Nut-free Nursery, too far?

[Seeyouentea]

Ok, I'm open to being told otherwise...

My ds is allergic to milk, soya, fish and chickpeas. Varying reactions ranging from wheezing/ vomiting/ facial swelling (milk) to excezma and nappy rash with diarrhea. It's all pretty under control and he hasn't needed his inhaler or piriton for ages. Other things yet to be indentified (he's 18 months) cause low level reactions with loose bowels and dirty nappies (up to ten a day in a bad patch) that cause instant and vicious nappy rash. I went through MANY many creams (all that I found sold and prescrbed) that didn't bring his excezma up and make it worse. We've used this cream for a while and it's great, it's the difference between being a little red and sore to open sores.

Two weeks ago his nappy rash cream was handed back because they noticed (4 months on) that it contaied peanut oil. I explained it was all that worked for ds, they've seen him at his worst. I was told I should understand as my ds is allergic too. I've said nothing yet but already his bum is getting bad. They're trying a mixture of vaseline and his excezma moisturiser (doublebase) but it's still creeping up. Nappy changing is descending back into a painful expereince full of screaming and he runs away or cries after soiling.

I'm starting to feel a little put out, one child at a time is changed by staff wearing gloves in a room well away from food. I can't see the risk of contact. Unlike the times other children eat their cereal around my son. The nursery can't be dairy free and it's well managed.

Is it going too far? I'm wondering about changing nursery if I can't find an alernative cream soon which would be a huge shame as it's a wonderful place, but I can't bear to see ds so sore.

Im allergic to peanut and hazlenut, have been since long before it became mainstream knowledge long before blanket bans, people taking it seriously and the knowledge people have today.

I have had three sets of anaphylatic shock which was terrifying but on the whole I have self managed it since I was 6. (28 now)

I can totally appreciate people been frightened and over cautious but there has to be some common sense line surely! Peanut oil. In a pot, applied wearing gloves, kept in a safe place is low risk. Changing mats should be cleaned down appropriately after use anyway using dettol. Does a child with nut allergy never touch a door handle when out? Hold onto a bus rail? handle coins? All are things which could be covered in nut produce.

I do think the world has gone a little bit insane. Bit like the kitchen roll I bought that did not contain nuts.... really

I think it is a training issue. The nursery clearly need to get someone with allergy expertise to come in and teach the staff about how to handle these issues. Blanket banning things sounds like the well-meaning attempts at policy-making of someone who isn't well trained.

As a mother of a multiple allergic child, and a early yrs worker with a past work history in day nursery in management roles, i would say that,

1. there is a possiblity that the peanut oil in the cream is highly prosessed, heat treated and is a very , very, low risk, protein wise. ( u could consider contacting the company and asking?)

2. re-thinking the nappy changing area, as someone else mentioned and seperating your childs creams etc, perhaps in a plastic labeled box, would lesson the chance of cross contamination.

3. good hygeine routine would stop the above! (btw check that non latex gloves are used if your child has ezcema.)

4. its still possible that your child may be allergic to peanut as you have a confirmed allergy to legumes/chick peas. (just add that to a list to check one day! )

5. an adult with peanut allergy can manage to change a child's bum without eating the penaut oil containing cream, and can wash hands , and use good hygeine, ( disposable blue paper roll to put on changing mat stops this aspect of cross contamintion) , plenty of nut allergic stuff in nurseries in this day and age!

the school , like many others are over reacting out of uninformed fear, and need to consider and reveiw there allergy policy with head office.

good luck!

Eragon, re point 4, can you expand? He's had peanuts a few times, all fine. I'll admit I'm not the most knowledgeable about allergies as I've no experience of food allergies before.

Eargon, his cream is labelled and in a separate box. It's the nursery system for all wipes/ nappies etc. Has a picture of each child n their box

Peanut allergies can be triggered from trace amounts of peanuts or even by inhaling the vapour from peanut oil. Someone severely allergic can have a reaction just by being in the same room as someone with traces of peanut on their skin. This is why some schools and nurseries have a no nut or peanut rule.

