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Robyn Bullock
English 2010
Professor Denise Pfeiffer
March 5, 2012
Managing Food Allergies and Food Intolerances in
Jordan District Elementary Schools
With the increase in reported allergies occurring in school age children, schools have to
be proactive in how to make the environment as safe as possible for a child with food related
medical conditions. The latest national statistic shows approximately 8% of children under the
age of 18 have an allergy to one of the major classified food allergens, peanuts, tree nuts, dairy,
eggs, soy, wheat, fish, or shellfish (Gustafson). Dr. Mark Hyman says “We are facing an
epidemic of allergic (60 million people), asthmatic (30 million people) and autoimmune
disorders (24 million people).” Studies also indicate that most life threatening allergic reactions
happen while a child is at school, with the most severe reaction of anaphylactic shock happening
in children with nut allergies (Durbin). The difficulty schools face is how to provide the least
restrictive, safe environment for all children. Not only do schools need to address the issue of
allergens in the cafeteria but this major health concern must also be addressed in the classroom.
According to Richard A. Cone and Emily Martin “The main types of disorders of the
immune system are allergies and autoimmune diseases.” Both allergies and autoimmune
diseases are caused by the bodies immune system attacking a food or toxin thereby creating a
reaction. Although food intolerances are not immediately life threatening the symptoms can be
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similar and usually involve the digestive system. Timi Gustafson states, “There can be
conditions, where food tolerance and allergies overlap. Celiac disease, for example.” She goes
on to explain that some food intolerances such as celiac trigger an autoimmune response as does
an allergic reaction. Therefore parents and schools must be as diligent in keeping a safe
environment for those children diagnosed with autoimmune food intolerance as well as those
diagnosed with food allergies (Dana Korn).
Children in school constantly come in contact with possible allergens on a regular basis.
Teachers have arts and craft projects, counting assignments that use food as manipulatives, and
science project using food to teach a concept. Parents enjoy bring treats to celebrate a child’s
birthday. Class parties are held in which food is served. A person with a food allergy does not
have to eat a food to have a reaction; touching that food item can also cause a severe reaction.
Hand washing at school is another concern. Children do not always wash their hands
after eating or touching a food another student might be allergic too. Then if that child who ate
the food touches the child with an allergy it can create an allergic reaction.
It is imperative that parents teach a child with allergies safety practices and to say no to
non-approved treats. Depending on a child’s age that child should be taught to recognize the
symptoms of an anaphylactic reaction and to tell a trusted adult. Even with that training and
information from the parents of a child with an allergy, classroom teachers should be proactive in
trying to provide a safe environment. Teachers should know the warning signs of an allergic
reaction and anaphylactic shock.
Virginia and six other states have legislation underway “which would allow school
officials to administer epinephrine to students believed to be in anaphylactic shock.” according to
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the report Food Allergy: A National and Deadly Problem. This proposed legislation is in
response to deaths or near deaths that have occurred in that state. A student would not have to
have a known diagnosis with a prescribed EpiPen available for school personnel to administer
the epinephrine in cases of emergency. The state of Utah does not currently have any proposed
legislation regarding allergies in schools.
Schools should not mandate a school wide ban on certain foods. Doing so could create
an environment in which students with allergies feel a false sense of security (Jeanette Bradley).
No place outside of the home should be considered allergy free. Placing a ban could also create
a situation in which other children will feel deprived and could lead to bullying. Schools should
make decisions on a case-by-case basis since every child with an allergy can react differently.
There are also too many types of allergens to make such a ban practical.
Warning Signs of Allergic Reactions or Anaphylactic Shock
The warning signs are different with each person. The most common symptoms are
“tingling of the mouth, skin rash, nasal congestion, vomiting, abdominal cramps, diarrhea,
dizziness, swelling of the tongue and throat,” according to Dr. Gerard Lalande. When those
symptoms turn to anaphylaxis it becomes life-threatening, since most often there will be swelling
of the throat making it difficult to breathe. It can also cause possible loss of consciousness or
the heart to stop. This condition can rapidly result in death if untreated. Treatment for mild
allergic reactions can be over-the-counter or prescription antihistamines, but as Dr. Gerard
Lelande states a “severe allergic reaction is a medical emergency, requiring an immediate
injection of adrenaline.” Symptoms can occur anywhere from a few seconds up to two hours
after contact with the allergen (Jordan School District).
