are in fact the best line of defence in taking care of their classmate. Children are more accepting of changing and looking out for their food around there classmate than their parents are. It’s disgusting but true.

It is up to you to work with the staff and school administration to have the whole class learning and being educated by having a child with a food allergy in the class and the school in general. With the children in the class taught early in the school year about food allergies it’s amazing how they look out for food on the ground, or if someone spills food on themselves.

If you avoid the issue, you are asking for big trouble, not just now but in the future. The child has a food allergy, so teach everyone around you how to reduce risk and notice the signs of food allergy and your child and everyone else will be better off for it.

Granted, you may have to search around for a school that you feel can handle the challenge (we did), but it’s no less of a challenge for the school than having a wheelchar student, or a student with learning disabilities, they just have to learn and teach new skills.

Sorry for the rant, but you have to change your thinking, or you’ll go crazy (more so than the rest of us) dealing with anaphylaxis.

Aaron