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House Call: Food allergies require careful planning before school starts

Before you know it, the new school year will be starting. You may have already purchased your child’s lunchbox with her favorite characters on it.

If your child has any food allergies, especially life-threatening ones, there are steps you must take before school starts to help ensure your child has a safe school year. In Washington, you must provide the school with a completed Severe Allergic Reaction Plan and Medication Order. This paperwork, and the appropriate medication in the event of an allergic reaction, must be in place at the school before the start of the school year.

Details and forms for the Spokane public school system are available at www.spokaneschools.org/Page/1803. You may also call the health services coordinator at (509) 354-7298 or the director of nutrition services at (509) 354-7270.

The best way to avoid life-threatening situations is for your child to bring lunches and snacks from home. If he or she is going to participate in a school lunch program, you can work with the school to create a plan that meets his or her special dietary needs.

It is important that your child thoroughly understands that it is not OK to accept food items from friends. Sharing is great, but when you have food allergies, it can be harmful. For some, exposure to very small amounts of an allergen can cause a reaction. Thorough and frequent hand-washing by everyone in the school can help limit the possibility of accidental exposure to food allergens.

The most common food allergies are to peanuts, tree nuts, shellfish, milk, eggs, soy, and wheat. A reaction can happen minutes after an exposure or up to two hours later, so care must be taken to monitor a child if an accidental exposure is discovered.

In addition to varying reaction times, the symptoms of an exposure vary from person to person. Symptoms of a mild food allergy reaction include the following:

Red, swollen, or itchy skin

Redness of the skin or around the eyes

Itching in the mouth or ears

Nausea or vomiting

Diarrhea

Abdominal pain

Nasal congestion or a runny nose

Sneezing

Dry cough

Odd taste in mouth

It is possible to have had only mild reactions to a food in the past and then have a severe reaction the next time. Because of this, food allergies should always be taken seriously. Symptoms of a more severe reaction include obstructive swelling of the lips, tongue, and/or throat; difficulty swallowing; shortness of breath or wheezing; turning blue; feeling faint, confused, or weak; loss of consciousness; chest pain and a weak pulse. If any of these occur, call 911 and follow the Severe Allergic Reaction Plan.

Thinking on how to prevent food allergies in the first place has changed in the past few years. We used to advise that babies not be given any of the foods commonly associated with allergies until they were a year old. New evidence suggests that early exposure can be preventive. I now tell parents that at around two to four months, they should share tiny tastes of the various foods they are eating with their child to help prime his system to not become allergic. That method is a bit “back to the future,” as it was how us mature people and our ancestors were fed.

It can be scary sending a child with a food allergy off to school, especially if the allergy is new or if it is your child’s first time at school. By working closely with your child’s primary care provider, allergist and the school, you can all work toward a happy, healthy and uneventful school year.

Dr. Bob Riggs is a family medicine physician practicing at Group Health’s Riverfront Medical Center.


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