How to Manage Your Child’s Anaphylactic Food Allergies

When your child has food allergies, sending them to school can be stressful. But with the right strategies, you can breathe a little easier.

The key is to focus on prevention and emergency preparedness, says Michael Pistiner, MD, director of food allergy advocacy, education, and prevention at Mass General Brigham for Children at Harvard Medical School in Boston and member of the American Academy of Pediatrics section on allergy and immunology. “These are the pillars of food allergy management that families need to implement at all times and in all situations, including school,” he says.

While you can’t be by your child’s side in the classroom, you can take steps to prioritize your child’s safety and prevent exposure to food allergens. Keep reading to learn how.

Here’s what you can do before and during the school year to ensure your child’s safety:

Bring an Allergy Action Plan to Your Child’s School

Ask your child’s pediatrician or allergist to fill out an allergy form or allergy action plan that you can pass along to the school health office; you can find one from the American Academy of Pediatrics (AAP). It should include information such as their allergy, when to treat an allergic reaction, and emergency protocols, says New York City–based board-certified allergist and immunologist Dean C. Mitchell, MD.

It’s also important to fill out any allergy forms your child’s school has requested and turn them in by their deadline so there’s plenty of time to get a plan in place, says Dr. Pistiner. You can do this annually, but it’s especially important to do so when your child starts at a new school, receives a new prescription, needs a replacement for an expired prescription, or if there’s a change in your child’s list of allergies, he says.

Ask About the School’s Allergy Protocols

• How the school oversees meal time in the cafeteria or classroom, and if there are designated areas for students with food allergies
• How the school manages classroom celebrations, field trips, and “specials” (art class, drama class, and so on)
• How substitute teachers are made aware of your child’s allergy
• Whether students are allowed to bring in treats for the class for special occasions, and if so, how those with allergies are protected

Have a Medication Plan

Determine the Safest Meal Option

Your child may be better off bringing lunch from home, if that is an option, as you have greater control over what they’re putting into their body. “Children with food allergies tend to do better with packaged foods, since you can know with some degree of certainty if the food contains an allergen or was manufactured at a facility where there can be cross-contamination,” Dr. Mitchell says.

Children also play an important role in reducing their risk of anaphylaxis. “The roles that a child can play in their own self-management and understanding will change with age and their developmental capabilities,” says Pistiner.

Check out these tips on how you can prepare your child to manage their anaphylactic food allergy at school:

Teach Your Child the Basics

They should know what their specific food allergy is, the signs of a reaction, and what to do if they start to experience those signs.

Show Them How to Read Labels

Older children can be taught how to do this themselves, while younger children should be taught to ask for help. Practicing label reading before this responsibility falls on their shoulders can be a fun way to build your child’s confidence, says Pistiner.

Discuss What’s Okay and What's Off Limits

“Teach children not to take risks with food,” says Mitchell. Depending on your child’s allergy and the school policies, that might mean they don’t eat any cafeteria food and stick to what you’ve packed in their lunch box. You might also remind your child not to take snacks from classmates.

It may be hard for your child to hear about what they can’t have — so it can be helpful to also remind them what they can have (their favorite snack from home, for example, or allergen-free ice cream after school).

Emphasize — and Practice — Hand Hygiene

Remind your child of the importance of handwashing before eating, says Pistiner. Talk with them about how rubbing their eyes — and, yes, picking their nose — can be dangerous if they’ve come into contact with an allergen. Model good hand hygiene at home and work with your child to make hand-washing a habit before and after meals.

Ramp Up Self-Management Skills Over Time

As your child gets older, they may be able to carry their epinephrine themselves. If this is an option for your child at their school, “you can work with the school health office to determine where your child’s epinephrine is stored or if it’s carried in a bag that they keep with them,” says Pistiner. Your child should also be taught how to administer it themselves. However, he points out, the school should ideally have available epinephrine in case your child does not have it on them or is not able to self-administer.

The nonprofit organization Food Allergy Research and Education offers a Food Allergy Management in Schools guide that outlines how your child may take more responsibility for their allergy as they get older, as well as what other care team members — caregivers, school administrators, school nurses — should be responsible for.

Consider Other Precautions

Your child may benefit from wearing a medical alert bracelet or tag that notifies teachers and classmates about their allergy. You may also speak to your child’s doctor about preventive medications and treatments, such as oral immunotherapy, that may reduce the risk of an allergic reaction.

Birthday parties and playdates at friends’ houses can be challenging with an anaphylactic food allergy. As a parent, you don’t want your child to feel left out, but you also want them to stay safe. These tips can help you strike that balance:

Teach Self-Advocacy Strategies

Other kids may have questions about why your child can’t have certain foods or share snacks. “Prepare your kid to have these conversations and feel good about them,” says Pistiner. You might work with your child to come up with a go-to response to these questions: “I have an allergy to peanuts, which means I get really sick if I eat them. I bring my own snacks to be extra careful.”

Communicate Their Needs With Other Parents

Sending your child to a birthday party, playdate, or sleepover? Before drop-off, talk to the parent in charge about your child’s allergy — and, when possible, then meet them where they are, says Pistiner. For example, that might mean you send your child to the sleepover with their own snacks. Or, maybe you stick around the birthday party to keep an eye on your child and lend an extra hand.

Emphasize the Fun, Not the Food

It can be challenging — for both you and your child — to enter situations where your child may be at risk, or may not be able to fully participate in an experience due to their food allergy. A helpful reframe is to view food as a component of these experiences — not the core of them. “Deemphasize food as part of the celebration and focus more on activities and fun,” says Pistner. “The expectation does not have to be eating what everyone else is eating but interacting, having fun, and playing.”

• The key to food allergy management is prevention and emergency preparedness.
• Your child’s provider should fill out an allergy action plan, which can be distributed to the health office at your school. Meet with your child’s teacher and school administrators to discuss their allergy and what to do should they have an anaphylactic reaction.
• Children can play a critical role in managing their food allergies. Their responsibilities, which should be based on their age and developmental abilities, may include washing hands before eating, not sharing food with classmates, reading food labels, and carrying and self-administering epinephrine.