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Please could you help me with Allergy Management for school-milk, eggs,nuts(28 Posts)
dd2 starts school in September. She is allergic to CMP, eggs and all nuts.
We've had a meeting with the Head and her class teacher, which was positive and assured us that they've dealt with allergies before, staff are all epipen trained and epipens are kept in an accessible place. (They dealt well with dd1 (egg allergy, now outgrown).
We have spoken with the school nurse and the allergy specialist nurse who have provided the Emergency Action Plan produced by the hospital, which shows what to do if an allergic reaction occurs.
Dh and I and the school felt than an additional document 'How to make sure an allergic reaction doesn't occur' (or similar) is needed, so I had a stab at writing one.
I wanted to keep it simple so it could be kept in the register along with her picture saying she had allergies, and quick to read. I would love your views. its just below (I've called dd Bob!):
Bob has severe (anaphylactic) allergies to All Nuts, Milk and Eggs.
To minimise risk of contact with her allergens all staff will seek to ensure that:
Bob must only eat food provided from home in her packed lunch or treat box
Bob must never eat food shared by another child/adult.
Bob must never eat sweets, cakes etc provided by parents for birthdays and other occasions. Instead she can choose something from her treat box.
Bobs parents will provide food for parties or other occasions as required.
School will request that parents do not include nuts and nut products in packed lunches, but this is almost impossible to enforce and should not create a false sense of security.
Bob should not come into contact with nuts through arts and crafts or junk modelling, for example Autumn displays (conkers) or feeding animals (e.g. on school trips or bird food). Allergen free bird food and junk will be provided by Bobs parents.
All staff, (including lunchtime, supply staff and after-school activities staff) will be alerted to Bobs allergy and will be trained in using epipens and emergency response. Two epipens will be accessible at all times and taken on all school trips.
Bobs parents are always happy to answer any questions, however small. Please do not hesitate to ask us anything.
I'm sure I've missed something so I'd be very grateful for your thoughts.
I think that's great whelk. I would add something about staff encouraging all children to wash hands and faces after eating & drinking to minimise contamination and maybe something about wiping tables and floors after food too? My DS's school is very small so they have to use the same hall for lunch and assembly/PE etc. We had a few incidents of DS coming up in hives during PE when it was in the afternoon so they agreed to move it to the mornings wherever possible to avoid this as they don't have cleaners in after lunch.
What arrangements have you agreed for lunchtimes? We decided we didn't want DS to be sat on his own on an 'allergy table' but were worried about contamination so agreed that he would sit on the end of the table next to one of his classmates who knew him and his allergies well so understood about not sharing food and not touching him or his food during mealtimes. Also, as we're in Wales, all infants get free milk in primary schools so this was an issue too as DS is contact allergic to milk. The school ordered straws for the milk cartons to minimise spillages and DS sits in a different area of the classroom during milk-time with other kids who can't or don't want to drink milk plus they wipe all the tables down when they've finished. It's such a minefield but it's worked really well on the whole and he's just finishing his 2nd year in school without any major disasters. He's allergic to milk, wheat, eggs and nuts by the way and even has school dinners once a week.
Oh and the school contacts me in advance if they're planning on doing any cooking or food-based activities so that I can provide suitable alternatives. He does his 'cooking' on a separate table to avoid contamination. Thankfully the school now has a healthy eating policy that bans kids from bringing in birthday cakes or sweets for the class so we don't have to have a 'treat box' anymore (to be honest, he prefers fruit anyway!).
Conkers are nuts?? My ds is severely allergic but fine with Conkers, good job as it completely slipped my mind
Yes, great letter, well done
You might want to check exactly where within the school they plan to keep the epi pens.
Check that one goes to the lunch hall and to p.e. and to the playground supervisors at playtime. Some children at our school have one that follows the child round and the other kept at the central first aid point.
Have the school talked to you about where she will be eating her packed lunch?
The last thing she needs is to be sitting beside a sneezing child who is eating and egg and cheese sandwich. Some schools operate an allergy table with extra supervision and larger spaces between the children.
Great suggestions freefrommum. Many thanks
I don't know what to do about where she sits at dinner time. We chatted to the teacher and Head about it and there was no obvious solution.
The difficulty is at the moment she only knows a couple of other dc going to the school and they are not her friends. Perhaps this is something that we could think about when she has some reliable-ish friends..
Thank goodness theres not free milk here, but I am familiar with the issue as dd's been at nursery (milk central) for 3 years!
Valiumredhead - I was only alerted to conkers when I checked the Anaphylaxis Campaign website too! It hadn't crossed my mind either. Coincidentally I bumped into a friend who is a TA and she said that their nut-allergic little lad had come up in hives while making autumn displays!
Notanotherpackedlunch - We discussed the epipen location. Its a small school and it was felt that it was safest for all if it remained in the school office which is very close to dinner hall and her classroom. If they go on the back field then the epi-pen will go with dd.
Our school doesn't have an allergy table and I think I'm happy with that. dd1 managed well with her egg allergy and dd's teacher says she was watched like a hawk!!
