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Allergies and intolerances

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Starting Nursery - What have your nurseries done to ensure the safety of your milk allergic children?

13 replies

whelk · 08/01/2010 21:26

Sorry its me againn. Im finding the dairy allergy more difficult than dd1's egg allergy.
There seem to be many more elements to consider with a dairy allergy at nursery, not least other dc's formula milk.
What do other nurseries do?

Thank you in advance.

OP posts:
mamakoukla · 08/01/2010 21:41

Hello Whelk! It's all a bit nerve-wracking.

Our solution has been to take in all of DD's meals/drinks. All meals and snacks are taken sitting down, so this minimises 'transfer' of foodstuffs. They also try to seat her in a spot that reduces interaction with children (at the end of the table or in the middle inside of a 'U'-shaped table).

The nursery also has experience of handling children with food allergies as there are other children with problems too (it's a bit sad... can't remember knowing anybody with a food allergy as a kid). Have you asked the nursery what their approach is?

I have also been rigorous that they tell me if there has been suspected contact just so I know to keep my eyes open for any possible signs. It doesn't help if this happens, but I want to know.

whelk · 09/01/2010 15:06

Thank you Mamakoukla. I took in food for dd1 (allergies to egg, lentils and some fruit) for about 4 months so couldit do it again.
I don't really want to do that forever with dd2 as when they are bigger its nice for them to have what everyone else has. However if its the only safe way then thats what I'll do.

OP posts:
bonkerz · 09/01/2010 15:18

i work in a nursery where food allergies are quite common unfortunately! we do take steps to prevent access to allergy foods.

currently cook has separate containers in fridge and cupboard containing specific foods for each allergic child and also photo of child and list of foods they can and cannot eat on wall. Plates are allocated per child and marked so no mix up when giving food. ALL STAFF are aware of allergic children by posters in staff rom with pic of child/meds/what reaction looks like etc on it. If below age 2 then child has own seat with tray attached (not high chair as it is table height) this means child can still sit with friends at table but is further away and not actually at table etc IYKWIM.

foxinsocks · 09/01/2010 15:20

10 years ago mine did bugger all (that they said they would do) ending up with dd suffering severe problems because of their uselessness

I am hoping, 10 years later, that things have improved substantially

in all honesty, I wouldn't believe a word they said. If I did it all over again, I'd go in with your dairy-allergic child and insist on SEEING in action how they work with the allergies.

TheWicketKeeperIsDown · 09/01/2010 15:57

My DD also has CMP and egg allergies and I agree, the milk is the real bugger. She just started nursery a few weeks ago, so we've just been through/are going through this. I went in to have a chat with the director and manager of the nursery and felt much better about it all after that - they have dealth with many allergic children in the past, and with much more severe allergies as well. Also, the nursery manager gets anaphylaxis with cow's milk, so that allayed all my fears that they wouldn't Get It and would think that I was just an over-anxious middle class mum.

I also take in all DDs food. This was suggested by the nursery director to reduce anxiety for me and also her staff, but was what I wanted to do as well. There is no doubt that it is a MAJOR pain in the ass, but hopefully it'll not be forever. And we get a reduction in the fees for that. The highchairs in our baby room are all pretty close, but they put DDs a little bit away so that there aren't milky paws holding hands. Her cups/bottles etc all have her name label and allergy labels on (I got good ones from Stuck On You) as a reminder. My big concern, like you, was with other childrens' bottles of formula, and ultimately the staff and I agree that there is no perfect way of dealing with this, as I cannot 100% prevent DD grabbing a toy from a baby who's had formula and then sticking it in her mouth. The staff are being as vigilant as possible, and wiping down toys in that situation, but I don't want DD segregated from other kids - that's why she's at nursery in the first place. Also, I can't eradicate risk completely at her grandparents', at friends, or even in my own house. I can only take precautions.

Good luck with it all - I'm sure you'll be as pleasantly surprised as I and others have been with it all.

Sheilsie · 09/01/2010 23:52

My 14 month old DD is allergic to cows milk and eggs and has been a nursery four days a week since she was 6 months old. I wasn't filled with confidence at the start as they accidentally gave her a product containing milk on day 2. However, I think that her reaction gave them such a fright that there has not been a repeat. They cook her different meals to the other children. To be honest, I'm not always inspired by what she gets and I hadn't thought of providing her own meals. But I might look into it (especially if I get a discount)

babybarrister · 10/01/2010 08:02

This reply has been deleted

Message withdrawn at poster's request.

mamakoukla · 10/01/2010 18:03

Whelk, I have a copy of the menu and whilst I cannot replicate all of the meals/make them look identical I do try to make ones as similar as possible e.g. the type of meat, if it's a casserole or they are having rice, etc.

Ultimately the child does need to realise that they cannot eat all foods and that there is a very good reason to this. (= having different foods is not necessarily a totally bad thing as it reinforces this). DD will tell you 'no icky milk; special milk' and we are trying to teach her to say no to certain foodstuffs. If she asks to try, we tell her - 'no, there's XXX in it. Dr said no becuase it makes you YYY.'

whelk · 10/01/2010 20:47

I have arranged to speak at the staff meeting next week so keep your brilliant ideas coming!

