Starting school, whether primary or secondary, can be a daunting experience for anyone (both parents and children!) but, if you have an allergy, it is essential to be confident that this will be managed effectively.
As a starting point, book an appointment to discuss your child's allergy with the head/class teacher (before term begins if possible), and take with you written information about the allergy, as well as a written management plan of your child’s needs. Your doctor or paediatrician can help you complete a management plan, and further help can also be obtained from the Allergy UK helpline. The school may also need a letter regarding your child's allergy.
Plans should include details of symptoms, the procedure to be followed in an emergency, and details of any medication, as well as follow-up care. Medication and care plans can then be stored in the same area. Make sure you list all correct and current contact telephone numbers as well as information about what your child needs to avoid. If you are going to be away or out of the area, send in a written letter with alternative contact details for the specified time period. It may be useful to supply an up-to-date photo so that staff is aware of your child (this can be useful to add to management plans if school photos are not taken in the first few weeks).
Schools can obtain guidance from ‘Managing Medicines in Schools and Early Years settings’ (DFES 2005); this outlines useful information including management of medications, roles of parents/carers and staff training and policy development. It is available online and in hard copy. If you are finding that getting help with treatment regimes and emergency protocols from your child’s school is proving tricky, contact Allergy UK for further advice and ways you can move the situation forward.
If there is a possibility that your child needs medical care or the use of medical equipment then specialist input may be required, such as training sessions. Training for auto-injector pens can be arranged via your local doctor or school nurse.
Ask about staff training and who will be the delegated adult your child should go to, both at break times and during lessons, if there are any problems. Make sure your child and all staff know where the auto-injector pen or other medication is kept; this should be in a visible, easy to access area which is unlocked and accessible at all times.
- Always make sure you update new telephone/mobile numbers, addresses, etc.
- Ask about staff training if your child needs an adrenaline auto-injector device
- Find out how supply teachers are informed of your child’s allergy
- Ask the teacher to clarify where all medications such as inhalers, adrenaline devices, antihistamines etc, are kept and make sure your child knows who to ask if they feel any symptoms. Confirm the designated members of staff so your child is familiar with this routine
These are prescribed for people who suffer with severe allergies such as food allergies, wasp and bee stings, latex allergy and drugs.
- Consider a medic alert bracelet/ watch for your child (0800 581420)
- Ensure good asthma control is being maintained if child is also asthmatic
- Keep a note of Injector expiry dates both at school and at home. Epipen (http://www.epipen.co.uk/) and Jext (http://www.jext.co.uk/) have a reminder for expiry dates system which you can sign up for
- If your child is old enough, reminders about carrying auto injectors or knowing where they are kept will be useful and should be carried out regularly
- Remember to discuss other areas your child may go to around the school and suitable access to the auto injector. This should be stored in a named box with a copy of the management plan and instructions and, all staff should be familiar where this box is kept
- Find out about carrier /protection tubes for auto injector pens which allow safe carrying of medication if your child is older. (www.yellowcross.co.uk, www.kidsaware.co.uk or The Anaphylaxis Campaign www.anaphylaxis.org.uk )
It is important to think of any areas where allowances may need to be made for your child to have extra time, for example, to put on emollient after swimming, or to collect their packed lunch, or to go to have any medication they require. These issues can be dealt with in a non-disruptive way and a routine can soon be established as long as you inform the teacher and check with your child that the plan of action is working.
Remember to consider lessons that your child may take part in and the potential allergens which they may come into contact with. Research has shown that children who have asthma and allergies often have reactions due to triggers in the classroom, so it is not unreasonable to insist that your child’s allergy is taken into account when planning lessons. It will be necessary to ask the teacher to check the suitability of materials used in lessons to make sure they will not affect your child.
When children are at infant school the class teacher usually has the same children for all lessons and movement around the school may be quite limited as most lessons are in the same area. This makes it easier to assess and control the exposure to allergens.
