Empathy, Understanding and Objectivity Need to Prevail for Students with Food Allergies

March 30, 2011 - PRLog -- Food allergy is a growing epidemic in the United States, affecting more and more children every year. However, the food allergic child is not the only person affected.  Food allergy also impacts the child’s family as well as the people with whom the food allergic child and family interact. Given that over 12 million Americans suffer from a food allergy, we as a nation need to have awareness that food allergens can pose a potential threat to one’s life (even from one bite) and that avoidance of these foods is often not an easy task. This is a global social issue, and it takes shared responsibility to protect the health and self-esteem of these children. The food allergic child could be your child, or your neighbor’s child, or your child’s friend or classmate. The chances are high that you or your child interacts with someone affected by food allergy every day.  

The recent situation surrounding a family with a peanut allergic daughter in Edgewater, FL is disconcerting and has become a highly polarizing issue that has made national news. With emotions running high, it can be difficult for empathy, understanding and objectivity to prevail, but they must.

The Kids With Food Allergies Foundation (KFA) turned to its Medical Advisory Team to obtain some insight into the clinical evidence to help make sense of the issue.  According to Matthew Greenhawt, M.D., M.B.A., F.A.A.P., one of KFA’s medical advisors, a researcher and pediatric allergist with experience in investigating reactions occurring in educational settings, knowing the real risks versus the perceived risks can be helpful in school planning for children with food allergies. It is important, therefore, to review the facts about food allergy at school when thinking about this case and others that may be similar.

Several studies have been published that can help us understand this situation better.  Key findings include the following:

* Reactions do occur at school, and can be severe in certain circumstances. These tend to occur more frequently in younger children. However, the vast majority of food allergic children (even those with severe food allergy) can and do attend school safely every day.  A national food allergy expert alluded to this point quite eloquently in an interview with CNN on March 24.

* Bullying of students with food allergy occurs, and can take verbal and physical forms. In survey studies and observations, it is very common for food allergic children to report being teased, taunted, and harassed because of their food allergy.

* The risk of a severe allergic reaction occurring to an environmental accidental contact exposure that does not involve ingestion appears to be extremely low. In one study, researchers failed to detect peanut in air filters at the level of the neck after volunteers danced on peanuts on the floor of a poorly ventilated room. In another study, subjects inhaling from a jar of peanut butter at very close range did not experience significant allergic reactions. In a study looking at environmental exposures, there were no detectable peanut levels found on common school surfaces after they were cleaned with commercial products, and hand washing (but not liquid hand sanitizer) was sufficient to remove peanut from one’s skin.  

* Although schools sometimes employ peanut or tree nut free policies, one study reported that despite such measures, upwards of 19% reported that a reaction still occurred.  

* When reactions do occur, treatment is sometimes delayed or the wrong treatment is used. There is evidence that emergency action plans are not always followed as written, and that many food allergic students neither maintain an emergency action plan nor maintain emergency medication such as epinephrine at school.  

* In published registry studies, the vast majority of fatal food reactions occur among adolescents and young adults. Among this population, intentional risk taking and general indifference to their food allergy has been documented; examples of risk-taking behavior include increased willingness to take chances by knowingly consuming known food allergens and not always carrying epinephrine.

Thus, while there is a recognized risk for an allergic reaction to food such as peanut to occur at school, it’s unlikely to occur without the child actually ingesting a peanut-containing product or putting his hands into his mouth after touching a peanut product or contaminated surface that has not been washed. Unfortunately, in many cases both the school and the food allergic family are not always prepared to treat such reactions.  The following are some important points to consider:

* Kids with food allergy, even to foods associated with severe reactions such as peanut, can and do safely attend school each day, and this is the common goal that we all must work together to achieve. Good school policy as well as community and school education can help achieve this goal.

* Students with food allergy need to have a current emergency action plan and maintain emergency medication such as epinephrine at school. Parents should make sure that the school is able to understand how to handle situations and if necessary, take the responsibility to train staff how to recognize a reaction, and use self-injectable epinephrine.

* Simple strategies, such as hand washing after food contact, not sharing food, and being aware that certain children have dietary restrictions when planning craft projects or class celebrations can be of great utility, and pose minimal disruption to both the food allergic child and the unaffected children.

* Restrictive policies and sentiment that these children should be home-schooled are not helpful and can be quite damaging to a child’s self-esteem.

* This case clearly illustrates that management of food allergy in the school setting has to be a shared responsibility, since it affects EVERYONE, not just the food allergic individual.  

* The frustration expressed by parents of unaffected children should not be dismissed by those who are affected by food allergy. Similarly, the fear and anxiety that may be experienced by the family of those with food allergies also needs to be taken into account. It is important to recognize that both sides have the right to express their feelings, and this expression can hopefully be used to foster a productive debate that leads to a mutually satisfactory solution.

* Better understanding of the risk of food allergy can lead to practical decisions for a child with food allergies in school, and minimize intolerance that can divide a community.  

* Efforts should be focused on common sense approaches stressing empathy, understanding, and a sense of a communal effort to protect all students– those with and without food allergy.  

* Until there is a cure, it is important for school communities to aggressively work to devise a tenable compromise that allows children to just be children and attend school normally.

Just remember, food allergy can occur at any time—if you are unaffected, this could be your child one day. We all need to work together to keep students with food allergies safe and included.


Matthew Greenhawt, M.D., M.B.A., F.A.A.P., is research director at the University of Michigan’s Food Allergy Center and assistant professor in the division of Allergy and Clinical Immunology at the UM Medical School.

# # #

About the Kids With Food Allergies Foundation
Founded in 2005 as a charity, KFA is a national organization of 24,000 individuals, families and businesses working together to improve the quality of life for children with food allergies and their families. KFA focuses on day-to-day support for families, including emotional and social support; personalized food/cooking assistance; and family activities. Its interactive website provides a powerhouse of resources, including the nation's largest online support community for families; quality education materials edited by a multidisciplinary medical advisory team; and an online collection of more than 1,000 "allergy-friendly" recipes. The recent, unprecedented rise in food allergies has spurred the organization's rapid growth. To find out more, go to: http://www.kidswithfoodallergies.org .