I knew something was wrong with my son. Some days he just didn't act right. He was hyperactive and angry. He would not cuddle or let me hold him longer than a few minutes, and he refused to wear clothes. If I tried to discipline him, he would sit and rock back and forth.
Other days he was fine. He loved learning but his work was inconsistent. When he was "off,' his drawings were no more than scribbles, his colouring all over the page. When he was "on," you could tell the difference between his trees and his people; he coloured inside the lines.
I lost babysitter after babysitter. Then he was kicked out of Sunday school. "Don't bring him back," the teacher said, "I don't know what to do with him." She only had him one hour, once a week and she didn't know what to do with him? I just cried. By this time I had four children under 6, and I didn't know what to do.
My sister recommended a book "Is This Your Child?" by pediatric allergist Doris Rapp. I devoured that book; it gave me hope. It helped us to figure out our son's problem: food colouring.
Once I eliminated food colouring from his diet I had a new child. So did the Sunday school teacher; she just had to quit giving him Kool-Aid and cookies at snack time.
I couldn't blame my pediatrician for not knowing what was wrong with my son; 20-some years ago, food allergies and intolerances were not as prevalent as today. Now, however, about one in 13 school children suffer with food allergies in the United States alone. In the ten years from 1997-2007, allergic incidences increased by 18 per cent, except for peanut allergies, which tripled by 2008.
The most common food allergies in children are milk, egg, peanut, soy and wheat. Most children outgrow allergies to milk, egg, soy and wheat by age 10-15.
Not so for peanuts. Only 15-20 per cent of children outgrow peanut, tree nut or shellfish allergies, and reactions to these foods account for most allergy-related deaths.
Scott Commins, MD, PhD, and an assistant professor of medicine and pediatrics at the University of Virginia, performed a clinical trial involving peanut-allergic individuals. He said the symptoms from peanut reactions are not necessarily severe. They can vary from itching around the mouth and lips, hives and gastro-intestinal upsets to anaphylaxis.
But just because your child has never had a severe reaction, it doesn't mean it couldn't happen.
Reactions from foods manifest in two ways. A true allergy, said Dr. Madeline Dillon, a board certified adult and pediatric allergist, involves an immune system response that produces certain antibodies to the offending proteins. In other words, your body treats the food as an enemy and produces antibodies to attack it.
If that immunologic response is not present, the reaction is referred to as a food intolerance.
But to most parents, this terminology doesn't matter. They just want to protect their children from an experience that could range from uncomfortable to life-threatening - especially when they are in the care of others, like at school.
Studies show that up to 15 per cent of children with food allergies will experience a reaction while at school and that about 25 per cent of anaphylaxis cases in a school setting involve children with no prior diagnosis of allergies.
So what's a parent to do?
1. Communicate with your child's school personnel. Whether your child exhibited symptoms of an allergy yesterday or years ago, let the school know. Primarily this is done by filling out the proper health history forms. Some school districts request the child's physician add his specific instructions in case of a reaction and orders for medication when necessary. Parents should begin this process early enough that the child is not starting the school year without the proper documentation in place.
2. Supply the school with any medication your child may need should a reaction occur, and replenish that supply when it expires. Since epinephrine injectors (Epi-pens) come in a two-pack, parents will frequently purchase one pack and send one Epi-pen to school and keep one at home. But according to Dr. Dillon, if the child is in danger of anaphylaxis, two Epi-pens should be available at all times. To make this possible, she encourages parents to purchase two packs - one for home and one for school.
3. Discuss the issue with your child. Make sure he understands what he can and cannot eat. Tell him to never share food with his classmates. Darlene, mum of two, says that her child's private school has a "no food sharing" policy for the younger grades to protect them from a mishap.
4. Discuss incident protocol with your school nurse. Ask where the child's medication is stored. Should your child exhibit signs of anaphylaxis, exactly what would happen?
Other things to consider:
- Read all papers that come home promptly. If your child's class is having a birthday party or some other celebration which might pose a threat, it should be communicated in a letter.
- If you are preparing food for special occasions for your child's class, ask the teacher if there are any dietary restrictions in the classroom.
- Pack your child's lunch to ensure avoidance of the foods and food colourings your child might be sensitive to.
Parents and schools must continue to work together to protect the children. However, parents agree that the allergic child's classmates make the biggest difference. "They are quick to comment that it may not be safe for my son," one parent said, "or remind someone to read a label. Good friends can make all the difference at school."
Finding an Allergy-Friendly School
LaShonda, mum to a 5-year-old, peanut-allergic child, needed to consider her son's allergy when looking for a preschool. Before discussing Camden's allergy, his school did not have a plan in place. However, after LaShonda told them of the severity of the issue, one of Camden's teachers agreed to take a class on treating children with anaphylactic allergies.
When approaching a private school, you might want to ask the following questions:
- Has someone in the school been trained to care for and administer the Epi-pen?
- Is that person (or a substitute) on school premises at all times?
- How are parents notified about allergies in a classroom when asked to send snacks to school for special occasions?
- Will my child be separated from other children eating peanut butter (or other offending foods)?
- Will hand washing/table wiping be enforced after eating and before playing?
"I have found that most places are willing to work with this allergy," LaShonda said, "and if they do not already have something in place to keep my child safe, they are willing to incorporate a plan."