DS1 used to get horrible nappy rashes - until we switched to alcohol free wipes. They were hard to get 7 years ago, but most brands do a version, now.

It is advised by the dcfs and ofsted that all nurseries providing care for children under 5 should be nut free as it is advised that children under 4 are not given nuts and if your cream is in any way able to be around other children whose parents have not given them nuts or have not tested there sensitivity to nuts and then are exposed and suffer a horrific reaction because of the peanut oil it is not worth the risk to the nursery and to be honest you are going to find it really hard to find a decent nursery who is willing to accept the risk of using the peanut oil cream unless you can find a child minder

Who advises that children under 4 shouldn't have nuts?

well. peanuts are a legumme and yr son is allergic to two of them already, soya and chickpea, however, if consumed with not reaction, and they are not cross contaminated with any other nuts, i would carry on.

certainly , the loose stools can be an allergic reaction, so its worth considering another allergen in the mix that needs to be removed from the diet. although i am sure that must be under medical investigation anyway?(ok with eggs ?)

the school already have taken steps to box and label your childs nappy stuff, so why are they being so over the top? are they a chain nursery? can u ring head office?

lets chill on the airbourne vapour with peanut oil stuff everyone....(parents of allergic kids do have regular freak outs for a very good reason, lets calm down on ideas like this that are hazy etc)

quite a lot of ige allergens are airbourne, shellfish is the more problematic one for those with asthma and the allergy.
its difficult for an oil to break down to become an arerosol , much more of a problem would be dry roasted peanuts that are more of a problem.

those who do react, very rarely go in to full blown anaphylaxis, and have mild reactions or ones easily resolved with anti histamine.

cross contamination is more of an issue in the form of peanut butter, IMO as it does spread and cling to surfaces, but is easily removed with washing up liquid and hot water. (bleach doesnt work btw)

its entirely possible for an allergic child to be included in a day nursery, but in this artifical environment, accidents can happen easily and need constant high vigilance, and often reactions happen with very young children , simply because they are eating food that they may not have tried before. allergies always seem to be a more common food. so emergency training, with management training is really required. school nurses do the former, parents do the latter.
(i.e YOU tell them how to keep yr child safe, just because they have had a allergic child in setting before, doesnt mean that they understand fully what a multiple allergic kids need to avoid.)

As a parent, i wouldnt just talk to the head of the setting, but the key worker , room worker, and ask for certain procedures and photos, and read the general allergy policy and indvidual one, of which the latter should be constructed between you and the medical professional and the staff.

I would also inspect the kitchen, and cook directly to the cook.
as a precaution to the cook being absent and agency cook stepping in, i would provide a safe emergency long life lunch or snack, just in case.
or i would provide all food myself and if it needs reheating, inspect the microwave used and ask what food is re-heated in it?

DFES and OFSTEAD dont have a blanket ban on nuts , they have advisory steps taken at leader/head opinon.

if they did have a nut ban, pressure would be instantly put on them to ban other foods.

the medical proffession advices that whole nuts should not be given to children under 3 because of choking. however peanut butter etc is ok.

if the latest LEAP study proves that early introduction of certain foods prevent allergies from developing the new following generation will be eating peanut butter at a much younger age. perhaps, like african infants who are fed ground peanut as a first weaning food, and interestingly enough, none of them have peanut allergy.

As a CM myself, I've heard nothing about a DFES or Ofsted ban on nuts, and we are expected to work to the same standards of care as nurseries and other Early Years providers.