Some simple steps to reduce allergen exposure at school include:
- Do not let a child with asthma, eczema or house dust mite allergy sit on dusty carpets
- Do not allow a child with hayfever to sit near an open window in the summer
- Minimise exposure to heat sources for children with eczema
- Prevent exposure to allergens when using art and craft products.(This includes glues, paints, and old food cartons that may include food allergens i.e. for crafts and models)
- Take care when creating nature tables or pet corners with animal foods and touching of pets
- Take care with the choice of class snacks if children have a food allergy
Remember to discuss with teachers any potential allergens, both inside and outside the classroom, such as activity lessons, school trips, games and physical education. If your child has an asthma inhaler or an auto-injector adrenaline pen, ensure that these are taken to any sporting area or fixture.
As your child gets older, they will want to take control more of their allergies and may find it easier to discuss their needs with individual teachers themselves. However it is important that your child has a written plan as a back-up since even the most verbal children can sometimes forget to pass on a vital piece of information. Also a child’s recall of verbal instructions is not as good as many people think and messages may become muddled. You may find your child is being taught by different teachers for a number of subjects and it would help to ensure that all these are aware of your child’s allergies. It may also be helpful for supply teachers or helpers to be given this information.
Studies have shown that allergic children may be more prone to sleep disturbance which could affect their concentration levels and behaviour. It is important to ensure the teaching staff is aware of this so that any alterations in behaviour etc., can be noted and acknowledged. This will also limit the child being labelled as ‘difficult’ when physical symptoms could be a factor to consider. These problems may be due to disturbed sleep or irritation which makes the child feel more agitated at times or lacking in concentration and more tired than usual.
Make sure your child knows that it is important to tell someone if they feel any symptoms are starting even if they have been given a ‘forbidden’ food by a friend or eaten something by mistake. Sometimes children do not want to get their friends or themselves into trouble, and the importance of telling someone quickly is forgotten. This can lead to a more serious situation so it needs to be handled delicately.
Food allergy is increasingly understood by those working in schools, so most schools have processes in place to minimise risk to children with food allergy. Two common approaches are to have:
- A no-nut policy – this means parents are told not to include nut- based or foods made from nuts or peanuts in children’s packed lunches
- A no food-sharing policy – this means that all children, not just those with allergy, only eat their own food. In this way there can be no confusion or need for decisions to be made about whether a child with a food allergy can or cannot have some of their friend’s food
If the school does not have these in place, you can contact Allergy UK for advice about encouraging them to adopt these policies. In the first instance, arrange to meet with the head teacher once you know your child has a school place; you can then raise your concerns and make suggestions about how your child, and any others with food allergies, can be kept as safe from risk as possible. The head teacher of a school does not usually have any managing role regarding the school catering, but should be able to put you in touch with the people who do the school’s catering.
Some schools encourage children with food allergy to bring a packed meal, and this provides an easy solution to ensure that your child is eating safely. However, your child is entitled to a school meal, and many schools are now beginning to take food allergies into consideration when providing their food. You can help this process by:
- Giving the catering staff a copy of a picture of your child and their management plan. Whilst schools no longer routinely want sensitive information with pictures on display, the picture can be kept in a file so that new staff can have a child with food allergy pointed out to them
- Approach the school early so that it does not come as a shock to the staff that they are to cater for a child with a food allergy. You will probably know that you have a place at a school before the end of the previous school year; this would be a good time to visit and start taking steps to talk to the school caterers
- If you are given prescription foods (such as gluten-free pasta), you may wish to let the school caterers have a store of this. Give the caterers your phone number so that they can contact you directly if more information is required
- Ask if there is a specific member of the catering staff who will help your child each day and give them the required ‘safe’ prepared meal
- www.allergycateringmanual.com provide useful information about catering for allergic pupils in schools
Break times can be tempting; try to emphasise from a very early age that your child must not share snacks and ask the teacher to give gentle reminders to all the children about this rule. This could be done so your child doesn't feel they are the only one who has to keep the rule.
Supply any special snacks or "birthday treats" in a labelled tin (the teacher can then give these out if other children bring in treats for birthdays). Try to send in "extras" each half term so your child does not run out and supply your child's own allergen-free cake if you know in advance the birthdays of classmates who may take in cakes. When it is your child's birthday perhaps they could supply a suitable allergen free cake for all to try (discuss this with the teacher first).
