Friday, September 25, 2009

Interview on School Experiences with Food Allergies: Flourishing with Food Allergies by A. Anderson

Last month, I reviewed Flourishing with Food Allergies by A. Anderson. As many of my readers know, I've shared here that my 10 year old son Andrew has major food allergies and the worst offenders for him are life threatening anaphylactic allergies to peanuts and tree nuts. This subject is near and dear to my heart and one that I have great passion for. As a mother, I want to protect my child from dangers and I also have the responsibility to teach him personal responsiblity and independence. When you are dealing with food allergies, it is a challenge to keep in balance. For me, the hardest situation is preparing for the new school year going back to school and ensuring all plans are set into place and that my son is in a safe environment. There are no guarantees and that is the scariest part for parents of children with life threatening food allergies. You have to prepare, cover the bases, educate and set up action plans so that your child and the teachers, students, staff, bus drivers, support staff are all aware. Each year, there is more awareness in my son's school district but there are always challenges and bumps along the way.

In reading Flourishing with Food Allergies, Ms. Anderson's older son had just finished kindergarten and was entering first grade. I was interested in hearing her perspectives from her school experiences with her son and to share them with you.

Here is an interview with Ms. Anderson that answers some of those questions:

How have you handled the school situation and do you have any further thoughts and experiences?

Before school started, I brought my son in for a “challenge test” where he drank milk at the doctor’s office. We decided to do this because while his skin prick test was positive, the blood test for dairy came back negative. Further, I felt that after five years I really needed to know if he would actually react to drinking or eating dairy. The results of the test where that when milk was placed on his lips there was no reaction, but, when he was given ¼ teaspoon he developed a hive on his lip area and started to feel uncomfortable in this throat which manifested in his clearing his throat repeatedly. This reaction occurred within about one minute and the doctor administered epinephrine. This reaction was devastating to me, as I had hoped he had outgrown his dairy allergy. But to react to such a tiny amount of dairy really saddened and worried me a great deal.

I immediately called the nurse at the school, as the first day was approaching. I explained the situation and the results of the test. She called a meeting with the principal and my son’s school teacher so that we could all decide how best to keep him safe. We agreed that he would use a tray on which to eat his snacks and lunch to avoid unnecessary contact with allergens and also spilt milk--literally. We also agreed that he would sit at the peanut-free table so that he didn’t have any unnecessary exposure to peanuts or tree nuts (hopefully) since we have not given him either of these in the hope of fending off an allergy by introducing them when his digestive system has healed and matured. He was also placed in a peanut-free classroom with a teacher trained on health issues and administering Epi-Pens, who agreed to never allow him to have any food other than that brought from home.

Although I was emotionally drained from the worries of my son entering kindergarten, he was thrilled and thrived in school. My other worries about his not attending pre-school, were apparently unnecessary, because his teacher reported that his academic skills, attitude and social skills were all excellent and he was a pleasure to have in class. I remember feeling so pleased when she told my husband and me that every morning when she asked him how he was today, he would respond, “Great!”

But there were a few issues that did arise.

The first was the school bus. My son desperately wanted to take the bus. Since he was too little to carry and administer an Epi-Pen himself, we did not ask for permission that he bring his Epi-Pen Jr. onto the bus. We felt it could also endanger other children if it was taken from his person. So I began to question the emergency procedures of the bus. My questions included: Does the bus driver know how to administer an Epi-Pen? How long would an ambulance take arrive at the bus if there was an incident? Would the ambulance have an Epi-Pen Jr.? Would the ambulance emergency personnel know how to administer it? If there was a first responder (police or fire) would they have an Epi-Pen Jr. and know how to administer it?

As I began to question, I found the answers to my questions through the local fire department chief. She was pleasant and very responsive to my questions. She asked for time to work through the issues, the plan and to discuss the execution of an emergency process involving an allergic reaction with her school and bussing company counterparts. The process took a few months, but she identified the problems, carried out discussions at the regular meetings and developed a solution along with the means for improvements to the process as required by law. Specifically, while the ambulance would have the Epi-Pens and trained personnel, there was a communication gap that existed between the first responder and the school: There was no private channel over which to communicate with the school so as to ascertain which children had health issues on a particular bus that is in an emergency. So she budgeted a few thousand dollars to purchase this private channel so they would be in compliance with HIPPA privacy laws. She also set forth an interim solution until that channel was in place.