The only advice I've heard of regarding nuts is that small children shouldn't be given whole nuts because of the risk of choking, but no reason for Early Years settings to be nut free at all, and that hasn't come to me via Ofsted!

flisspaps ! love your name, really gave me the giggles. (sorry to interupt thread subject)

You have my sympathy. DS is allergic to milk and soya and the nappy rash associated with allergic diarrhoea has to be seen to be believed. We are so lucky with our nursery - really kind and proactive and the staff go out of their way to bring in DS friendly items so I can't help there I'm afraid. However, what really worked for us bumwise is using cavilon. It's a water impermeable barrier, either as a spray or (more kind) on a single use sponge applicator. Originally used for prevention of pressure sores in the elderly but fantastic for allergic bums. Put some on after every change then lashings of cream - we used hydromol, don't know if you've had that? Sorry if you've already tried this and it didn't work.

FWIW my DS is severely allergic to kiwi fruits (and some nuts). The other childen at nursery were still able to eat kiwi fruit at the same table as him at meal times, they didn't ban kiwi fruit.

They did always have an adult at the table with them though and DS was old enough to know he couldn't eat kiwi.

adult at the table for young children should be a the standard for a good allergy policy in a young child setting, so this does sound good.

If they are that concerned, what do they do about children who might have had peanut butter for breakfast before coming in? The logic of bans does seem really flawed.

Sorry I think you are being totally unreasonable. You of all people should be able to understand the need to keep the nursery peanut free - however, ask them to confirm that there is a child who is actually allergic to the cream as I don't think they contain the proteins. It must be possible to find a different nappy cream just for at nursery .... obviously vaseline / doublebase a waste of time (would have thought sudocrem better or even timodene) - surprised to read that metanium and bepanthen both contain nuts.

Interesting that the people who think that the nursery are being unreasonable are the ones with experience of nut allergies......and I'm inclined to agree. It's nonsense to make so much fuss about a cream containing peanut oil and yet tolerate all other allergens.

There are so many allergies among my relatives that if we applied the banning logic used here, the only thing to be served at family parties would be lettuce!

LOTS of skin products contain food in some forms, and high amount in ezcema treatments.

she is not being unreasonable, good hygeine practice should ensure that risk is so so small its not worth being concerned.

i am always more concerned about day nursery staff using latex gloves to apply a childs ezcema creams.....

BTW lots of moisterisers contain nut oils and my severely nut allergic cousin has been using one with almond oil in for years with no reaction at all. She didn't even realise what was in it until I absent-mindly read the ingredients one day.

Another one who has dc allergic (severly - anaphylaxis) to kiwi and pineapple. DD and DS2 are both badly affected by this. Yet neither of their schools will agree to ANY sort of rules around kiwi or pineapple. Because obviously a nut allergy is more severe.... Kiwi and pineapple juice can squirt quite a long way, and cross-contaminate things easily.

I have had DS2's primary school telling me that I should give him little bits to 'desensitise' him to it. Against the advice of his consultant. . I'm bloody sure the school wouldn't take that tack if DS2 was nut allergic, as the school is nut free. But, of course, only peanuts can cause anaphylaxis....

And unless you have SEEN the diarrohea associated with allergies, and how acidic it is, and that it can almost 'burn' a dc within less than a minute of it happening - you would have no idea HOW important it is to find a cream that WORKS to relieve this pain. When you have changed your dc's nappy within seconds of them having diarrohea, yet their bottom is BLEEDING, you would understand how important this is. And, often, Z&C cream is the one that works best on this...

If you have a friend in the states have them send you a tube of nappy rash cream called "triple paste". It works miracles

yanbu

peanut hysteria, really

Huntycat,this is what was talking about-acid diarrhea. I've held his legs as it's squirtying out and it's burnt either side of the tissue I was catching it in

I have a peanut allergy (amongst other nut allergies) as does my son. We both have eczema too. There have been some studies that indicate a high number of peanut allergy sufferers who also have eczema may have got the allergy because of extensive use of emollients containing peanut oil. As for the school of thought that if there is none of the protein present in the oil it wont give a reaction I totally disagree, as does my sons allergy specialist.

It is very difficult finding a cream that suits when there is eczema and allergies present, I have had the problem for many years and have yet to get an appropriate answer from a gp as to why they insist on prescribing creams containing peanut oils to both myself and my ds.