If your child has a seasonal allergy, make sure that you visit your GP prior to the season for adequate medication and advise the teacher about difficulties such as games lessons outside, wearing of sunglasses, etc. Try avoidance techniques or measures to eliminate exposure to allergens, such as showering hair after games lessons or at home to remove pollens.
Check ingredients and offer to provide alternatives if possible for cookery etc, ask the school if they could adapt a recipe (for example nut-free ingredients, etc.) so your child is included and the other children all use the same products if possible. However, there may be other children with different allergies who may are not able to use the same ingredients as your child, so it may be easier just to supply your own child’s ingredients.
Check activities such as playdough, art lessons, nature tables and care of the class pets. Be especially aware of any contact allergies, such as eczema, which could be made worse by some activities. Ask the teacher about alternative activities which may be available for your child, together with a small group of children. Discuss distraction techniques to prevent focusing on factors such as itchy eczema (The National Eczema Society have more guidance on these issues 02075618230). For older children, lessons such as science should be discussed regarding chemicals, etc.
For PE and Games, make sure staff are aware of the children who have asthma. Reminders from staff may be necessary about taking inhalers/ Epipens to sports fields (and especially off site). Emphasise the need for additional 'swim' time which will allow for children who may require emollients or showering if they have eczema.
It is important that your child is included in all outings where possible and it is also important to make sure that they are enjoyable for your child without any, or minimal, risk of allergic reactions.
- Day trips and trips away will need careful forward planning - ensure you are given all details and meet with the teacher to offer suggestions or discuss any points that may concern you. It will be helpful to get this ready several days in advance so that you are not trying to explain on the morning of the trip, as it may be that additional medications are needed, such as two auto-injector pens. Ensure that the management plan is taken on the trip by the teacher and a mobile telephone is available (in case of emergency)
- Provision of extra packed lunch items, drinks etc., and spare adrenaline devices may be useful
- Avoid eating/ drinking outdoors especially from open cans if wasp/ bee allergic. Overseas translation cards may be useful if going abroad
Explaining to other children about your child’s allergies could be done by the child and teacher, or you may find it useful to go and talk to the class. Children are naturally inquisitive and will want to know why your child has to avoid certain things, so it is easier to be open and discuss any issues surrounding the allergy that the children should be aware of. Always make sure that any information is age-appropriate; the class teacher or school nurse may be able to advise upon this.
Circle time is a good environment to introduce the subject of allergies to other children and to talk about how to help an allergic child deal with their allergy. It can be useful to explain about situations where your child can and cannot take part, for instance, other children can often think that they are being kind by offering sweets etc., to an allergic child so that they are not left out. They may also not understand why some children cannot take part in activities, such as sport, and it can be helpful for teachers to explain this to classmates, even quickly when starting an activity where one child cannot take part for medical reasons.
There are various books available to help explain allergy to children and further information on these can be obtained from Allergy UK. The most important thing is that your child feels included and secure, and that the other children do not feel they have to be kept apart from your child. It is easier if these situations are dealt with from an early age then, as the child grows up, their confidence also increases and they may find it easier as they get older to cope.
As your child gets older, very often their friends will be able to offer a great deal of support to them, so it is important that they understand as soon as possible about your child’s condition.
Remember that all children need extra reassurance when starting/ going back to school and flare-ups of allergic conditions, such as asthma or eczema, can occur at any time. Tiredness due to lost sleep, if the child has allergic symptoms at night, may be a problem, so always take this into account. Always advise the teacher the next day if there has been a problem so your child's needs are fully understood. Ask the teacher to notify you of any problems encountered during the school day so you are aware of any potential triggers or problems which could carry on after home time. Try to manage any flare-up but, if things do seem to be going haywire then contact your GP/ Allergist to ensure you have the condition stabilised and once again feel in control.
Always make sure you notify any new school of all your child’s needs and, if they go to visit a new school for the day, make sure you send in detailed information relevant to your child’s needs. Consider travel arrangements and whether appropriate people, i.e. school bus escorts or drivers, need to be notified of your child’s allergy.