Leaving your child in care for the first time can be hard, and these feelings are likely to be worse if your child suffers from the life threatening type of allergic reaction known as anaphylaxis.
With increasing incidences of allergies and no national guidelines for the management of anaphylaxis in schools, pre-schools or child care services, what are the child care options for parents of pre-school children with allergies?
This article will hopefully provide some answers.
Anaphylaxis is a generalised allergic reaction, which often involves more than one body system (e.g. skin, respiratory, gastro-intestinal and cardiovascular). A severe allergic reaction usually occurs within 20 minutes of exposure to the trigger and can rapidly become life threatening.
According to Anaphylaxis Australia, peanut allergies are the most common, followed by egg, cow's milk and tree nuts, such as cashews.
A recent report published in the Medical Journal revealed that the number of pre-schoolers with life-threatening food allergies has inexplicably soared in the last decade. Between 1994 and 2005, the number of hospital admissions for severe allergic reactions rose from 39 in every million children to 194.
The child care environment
For the parents of children with anaphylaxis it may seem that home based care such as offered by a nanny, au pair, parent or grandparent is the only option. However this is not the case, many child care centres are well prepared to deal with children with allergies and offer staff training, anaphylaxis action plans and safe environments to protect children.
President of Anaphylaxis Australia, Maria Said, said that keeping children safe from an allergic reaction requires child care centres to reduce the environmental risks, offer staff training and maintain an action plan to ensure all staff know how to recognise and manage an emergency situation.
“The best way to protect children is to ensure they are promptly and properly diagnosed. We encourage all child care facilities to access training by dedicated anaphylaxis educators and ensure that all staff receive annual training on preventing an anaphylactic reaction; recognising symptoms of a reaction and practice how to administer the lifesaving EpiPen adrenaline auto-injector.”
For parents who have children with anaphylaxis in care it’s important to maintain a constant line of communication with carers. You should:
- Inform staff of your child’s diagnosis and its cause. Many services may be very experienced in dealing with children with allergies and staff may well have undergone training, however, it is still important to talk to the carers about the unique circumstances of your child’s condition. Take the time to explain the primary triggers, how long a reaction takes to come on, how to deal with the reaction, how to calm your child and any other variables which you have discovered from parenting your child through a reaction.
- Discuss prevention strategies with staff. Most child care services will have stated policies and procedures for preventing and dealing with severe allergic reactions. Indeed, the ideal way for dealing with anaphylaxis is prevention! Ask staff how they enforce prevention strategies with other parents in the centre and how well enforced the prevention strategies are.
- Work with staff to develop an Individual Anaphylaxis Health Care Plan. This should be based on your experiences and will provide the child carers with unique information they can use to keep your child safe. You should also provide your child care service with an Anaphylaxis Action Plan that is signed by your child’s doctor and has an up-to-date photograph.
- Another important factor is to ensure your child care service has a supply of your child’s adrenaline auto-injector and you should check every once in awhile to make sure the adrenaline has not expired.
The service you choose for your child should be willing to accommodate, within reason, an individualised plan for managing your child’s allergies. This plan should be put together using the information supplied by you through the process described above and if there are points of disagreement between you and the service you could defer to your child’s doctor for the deciding say.
According to ACECQA an individualised action plan may depend on a range of variables including:
- Your child’s age and understanding of the situation
- The ages of the other children in the service
- The severity of the allergy
- What your child is allergic to
- The care environment including: the ratio or children to carers, levels of staff training and experience
The upside of allergy rates increasing is that more people are aware of the problem and how to manage it. This means that kids with allergies can safely participate in most, if not all, of the opportunities available to kids without allergies. To maximise the chances of your child enjoying a safe and happy time in child care there will need to be close and ongoing communication between you, your child care provider and your GP. This seems a small price to pay to ensure your child enjoys a full and active life in a high quality child care service.
Further reading
www.allergy.org.au
www.allergyfacts.org.au
