Food allergies are a growing problem among children
attending preschool and day care. The parent of a food-allergic child must work
with the child care facility to assure that the setting is as safe as possible
for the child.
Background:
·
Food allergies affect up to 8% of infants and
pre-school children. Half of them are at risk for anaphylaxis.
·
Food allergic reactions can range from mild skin or
gastrointestinal symptoms to severe, life-threatening reactions.
·
A delay in the administration of life-saving emergency medication,
particularly epinephrine, is a major factor in death from food allergy.
·
It is essential that child care facilities have detailed plans for
both (1) avoiding accidental exposures to food allergens and (2) promptly
treating reactions for all food-allergic children.
What Is Anaphylaxis?
Anaphylaxis is an allergic reaction affecting
multiple systems in the body. Upon contact with a food allergen, the body releases
chemicals into the tissues of the heart, lungs, digestive system, or skin.
Blood vessels widen so much that blood pressure plummets.
Every reaction is different;
not all reactions show the same symptoms. Symptoms may include:
·
Inconsolable crying, listlessness, looking scared,
or pointing to the throat, ears, chest, etc., particularly if the child can’t
verbalize symptoms.
·
Flushed,
tingling, or itchy skin; swelling of lips or joints; hives or rash; sweating;
paleness.
·
A
lump, itch or tickle in the throat; throat tightness; hoarseness; difficulty
swallowing
·
Nasal
congestion; runny nose; a feeling of “fullness” in the ears.
·
Chest
tightness; wheezing or high-pitched sounds from the lungs; shortness of breath.
·
Nausea;
abdominal cramps; bloating; vomiting; diarrhea.
·
Sense
of impending doom.
·
Lightheadedness;
faintness; irregular or rapid heartbeat; confusion; passing out.
Patients who
do not have life-threatening symptoms initially may progress to life-
threatening anaphylaxis. Adequate
warning signs, such as hives, are not always present before serious reactions
develop. The first warning signs may be
only “a funny feeling in the mouth” or abdominal discomfort.
Foods
that most commonly cause anaphylaxis are:
· Peanuts · Tree nuts · Shellfish · Fish · Milk · Eggs · Soy · Wheat
· However, ANY food can cause
an allergic reaction
Exposures
to food allergens occur most frequently through eating and tasting. However,
less commonly, reactions can occur as a result of merely touching or inhaling
the food.
Protecting
a child from exposure to an offending food is the most important way to prevent
life-threatening anaphylaxis. Most anaphylactic
reactions occur as a result of accidental exposure to the allergen.
Parents’ Responsibilities:
Parents should provide:
Ø Documentation
and description of the food allergy signed by a doctor.
Ø Instructions
on steps that need to be taken to avoid that food.
Ø A detailed Allergy Action
Plan to be implemented in the event of an allergic reaction, including the
names, doses, and methods of administration of any medications that the child
should receive, including symptoms that would indicate the need to administer
those medications.
Ø Doctor’s
order for epinephrine by auto-injector (or EpiPen®) and any other medications
needed.
Ø Parent’s
signed consent to administer all medications.
Ø A
sufficient supply of necessary up-to-date medications (including EpiPens®).
Ø Arrangements
for proper storage of such medications in an unlocked cabinet always accessible
to staff.
Ø SAFE foods for their children, as agreed upon with the facility.<