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| Multiple strategies for allergy management needed in ECEC
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With the increasing prevalence of serious allergies in children, there is significant pressure on early childhood education and care providers to have an up-to-date and effective management strategy in place.
Typically the avoidance of known allergic triggers is the mainstay of most management strategies; however, incidental exposure can still occur despite our best efforts to protect children with severe allergies.
For this reason the Australasian Society of Clinical Immunology and Allergy (ASCIA) recommends the development of broader management plans in child care environments, which includes food avoidance but goes further to cover:
- age appropriate education of allergic individuals and their peers
- staff training in the recognition and management of allergic reactions
- development of strategies to reduce the risk of accidental exposure including individual health care plans
- an emergency response plan for when exposure does occur.
ASCIA does not recommend blanket food bans, although it says that restricting some important food allergens (such as nuts) may have a place in reducing the risk of accidental exposure in very young children who are too young to be relied upon to avoid contact with potential allergic triggers themselves, either by ingestion or cross contamination of equipment like toys or play services.
ASCIA says blanket food bans in early childhood education and care settings are not enough to protect highly allergic children because:
- It is not possible to guarantee complete removal of an allergen such as peanuts from the school community, regardless of policies to do so.
- Blanket food bans may give parents/carers and allergic individuals a false sense of security, assuming that the school or childcare is 'nut free' for example.
- Children can be at risk of anaphylaxis from many foods, insect stings or bites. Therefore it is not possible, nor practical to ban all food or insect allergens from a school or childcare service.
- It is more important for schools and child care services to implement a range of age appropriate risk minimisation strategies and consider children with severe allergies when planning activities. This may also include asking that nut products, for example, are not sent to school in lunch boxes for young children in childcare, pre-school and early primary school. This is not the same as banning the food. Not using some foods in cooking classes or science experiments or not using some allergens in foods supplied by preschools are other issues to consider.
ASCIA President, Associate Professor Richard Loh, says schools often ban nuts, however, children can be at risk of anaphylaxis from many other foods including milk, eggs and even fruits.
"Up to 2 per cent of children can be at risk of anaphylaxis from insect stings or bites. It would be impossible to ban all allergens from a school therefore we cannot recommend food bans.
"Age appropriate education of children with allergies and their peers is an essential risk minimisation strategy. It is important for all children to be educated about allergies and the risk minimisation strategies applicable to them, such as hand washing before and after eating and not sharing food" said Mr Loh.
The Chair of the ASCIA Anaphylaxis Committee, Dr Raymond Mullins, says "Schools and child care services need to determine what allergies they need to manage, the age and maturity of the children and implement effective risk minimisation strategies based on this information. He says advanced planning and communication with parents or carers is also very important.
"It is important to realise that education about food allergy beyond affected children, parents and teachers to include non-affected children and their parents is often needed to enhance cooperation and create a safe environment at school."
"Schools should be prepared for when a student experiences anaphylaxis by having appropriate emergency response procedures in place. This includes staff undertaking training in how the recognise and respond to allergic reactions including anaphylaxis, as well as how to prevent exposure to known allergens" said Dr Mullins.
You can view the current ASCIA guidelines for prevention of anaphylaxis in schools, pre-schools and child care here.
ASCIA offers free, ACECQA accredited, training for early childhood education and care providers. Click here to learn more.
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