As I mentioned at this week's "Back to School Night" event, this year we have twelve children in our school with severe allergies (all ages, kindergarten through junior high). Although many food allergies can be managed through a program of strict avoidance of the allergen, reading food labels, and thoroughly washing hands, peanut allergies are different. Children with allergies to nuts can have a severe reaction if they have even the slightest contact with nut residue.
We have a 40+ page policy handbook for managing food allergies in school. We have laminated charts with photos of the children with severe allergies, so that all will recognize them. We have designated their classrooms, and all of the specials' classrooms, as "no nuts allowed" rooms. All staff have been trained in the use of an epi-pen, and how to recognize symptoms of anaphylactic shock. We have two peanut-free tables in the lunchroom which are cleaned with separate cleaning supplies.
In spite of all this, one of our kindergarteners still had a peanut reaction last week (he was treated with an antihistamine and is fine). Apparently, he touched something on the playground that had been touched by a child with peanut residue on their hands from lunch. The School Committee will be discussing the issue of peanut allergies at this week's meeting, but I welcome parent input as well. The question: should we make the entire school a "no nuts allowed" environment? (Yes, I know, but I can't send ALL the teachers home!)
While this question can't be decided by "popular vote," I do welcome parent input as we review our policies for the safety of all our children. Our school allergy handbook is now available on "Edline," under the "News" category. I encourage all families with questions about our policies to review this handbook.
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6 comments:
Dr. Miller we commend you for opening the discussion about making St. Paul a peanut/nut free school. We are also pleased to see the allergy policy posted to edline to help make everyone at school more allergy aware. Overall we feel that the current allergy policy takes many steps to make those with allergies safe at school, but falls short by allowing peanuts/nuts in the school. This was demonstrated when one student, our son, had an allergic reaction on his second day of school. Ultimately a “no nuts allowed” policy would provide the safest school environment for those with peanut/nut allergies.
Our son is a happy, energetic, typical kindergarten student, whom we love dearly. He is also a 5 year old with a severe peanut allergy. When we learned two years ago that he has a severe peanut allergy, we set about educating ourselves and him about living with an allergy. With a severe peanut allergy, just one peanut could harm our son, even kill him. He could die from coming into contact with even a minimal amount of peanuts (traces of peanut oil or residue, or by inhaling air/breath that has been exposed to peanut products). We’ve learned how to avoid peanuts, often foregoing a trip to the local bakery or ballpark, avoiding touching hands-on exhibits at museums, and bringing our own cake to birthday parties, for example. At the same point though, we understand he cannot live in ‘a bubble’ and will ultimately need to manage his allergy on his own. We do not, however, feel that a person in kindergarten or in elementary school is capable of managing a peanut allergy on his/her own. A child still needs the help and support of adults. For example, our son will ask an adult if something has peanuts in it before eating it. He looks to adults to help protect him and keep him safe. A school where nuts are not allowed helps to protect him and keep him safe. A school where nuts are not allowed also educates people on life threatening allergies and makes everyone more allergy aware.
The current policy of having a child wash his/her hands after ingesting peanut butter, while helpful, leaves the burden on a child for being responsible for washing his/her hands well so not to endanger his/her classmate. We believe it is safer not to have the nuts there in the first place. This shifts the burden from children to responsible adults who are packing the lunches.
We have heard concerns a nut free environment cannot be achieved and we respectfully disagree. Our son has attended 2 other schools, one a preschool, and another school that ranged from preschool through eighth grade, similar to St. Paul. Both of these schools were nut free. Our daughter’s local preschool this year has also asked parents to “help entirely eliminate peanut products from our school atmosphere.” We believe it is possible to achieve an allergy aware, nut free environment. We experienced them in the past. Indeed it would require effort at first, but we are sure everyone would agree keeping a child safe is worth the extra work.
We have also been told that a nut free environment would provide a false sense of security. We believe having nut free classrooms creates a false sense of security more than a nut free school would. For example, consider a situation that a parent has multiple children at St. Paul, with one in a nut free classroom. What if the lunches or snacks get mixed up on the way to school? This opens up risk to those with allergies. With all children currently able to enjoy peanut/nut products in the cafeteria, everyone could in reality bring in peanut butter and jelly sandwiches tomorrow or even worse, peanuts to crack open. Our son could be completely surrounded by items that could cause great harm to him in the cafeteria, with the exception of his nut free table. No one knows the exact level of exposure in the air that could lead to a reaction.
If there was a nut free policy, someone might make a mistake or forget and pack a peanut product, but we believe that would be a small percentage. Most people want to do the right thing and adhere to school policies. Having a nut free policy is a more proactive approach of eliminating the risk, rather than a reactive approach of being epi pen ready.
We realize some children love peanut butter, and it’s a convenient, easy lunch to assemble, but there are alternatives such as sunflower butter or soy butter. Both products taste similar to peanut butter, and are actually healthier than peanut butter. We are not asking that children never eat peanut products; we are just asking that they consume them outside of school.
We strongly and respectfully ask that St. Paul become a nut free school. It is not just a nice thing to do; it is the right thing to do. A young child cannot manage this allergy on their own. We cannot ask other children to take the burden of the responsibility for managing it either. We, as adults, need to step up and protect all children, and not just do what is convenient or easiest. Every child deserves the right to be safe at school.
