A recently released publication is suggesting global recommendations on how to manage food allergy in schools and childcare centres, including: ensuring there is food allergy training, allergy action plans, and site-wide protocols; using epinephrine as first-line treatment for anaphylaxis; having stock epinephrine available (stock epinephrine means having epinephrine auto-injectors such as EpiPen®, ALLERJECT®, or Emerade™ that are not prescribed to anyone and can be used in an emergency); and removing site-wide food restrictions and allergen-restricted zones.
The recent headlines have focused only on 1 of the 8 suggested recommendations, which is the removal of food bans. Food Allergy Canada’s position on this issue has not changed. We continue to support food restrictions in certain situations as one possible risk minimization measure as part of a comprehensive approach to managing food allergy. However, the conversation we should be having is about educating and normalizing a serious medical condition. We eat together as a community and having broad-based knowledge of food allergy and support for its management allows everyone to be at the table.
The foundation of a comprehensive approach to managing food allergy is education and access to epinephrine auto-injectors:
- Education to ensure childcare centres, teachers, staff, and the community understand food allergy as a medical condition, how to help prevent reactions in the first place, and treat them appropriately if they do happen.
- Access to life-saving epinephrine and having stock epinephrine ensures critical access in case of an emergency.
A comprehensive approach will also normalize food allergy by helping others understand how to support impacted children in managing their allergy, which reduces bullying and builds inclusion.
The intent of the suggested recommendations is to help local communities develop what works for their specific situation and environment, as noted by the authors: “due to the lack of high-quality evidence available in the literature, the recommendations are rated “conditional” and policymakers are encouraged to adapt the guidance to fit their local circumstances.”
It’s important to note that the recommendations provide a global review and was not developed specifically for the Canadian environment. Canada has already established an approach to managing food allergy in schools, backed by legislation in some provinces (e.g., Sabrina’s Law in Ontario, Protection of Students with Life-threatening Allergies Act in Alberta).
The international recommendations should prompt discussions for schools and childcare centres to evaluate their current practices and consider the following questions as a part of building a comprehensive approach to managing food allergy:
- Education and training: What is being done to educate school staff and the community on food allergy?
- Allergy plan: Do you have an allergy plan for all impacted staff and students that provides details on their allergens, how to recognize allergic reactions and what to do in case of an emergency?
- Risk management: Where do students eat, where would reactions most likely take place, what supervision do you have, what are the cleaning policies, etc.?
- Access to epinephrine and emergency response: What is your emergency procedure and do you have access to epinephrine? Do you have stock epinephrine?
Education is the cornerstone for this condition that relies on community support in the management of it. We will continue to work hard on behalf of the food allergy community, and the 500,000 Canadian youth impacted by food allergy, to ensure Canadian schools remain a safe and inclusive place for all kids.Tags: School, School policies