FOOD FEARS

Just before the bell rings one chilly morning, a herd of fidgety first-graders files in to Mrs. Sherwood’s classroom at Arlington Elementary School on Spokane’s North Side. They hang up their coats, stow their backpacks and head straight to two kid-sized wash basins where they lather up, rinse and dry their hands with paper towels.

Good hygiene, to be sure.

But the ritual could potentially spare 6-year-old Pamela Nave a trip to the nurse’s office.

“It’s just a precaution,” teacher Bekki Sherwood says. “If they had peanut butter or something for breakfast.”

Nave, a bubbly girl with long brown pigtails, suffers from a severe peanut allergy, as does another child in her class.

No one is sure why, but food allergies have become more common in children in the past decade. The number of young people with peanut allergies doubled between 1997 and 2002, according to the Virginia-based Food Allergy & Anaphylaxis Network, or FAAN.

And that means schools increasingly must find ways to keep these children – some of whom have an allergic reaction merely after smelling the culprit food – safe.

“It’s absolutely become more of an issue,” says Anne Munoz-Furlong, founder and CEO of FAAN. “The good news is we’re seeing much more of a focus on managing food allergies before a crisis, across the board.”

In 2002, a Spokane Public Schools task force outlined the awareness, prevention and preparedness steps necessary to protect students with life-threatening allergies. The task force’s efforts followed the 2001 death of Nathan Walters, a Logan Elementary third-grader who suffered anaphylaxis after eating a peanut butter cookie on a school field trip.

Now, in Spokane schools, the youngest students watch the video “Alexander, the Elephant who couldn’t Eat Peanuts.” They learn how to be a PAL, under the Protect a Life Program, so they can watch out for their friends with food allergies. Kids with allergies carry a bright green card through the lunch line. There are emergency-response checklists, and every student with severe, life-threatening allergies must have medication and an action plan before registering for school.

This year, 254 of the district’s 29,795 students have life-threatening allergies, says Kathe Reed-McKay, the district’s coordinator of health services.

But neither the Spokane Schools nor any other area districts have taken steps to declare their schools peanut-free. District officials say they made the conscious choice against a ban so no one has a false sense of security.

“We don’t pretend that it’s going to be perfect,” says Doug Wordell, the district’s director of nutrition services. “It’s not and it cannot be. We don’t say ‘allergen-free.’ We don’t say ‘peanut-free.’ ”

That’s as it should be, Munoz-Furlong says. At least two studies have found that all-out peanut bans do not work, she says.

“We want to make sure everyone is always on guard thinking a reaction could occur rather than, ‘We don’t have to worry because one won’t occur,’ ” she says. “We know that education works. If you get children to look out for each other, they will fiercely protect their friends.”

The Coeur d’Alene School District has taken a similar approach. All students with life-threatening allergies must have an emergency plan in place and medication available, and everyone who has regular contact with the child is made aware of the plan, says Cindy Perry, director of school health services for the district.

Some schools offer peanut-free tables in the cafeterias, says Ed Ducar, the district’s food service director.

“The hard part,” Ducar says, “is that as kids get older, they don’t want to be really identified. As they get more towards high school, they’re not wanting to sit at a peanut-free table.”

In recent months, Ducar has also been working to help students with food intolerances, not life-threatening allergies.

He’s been making a list for parents and students of gluten-free foods. Kids with a note from the doctor, saying they have gluten intolerance, are offered substitute foods, such as fruits, vegetables and yogurts, when the day’s lunch is not gluten-free, Ducar says.

“I like the term ‘a reasonable approach,’ ” he says. “We can’t provide separate meals for every student in the district.”

The Central Valley School District is currently following Spokane’s model to compile a 100-plus-page book of policies for safeguarding students with life-threatening allergies, says Cheryl Funke, the district’s school nurse specialist.

About 70 students in the district this year have life-threatening allergies to peanuts, tree nuts, milk, latex, eggs and other items, Funke says. There’s even one student with a severe allergy to mustard, she says.

“We’ve had a policy and some handouts available,” she says. “We’re actually beefing it up. Pieces of it are out there. We’re collecting the different pieces and putting it together.”

The manual will also outline proper procedures outside of the school cafeteria, such as on field trips. That’s an area of great concern for parents of children with severe allergies, says FAAN’s Munoz-Furlong.

“Everybody worries about the cafeteria when, in fact, when we look at reactions, the majority of reactions to peanuts occur in food brought to classrooms for parties and celebrations,” she says. “Once you have a system in place, you’ve got to review your plan. Anything that’s different – a substitute teacher, a field trip, a special assembly – that’s when things are going away from the normal system and the risks increase.”

In Central Valley schools, parents must provide food when students go on field trips, Funke says, and food-sharing is actively discouraged. In Spokane, parents can either send food along on field trips or the district will offer a peanut-free sack lunch, Wordell says.

In all districts, especially when there’s an allergic child in class, parents are encouraged to bring only safe foods for classroom celebrations.

But the bottom line is that there are no guarantees. And all children with life-threatening allergies, no matter how young they are, need to be made aware of the foods that could potentially kill them, Wordell says.

“Don’t ever eat anything you are not absolutely sure of,” he says. “Period. The end. You just don’t take the risk.”

Elizabeth Nave has tried to engrain that message in her first-grade daughter, Pamela, who suffers from a life-threatening allergy to nuts and also to horses.

“If we don’t see a label or can’t read the original bag,” Elizabeth Nave says. “It’s a no.”

Nave originally wanted to send her daughter to private school because she thought it might be safer, but she couldn’t afford it. So, she took a job as an aide at Arlington Elementary so she would be near the girl all day.

When Nave first found out about her daughter’s allergy, when Elizabeth was 3-years-old, Nave says she “was in tears.”

“I was so scared. I wanted to homeschool,” she says. “I was not going to let her out of my sight.”

Just last week, Nave took the girl home from school after she started having an allergic reaction after smelling peanuts in her classroom. Her cheeks got red and Pamela said her eyes itched and her throat felt funny, her mom says.

Whenever there’s a party in the classroom, Nave offers to do the baking. Students in Pamela’s class wash their hands each morning upon entering the room and again after lunch. The desks are scrubbed down, as is Pamela’s lunch table before she eats.

“She sits at a separate table in the lunchroom, which kind of worried me because of the social thing,” Nave says.

Nave, who also has a 28-year-old daughter, knows she will likely lose control over Pamela and what she eats as the girl gets older. It’s a scary thought, one she hasn’t spent much time contemplating as she works each day to keep the 6-year-old safe.

But, she says, “I don’t think she’s going to like me following her to school every day when she gets older.”