Parents often worry about how their child with allergy will be cared for outside the home by other people. However, through allergy awareness and education, this anxiety and concern can be reduced.
The majority of children attend some form of childcare before they get to school age. These settings include:
- Relatives and friends
Whatever age your child first attends a child care setting, their allergies will need to be taken into consideration.
Allergy UK is committed to providing resources for childcare practitioners so that they can be as allergy aware as possible. Through these resources we hope that children with allergies will be welcomed into childcare settings by carer(s) who are trained to manage allergies.
Below is some information about how to manage both formal childcare and your child’s social life beyond the home.
Whichever type of childcare you choose for your child, you will need to discuss with the carer(s) any special arrangements that are required to keep your child healthy and risk free. We strongly recommend that you and the carer(s) take the time to write an allergy management plan. Although this may sound very formal and unnecessary for a casual childcare arrangement – for example if a friend or relative is the carer – it can be vitally important to the welfare of your child.
An allergy management plan is simply a list detailing how your child’s allergies will be managed on a day-to-day basis and what to do in the event of an allergic reaction. It means that you and the carer(s) know exactly what is needed and expected and it acts as a reference for new or temporary staff. It is also a means of reassuring your child that everyone involved in their care is aware of their allergies.
The first part of the management plan should be about your child’s allergy or allergies. The information needed here is a clear description of what your child is allergic to and an outline of what symptoms your child shows when having an allergic reaction.
If your child needs regular treatment during the day to keep symptoms in check - such as eye drops during the hay fever season, or emollient cream for atopic eczema - then the plan should state how often the treatment should be given and who will be responsible for giving it.
Some childcare settings will need a letter from your child’s GP before they can give treatments. This letter should state the treatment prescribed for your child and should be kept with the management plan so that it can be referred to at any time. Check with the carer(s) whether they require a letter and make sure you keep a copy for your own records.
Sometimes emergencies arise and it is vital that the management plan clearly states what the carer(s) should do. A simple list of procedures should be written into the plan including step-by-step instructions explaining how the reaction should be managed. This will mean that carer(s) know exactly what to do and will be less likely to panic. It may be worth having a practice run-through of the emergency procedure with the carer(s) to prepare them for an emergency but it may be wise not to include the child in this so as not to worry them.
A copy of a suggested allergy management plan for pre-school settings and childcare settings is available from the Allergy UK website.
Training is essential for those caring for your child. Although you may be expert in helping your child with inhalers or with nose sprays, you may need to encourage childcare professionals to increase their knowledge through training. You may be able to show them how to give treatments but there are other sources of training and information available and your doctor should be able to give you advice. The Health Visiting team is responsible for health education in Early Years settings such as nurseries and playgroups, contact your local baby clinic to ask for help in organising this. Contact the School Nursing team for allergy education in schools, or children age 5-18 years.
Charities and organisations will often be very willing to give talks to carer(s) about a particular allergy or allergic disease. Whilst this does not provide a substitute for proper training in care and management, it does help people working with your child to understand the nature of the condition involved.
For more information on the training available you can contact the Allergy UK helpline on 01322 619898.
In many cases, having an allergy means that a particular allergen or allergens must be avoided. This is essential with food allergy and there are many ways in which childcare settings can adapt and cope with this aspect of allergy management. However, if you are not satisfied that your child’s environment is sufficiently risk free, then it is best to look elsewhere for childcare.
Often carer(s) and nurseries have already thought about allergy triggers in their childcare setting. This is because they have to perform risk assessments for all aspects of their practice and the environment they work in. In this case, they will be knowledgeable about avoidance of allergens and many of the larger nurseries will have a clear policy on food allergy. For example, their nursery may be a ‘nut free zone’ and may have a “no food sharing” policy.
These policies are helpful if food is brought into the childcare setting by other parents for lunches, or if lunch is provided for your child during the day. It is a good idea to request that a clear set of instructions about your child’s diet is displayed where the food is prepared, along with a photograph of your child. Whilst this may not seem essential for small settings, it is very important that a copy of your child’s requirements is kept on display in larger settings such as play groups or nurseries. It is a constant reminder of your child’s allergies and provides a quick reference for carer(s).
It is not only during meal times and snack times that food can be an issue. Many craft products - both commercial ones and those made by carer(s) - can contain ingredients that could trigger an allergic response. For instance, using a flour-based play dough will be out of the question if a child in the nursery has a wheat allergy. It is not just that they can’t be involved; if it is a severe allergy even traces of the allergen on surfaces, on other children’s hands and in the air could be enough to trigger a reaction. For this reason, you need to ask the nursery to check products and ingredients and ask that they be excluded if necessary.
Sadly, childhood allergy is on the increase so your child’s carer(s) will probably have some prior experience of managing allergies. However, even if carer(s) are welcoming and seem knowledgeable and confident about allergy, they will need to understand your child’s particular allergic responses. A written allergy management plan helps staff learn about your child’s requirements and can be referred to if there is any doubt about your child’s allergy.
Leaving a child in someone else’s care can cause anxiety to both the parents and the child. When your child has an allergy this anxiety can be magnified but by taking steps to work with your child’s carer(s) you will make the childcare environment as risk free and as supportive as possible. It is then the responsibility of your child’s carer(s) to ensure that the allergy management plan is followed. Over time it may be necessary to adapt the plan as the carers become familiar with your child’s needs and your child adapts to the routines of the childcare setting.
Ask occasionally how treatments are going, or check from time to time that new staff know about your child’s condition. It is also worth asking whether your childcare organisation has set reviews for your child at which time it would be appropriate to update them about any health issues.
Learning to trust that other people can care for your child with allergies is not easy but having a definite plan in place will help relieve some of your anxiety about managing allergies outside of the home.