I am providing the details of the bus emergency plan that she worked up on my blog at Flourishing With Food Allergies. It is important for me to state that if parents ask these questions of their own town, that they do so respectfully. A parent’s concern for their child should not manifest into anger at the town officials or school employees. Patience is important as well. This process took several months--but it was well worth the effort and the peace of mind it gave me. The fire chief even thanked me for being patient and nice--which leads me to believe that people often get impatient and angry over issues such as these.

The second issue that arose during the year was in December, when a friend of mine who volunteered at the school, advised me that my son was sitting alone at the peanut-free table, because the teachers moved him to the end of the table to avoid the other children at that table who were eating diary. This made my friend feel sorry for him and made my heart ache. Because my son had no reactions at all over the first four months of school and showed an ability to understand and comply with his allergy, my husband and I decided that he should be moved to the regular lunch table. But the nurse at the school was not pleased about this decision, as she felt he was safe where he was sitting.

Even so, I persisted with this change and explained that I had to be concerned not only with my son’s physical well being, but with his emotional well being as well. My pediatrician strongly concurred with me and sent the nurse a note stating that my son should be fine at the regular lunch table since he was not sensitive to dairy by touch or through the air. It took about four weeks to get the school to agree to move our son. During this time, I wrote two letters requesting the move, the pediatrician faxed in his note, the nurse and I had two ten to twenty-minute phone conversations. The nurse also requested that I come in for a lunchroom meeting with the principal, cafeteria manager, teacher assistant and her to see the “chaos” of the lunchroom. Finally, she requested that I sign a waiver. Only then was everyone agreeable that our son could sit near people eating dairy at the peanut-free table. If that went well, then he’d be moved to the regular lunch table after a few more weeks. During the entire year he ate his lunch on a tray to avoid spills and to serve as a reminder to others that he has food allergies. (He said he liked eating on the tray.) Once he moved to the regular table, he seemed quite happy and there continued to be no reactions.

The third issue that occurred was in his peanut/tree nut-free classroom. One time when I was emptying his backpack, found his brown paper bag that contained his snack had a “NUT BAR” in it. One of the other children had brought these in and the teacher sent one home in each child’s back pack. This nut bar had both peanuts and milk. I was perplexed and disappointed with this decision. I asked the teacher why she did this, via email, and she replied that she thought someone in our house might enjoy it. I disagree with this decision and kindly let her know my preference for the future. On another occasion, she advised me that she planned an experiment where the children were to make butter from shaking heavy cream in a jar. When I expressed my concern to her and offered other science experiments that I found on the Internet, she decided not to do the “butter-making” experiment.

In summary, the issues for us involved:

  • Confirming the school bus, town emergency and school personnel had a school bus emergency procedure in place that took food allergies (and other health issues especially asthma) into consideration;

  • Starting off at the peanut-free table at lunch, then migrating to the regular lunch table half way through the year, when no reactions occurred; and

  • Communicating with the classroom teacher about candy bars and experiments in the classroom.

Has it changed your perspectives on school that she wrote about in the book?

I don’t believe so.

I feel that not sending my son to preschool was a good decision for him. He was ready for kindergarten both academically and socially. His spirit was good. He had no issues regarding separate from me. In fact, he once told me he didn’t miss me at all, then he thought about what he said, and added, “Well maybe a little mom…” I think in an effort to make me feel better. The only con to this decision is that I was less prepared than I could have been. Specifically, I was not used to others caring for my son so I felt quite worried when he entered kindergarten.

I feel that doing the challenge test was necessary to confirm my son’s reaction to dairy for him to know, for me to know and for the school nurse and teacher to know. Although the results were terrible, and made me feel worried, I also felt somewhat vindicated that my careful avoidance of dairy over the past five years was necessary and that I hadn’t been overreacting or “crazy.”

In summary, I feel it was important for me to think through each concern carefully and question various school and bussing procedures. I also feel that being proactive and initiating communication was important to alleviate worries and obtain answers. Further, reconsidering previous decisions such as the best place for my son to sit during lunch is something that I think is reasonable. Also, being patient, kind and respectful is important for everyone involved, but mostly for the sake of the child’s health and happiness.

Thank you to Ms. Anderson for sharing her hearfelt and personal experiences. You can read more information on her website Flourishing with Food Allergies.


  1. I can't imagine how scary it is when your child has a life-threatening allergy. This sounds like an insightful read for anyone who has to deal with this.

  2. Thanks for posting this. I'm sure it will be helpful for other moms who are in the same situation.


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