I would like to at least meet the dinner ladies to a)thank them and b) answer any questions c)watch what they do. So I might ask for this to happen. Its really they who are doing the most important job as that's when a reaction is most likely to happen
My DD has severe non-IgE mediated allergies (causing inflammatory bowel symptoms), and reacts to trace amounts. So, we've had to consider exactly the same as you, and are drawing up a protocol on this at the moment with our school (she's just leaving reception).
DD's school doesn't have an allergy table per se, but DD sits at the end of the line of tables designated for her class, with an adult and a couple of friends - keeps her at one remove, but still integrated. I highly recommend it - we've had a lot of allergen exposures this year, unfortunately, but none from lunchtime.
If you're not going the allergy table route, maybe at least consider a special high-sided tray for your DD to eat her packed lunch off? Acts as a sort of buffer zone for others' crumbs and food.
As an aside, does anyone out there have any experience of where to source expert input on prevention, rather than dealing with outcome? Our school has struggled to find anyone who could help, and as we sit under a gastroenterology rather than allergy team, we don't have access to someone who deals with these cross-contamination issues.
PS - You might want to include on your list equipment that may have been in contact with allergens, as well as materials that may contain them.
Thank you keepmum I will have a real think about where she can sit. What you describe is what dd has had at nursery i.e. with an adult seated next to her and that worked very well.
All of the help I've had keepmum seems to be about what to do in an emergency, rather than how to prevent one. Which is unsatisfactory.
At both nurseries and now school I have done one myself, each time thinking that there must be some sort of standard format for this. But I've never found one.
Hmm. Strikes me there's a massive gap in the advice available. Perhaps we need to create an allergy mums' consultancy service
Should've added that at lunchtime one of the Teaching Assistants from his class keeps a close eye on him and those near him. Also, when he first started (so didn't know most of the other children) they always left the seat next to him empty so that he had a 'buffer' zone between him and the nearest child but he was still close enough to chat and feel included. Now that all the children are very aware of his allergies it's a bit easier. When I meet the kids at parties etc they will often tell me what DS can't eat!
I agree that all the protocols seem to focus on managing reactions rather than prevention and this is definitely a 'gap' in the overall allergy management planning.
I think what you have so far is excellent. At my DS's school, the 2 people who patrol the lunchroom are highly experienced first aiders. They know who the children with allergies are, and they know to watch out for them. They also check regularly the they are ok, and happy/secure with their eating environment. I realise it may not be possible for all schools to provide this, but maybe something to discuss?
Thanks likeaninja they will have two dinner ladies for the reception children.
Many thanks all for your comments. I've added them in and dropped it off with her teacher today!
We agreed that it would be very helpful for me to speak with the dinner ladies in September. dd2 isn't staying for dinner the first two weeks so this will give us some time.
dd's teacher had also met with dd2's nursery keyworker, who is great with the allergy management, and she had given her some other things that may crop up, for example changing other children's tops if they spill yoghurt all over themselves.
I feel they are being very supportive and I hope this translates into practice.
Well done! I hope she has a really nice start in September
That's good to hear Whelk. Hope it all goes well in September!
Thanks. If only it was just uniforms to think about!!
Something to consider is a 999 script for school in case they need to call an ambulance for your dd. my ds is type 1 diabetic with some allergies to medicines and so it's important for medics to know accurate info on his condition. In the heat of the moment it'd easy to forget things! My mum finds the script reassuring to have when she cares for ds. It states his full name, date of birth, info on his allergies, details about his diabetes and insulin pump.
Thank you Tidypidy. That is on the emergency plan. Its really important to use the word 'anaphylaxis'.
With our recent experience, they came very very quickly!
This a great thread - dd starts nursery in August and all of the info is so helpful. Whelk, what you prepared is so useful for staff. Did you do similar for nursery?
I did Harverina and they did some additional bits. Please feel free to nick what I've written and add your own stuff that's more relevant for your dd's situation.
Really push the angle of having information somewhere in the classroom about it all - or in the register or somewhere.
I used to supply teach and quite often you'd go into schools and the only place allergy information would be displayed would be in the staffroom. Fairly often supplies don't go in there - some schools are viciously territorial over staffroom chairs, some schools are unfriendly and generally most supplies tend to work through lunchtime to clear the morning's marking and sort out for the afternoon... so it would be quite easy for them to not see any allergy posters going - plus in a school with multiple Y6 classes, you don't necessarily know if Johnny is in the class you have for the day if you're just seeing his photo on the staffroom wall without the class list in front of you (you learn as many names as you can but generally just in a knowing X child is called X and not being able to reconstruct a class list kind of way).
Always much more helpful if the information is somewhere on the wall by the teacher's desk in the classroom, or in the front of the register - somewhere that anyone involved with the class is going to see it.
Just something from a cover-teacher's perspective that schools always seem to blooming well overlook.
Thanks whelk I will steal it and use it when we meet with the head teacher I am so so nervous about her going to nursery but she is excited and I will not be letting her see how nervous I am. We will talk about her having her own snack box and that she shouldn't eat anything else but I don't want her nervous at all.
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