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Healthy
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No For Nuts
Peanut butter is an inexpensive, nutritious alternative to animal protein and is a favorite food of many young children. Unfortunately, an allergy to peanuts is very common. It is among the most dangerous allergies in children and can even be life threatening. The seriousness of a peanut allergy combined with the widespread presence of peanut products and products that contain peanuts makes this one of the most complicated food allergies to manage.
Just being in the same room when other people are eating peanuts can cause an allergic reaction from peanut dust in the air. Similarly, handling toys or other materials can cause a reaction because traces of the food are carried by other children and deposited on whatever they touch. Ensuring the safety of children with peanut allergies is a serious concern for childcare professionals.
Food Allergies
Food allergies can be understood as immune system responses to particular foods. The exact cause of food allergies is still unknown, but the allergic reactions can be life threatening. Although a child can be allergic to any food, just eight foods account for 90 percent of all allergic reactions to food: milk, eggs, peanuts, tree nuts (cashew, walnut, etc.), soy, wheat, fish, and shellfish. While children manifest food allergies differently, the symptoms usually can be observed in three areas:
- Skin problems (itching, rash, hives).
- Gastrointestinal problems (diarrhea, abdominal pain, vomiting, burning of the mouth, throat).
- Respiratory difficulties (wheezing, runny nose, nasal congestion).
Some people believe that children also may manifest food allergies in other areas such as inappropriate behaviors or mood disorder, though the evidence for this is less clear.
Childcare and Allergies
Childcare programs should have “allergy action plans” for each child with known allergies. Upon admission of every child to your program, be sure to ask parents about any known food allergies. If a child does have known allergies, a team including parents, caregivers, cooks and other staff members should be assembled to create an allergy action plan for the child.
- The food allergy action plan should have the following information:
- Name, date of birth, caregiver, and a photo of the child.
- What symptoms to look for as signs of an allergic reaction and where they are most likely to appear--mouth, throat, skin, stomach, lung, heart.
- Actions to be taken in the event of an allergic reaction including both medically appropriate measures and parent preferences for minor or major reactions.
It is important for all caregivers to be educated on the symptoms of anaphylactic shock and its emergency treatment. If the physician subscribes an epinephrine injection kit, all staff members need to be trained on how to safely administer the epinephrine.
Policies on Food Allergies
Be sure to have a clear policy concerning food allergies. The best way to protect against food allergies is to totally eliminate the problem foods from the facility. This approach requires that both staff and parents be informed about substances that are not allowed.
If a child in your childcare program has a peanut allergy, post large and visible signs to remind parents and visitors. If your program does not ban peanuts but instead works to keep peanut products from an allergic child, hand washing after meals and snacks is highly recommended to eliminate any trace of peanuts from the hands that could be transferred to other objects such as toys or the door knob. If children bring food from home for snacks or meals, serve the food for children with food allergies first, and have a caregiver sit at the table when the food is served to make sure other children do not share their food.
Food Preparation
Food preparation and meal planning is especially important for children with allergies. Food preparation surfaces, utensils, and any other materials used to prepare the meals need to be thoroughly cleaned prior to use.
Fresh foods are always preferred to packaged or canned foods since current requirements for food labeling are far from perfect. Current food labeling does not mandate understandable language, and ingredients that represent two percent or less of weight do not have to be listed in rank order. Check all labels carefully. Ask parents to provide a list of safe foods or to bring food items to your program.
Activities
Try to include all children in food activities. If it is absolutely not possible, then plan an equally attractive alternative. Instead of spreading peanut butter, use fancy fruit spread or cheese spread.
Help children understand food allergies in an age appropriate way. Recognize differences, but emphasize similarities. Use books, guest speakers, puppets, and dramatic play to educate children about dealing with food allergies and the feelings they may experience.
Plan a “People are the Same and Different” learning unit. Point out the similarities and differences in children. This activity allows you to point out the problem foods without singling out any specific child.
Safety
The most important ingredient of ensuring a safe environment for children with allergies is the caregiver’s genuine compassion and support. Although the allergic child has a life-altering, sometimes even life-threatening, chronic condition, they also can develop strong willpower and incredible strengths. These children often eat a very healthy diet without preservatives, sugar or junk foods. Some three-year-olds have better self-control than adults when facing candy or sweets. Admire and praise children for their strengths and never display pity.
Food allergies are manageable and also can be good learning opportunities for staff and all children. Remember, children do not choose to have allergies. It is up to the early childhood professionals to create a safe, compassionate and nurturing environment that appreciates each child uniqueness, provides fun and enriching learning experiences, and encourages caring, kindness and humanity.
I. Joyce Chang, PhD,
Associate Professor, Child and Family Development Program
Department of Curriculum and Instruction, Central Missouri State University
Internet Resources
Keep Kids Healthy, www.keepkidshealthy.com/welcome/commonproblems/food_allergies.html
Parents of Children with Food Allergies, www.foodallergykids.org
Food Allergy Initiative, www.foodallergyinitiative.com
Resources
The Food Allergy & Anaphylaxis Network, 11781 Lee Jackson Hwy., Ste. 160, Fairfax, VA 22033; 800-929-4040; www.foodallergy.org
University of California San Francisco Children’s Hospital, San Francisco, CA 94143; 415-476-9000; www.ucsfhealth.org/childrens/edu/foodAllergies.html
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