Below are some highlights from a websites that hopefully will help us convince you to go peanut/nut free and to articulate the issues our child faces every day:
An estimated 12 million people in the US have food allergies (Food Allergy & Anaphylaxis Network). Approximately 200 die each year from food/allergy related reactions (CNN), with 43% of children having some reaction at school (ABC news). The number of children under 5 with peanut allergies has doubled between 1997 and 2002 (Food Allergy & Anaphylaxis Network).
Severe sufferers also may experience potentially life-threatening anaphylactic shock in response to ingestion of peanuts. Anaphylactic shock is an allergic reaction in which the release of histamine causes swelling, difficulty in breathing, heart failure, circulatory collapse, and sometimes death.
As many as one-third of peanut-sensitive patients have severe reactions, such as fatal and near-fatal anaphylaxis. ("Anaphylactic deaths in asthmatic patients," Allergy Proc., 1989) (medicine.net)
There is no cure for peanut allergy and no therapies that eliminate or reduce the severity of peanut allergy. Current treatments only address the symptoms of an allergic reaction once it has taken place. (The American Peanut Council)
Strict avoidance of peanut and peanut-ingredient is the only way to prevent an allergic reaction. (National Institute of Allergy and Infectious Diseases, The American Peanut Council)
Reactions can begin and proceed rapidly, in extreme cases proving fatal within minutes. Severe sufferers must use epinephrine (i.e., adrenaline) to help prevent anaphylactic shock. If administered in time, an injection of epinephrine may reverse the anaphylactic condition by quickly constricting blood vessels, increasing the heart rate and stopping, swelling around the face and throat, and relaxing muscles in the lungs. Once administered, immediate hospital follow-up is required. (National Institute of Diseases, American Academy of Allergy, Asthma and Immunology).
Please make St. Paul School a peanut/nut free school. It could save a life.
The United States has a long history of passing laws and regulations at both federal and state levels to protect those that live here from physical dangers. Some of the first ones were early child labor laws and in most recent years, seat belt and anti-smoking regulations. St. Paul is a small microcosm of our country. If laws to maintain personal safety can be mandated at our highest level of government, then, surely, the Christian community at St. Paul should be able to go even further to care for its own.
Banning nuts from the building is similar to banning cigarette smoke. Inhaling second hand smoke may cause long-term lung disease while exposure to peanuts has caused documented allergy-related deaths. St. Paul is a smoke-free building. It should also be a nut-free building.
Robin and Mike Stiyer
The United States has a long history of passing laws and regulations at both federal and state levels to protect those that live here from physical dangers. Some of the first ones were early child labor laws and in most recent years, seat belt and anti-smoking regulations. St. Paul is a small microcosm of our country. If laws to maintain personal safety can be mandated at our highest level of government, then, surely, the Christian community at St. Paul should be able to go even further to care for its own.
Banning nuts from the building is similar to banning cigarette smoke. Inhaling second hand smoke may cause long-term lung disease while exposure to peanuts has caused documented allergy-related deaths. St. Paul is a smoke-free building. It should also be a nut-free building.
Robin and Mike Stiyer
In order to mitigate any future risk to peanut allergy students, the Steinhebel family supports the establishment of a peanut "FREE" school.
- Sam and Jennifer Steinhebel
c Thank you for inviting comments on this topic. We support making St. Paul a nut-free school environment. Additionally, I recommend the Administration and School Committee consider other areas of allergy/asthma concern.
For example, my son has asthma and is highly sensitive to scents. He has commented that one of his teachers wears perfume that bothers him. Many asthma sufferers have severe sensitivity to fragrances and strong scents. Even if it barely smells like anything to another, it can be a major irritant to an asthma patient.
In addition to discouraging the use of personal fragrance in a policy, consideration should also be given to not allowing fresh flowers in classrooms. Many allergy and asthma sufferers are extremely sensitive to such an environment.
I respectfully ask that in the overall review of "allergies and school", as this segment of Dr. Miller's blog is titled, careful consideration be given to include allergy awareness issues beyond food. If there are 14 children in the school with nut allergies, I would venture to say that there are as many if not more with an asthmatic condition who would benefit from a "fragrance free" policy revision.
Thank you.
Teresa Lucido
Dr. Miller, thank you for addressing this important topic.
I have struggled with food "banning" in the past. Should we tell others what they can or can't eat? I have concluded that a child's safety is paramount to all else.
My son, although allergic to other foods as well as peanuts, has been unconcious in my arms. He has been transported to the hospital, sirens blarring to be rescuitated after stopping breathing. The threat is not theoretical, it is real and it has happened.
Peanut butter obviously poses the greatest risk due to it's sticky nature and prevelance in the average child's diet. We typically eat 21 meals a week. You would be asking families to find a nut free alternative for just 5of those meals.
By banning nuts you would be greatly reducing the risk to those with multiple food allergies and virtually eliminating it for the nut allergic kids.
I am confident that vigilance will remain high, recognizing that it is impossible to remove all potential allergens.
How can we ingore this opportunity to protect so many children within the wonderful St.Paul Community?
Respectully yours,
Holly & Tom Ensor
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