The nursery has been great with dd1 (allergic to egg, lentils, and some fruit).

One issue is that the kitchen is 'off site'- servicing the school and special needs centre too. i think I need to build a relationship with the cooks too.

OP posts:
Bilbomum · 11/01/2010 11:22

Hi Whelk, I stuck to a childminder for ds (milk,egg, nut,sesame allergies) we've been very lucky she's been great and ensured all the kids have the same meals when ds is with her. He's been with her since 6 months and we've never had any problems. I thought the nursery situation seemed more risky for ds, at least I knew exactly who was looking after him.

He's now 3 and just started pre-school on a morning and that has been more problematic. Self service milk tables are now the norm unfortunately but we've managed to come up with some safeguards. Luckily they only have fruit to eat as he's just there on a morning. I did have to fight my corner for ds though, it wasn't easy to get them to take it seriously.

I agree with Mamakoukla though, they do have to know from an early age they can't always have what everyone else is eating and why. Your first instinct is to shield them from the knowledge but they have to know for their own safety.

I don't think I would put my trust in an off site kitchen facility though. There's too many risk factors involved, even if you get to know the cooks staff may change, temps may come in. Dairy crops up in such unlikely places, most people just don't realise unless they've had to deal with an allergy first hand.

whelk · 12/01/2010 20:44

Thanks All. I have just spoken with the Head of the Baby Room, who will also be dd2's key worker and she assures me that they already look after a child with a dairy allergy and she/he is catered for by the kitchen. I think this isn't off-site but caters for not only the nursery but the school and also a SN centre (all part of the childrens centre).
I am going to talk more with her but this seems more encouraging. I am happy to bring in food and probably will when we start but it in the long term (when she goes into the toddler room) I would like her to eat what others eat (as long as it doesn't contain dairt/egg)

OP posts:
UnseenAcademicalMum · 14/01/2010 00:12

To be really negative- when we wanted to put ds2 (anaphylactic to dairy) into nursery, we thought he would go to the same one as ds1 (egg, nut, legume and kiwi allergic). However, the nursery would not take him unless he had an epipen .

Needless to say we opted not to put him into nusery (especially as they pointed out all the "risks" such as staff not clearing away food containing dairy in a timely manner, staff not realising that a child who had just had milk had been sick etc etc). However, I think our nursery was particularly negligent wrt allergies (ds1 hae a number of unexplained reactions despite never being given food on the "allergy" list, yet since he started school and had packed lunches he has never had a reaction!!!) Other nurserys are probably far better.

Our nursery also banned people bringing in their own food.

bridewolf · 14/01/2010 10:35

every nursery should ask for medical back up when accepting a child with allergies in to school.
they need a treatment plan from gp or treating hospital ,before they can begin to write a care plan for the child. if they dont, their plans for health and safety of that child is more than shakey!

it should not be based just on parental opnion, ie, a casual comment as mother leaves, adding that little johnny cant have chocolate as he is allergic.

staff need a good grounding in allergy management, emergency care, and understanding of both ige and intolerance allergies, and this can be problemmatic.
when you are frequently short staffed, sending staff of on allergy training days can be difficult.
and of course many day nurseries have a high staff turn over, and many temp staff that come and go.

however, its possible to have a allergic child in nursery , and with a care plan.

as the mother of a multiple food allergic child, with a work history of working , running under five settings, i personaly provided my child with his own food.

however, i would have reconsiderd the idea if upon visting , that i could go and talk to the cook and witness the care of allergic children in the setting, and question the staff who deal with my child.

day nursery food is prepared by cook, handed to nursery staff, who pass food onwards in to the rooms, in total three or four pairs of hands pass the food around, so imo it can lead to mistakes.

ideas such as photo table mats can help here, so there are ways to lesson the chance of this, but there is always the possibilty of things going wrong. sometimes a sweeping virus around the nursery can detract attention to the normal protocals, and so accidental ingestion can happen, and if in the case of a vomiting bug, a reaction may not be recognised.

another reason why staff need to be allergy trained!

milk is a difficult allergy, as milk is an important part of under fives diet.
however, what i can say , is that in the case of babies, vomited up milk, or possiting milk after a formula feed, does pose less of a risk.
the milk has hit the stomach, and been partially digested, and so the milk protiens have changed.
a mild reaction still 'might' happen, and staff should anyway have a protcal in place to safely remove and clean bodily fluids, which in turn makes the risk of reaction lesson further.

so, its not impossible, it just requires more thought and care by staff and parents.

often one member of staff is in full control of preparing and feeding allergic child, this lessons the chance of mistakes with uninformed staff, so its worth asking for that in a baby and toddler room.

hope this is useful stuff, i am pretty much clued up on this subject, and often give voluntary allergy management talks to staff, and parents.

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