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Current Jordan School District Allergy Policy
All allergies are considered a critical medical issue (Jordan School District). Parents are
asked to request a health care plan. This request provides district nurses with the authorization to
contact a child’s doctor and with the physician’s recommendation draft a plan for prevention and
treatment of allergic reactions. Along with the health care plan a physician will need to sign the
district approved form for medication to be administered at school. Parents need to bring the
signed prescription form and non-expired prescribed medication to the school. All medication
must have a pharmacy label with the child’s name, instructions and expiration date. At the
elementary school level children are able to carry Epi-Pens and inhalers. Other medications
must be kept secured in the office. This is due to the urgent nature of an allergic incident where
a child must receive the prescribed medication immediately.
When the school has students that will possibly need an EpiPen injection nursing services
will provide training as to proper administration to school
staff. An EpiPen is injectable epinephrine that will prevent a
child from going into immediate anaphylactic shock from
ingesting an allergen. The current district guideline is that
three employees must be trained at each school (Jordan School District). Each individual trained
in EpiPen use must be retrained each year. Once an EpiPen has been administered that employee
stays with the student while other school personnel calls 911 and contacts the parents. The
employee will give the used EpiPen to the paramedics or EMTs upon arrival at the school. Even
though two doses are usually required at 15 minute intervals, Jordan District employees are
authorized only to administer the first dose.
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Elementary School Cafeteria’s in Jordan School District
With the increase of life threatening occurrences of anaphylactic shock due to peanuts
and tree nuts all Jordan School District cafeterias do not serve nuts in any form in school
lunches. Nutrition serves also makes a concerted effort to purchase foods from manufacturers
that do not process nuts in their facilities. However Nutrition Services has
no control over what other children bring from home for their lunches. To
provide a safe alternative so students do not have a reaction to cross
contamination many schools provide a nut-free table. Unfortunately
children sometimes feel isolated when they cannot sit with classmates (Jeanette Bradley).
This policy addresses two of the major allergies, peanuts and tree nuts but does not
address the children with allergies in the other major groups which are milk, eggs, wheat, soy,
and fish/shellfish (Jeanette Bradley). This is because most deaths from anaphylactic shock in
school age children are caused by a reaction to peanuts. It is not practical to have a separate
table for each type of allergy.
Jordan District Nutrition Services has a Diet Prescription for Meals at School form that
can be filled out by a student’s physician that can provide the cafeteria with information
regarding a child’s need for a special school meal (Jordan School District). When school
cafeteria personnel receive the request for special meals the information is forwarded to the
dietitian at Jordan District Nutrition Services. In conjunction with the parents, cafeteria
manager, and Jordan District dietitian a food plan is provided. Since there is only one dietitian
for the entire district this can sometimes take weeks before it is in place. The ingredient
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information on foods prepared or purchased by the district is often very difficult to receive by the
parents. Many times parents are frustrated and due to that frustration choose to send a sack lunch
from home rather than have their children eat a school prepared lunch.
Parents Responsibility in the School Setting
It is critical that a parent is a child’s advocate in regards to a food allergy. If a child is
diagnosed before starting kindergarten a parent should be proactive and notify the school of the
child’s allergy; by doing so a health care plan can be in place prior to a child even attending
school. If a child develops an allergy while attending school a parent should provide information
prior to the child returning to the classroom. The parent needs to fill out the appropriate
paperwork and be in communication with the teacher, cafeteria manager and office staff so key
personnel are aware of the specific allergy and the child’s reaction to the food. Not all patients
have the same reaction to foods so it is important that staff knows the specific reaction.
Parents should provide a box of approved treats to be kept in the classroom. These
approved treats would be available for those times when another parent or child brings food to
celebrate a birthday or some other event. The child would then receive a treat, even though it is
not the same as everyone else. This helps the child feel included while providing a safe food
alternative.
Parents should be invited to accompany their child on field trips. This would provide
supervision if their student should have an allergic reaction. If a parent is not available to attend
the teacher should make sure to have the student with them at all times. That teacher should be
trained in the use of the EpiPen in case of an allergic emergency.
Parents should be notified when there will be a special event that will involve food, such
as a holiday celebration or reward party. A proactive parent will participate in the planning of
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such events therefore creating a safe environment for the child (Jeanette Bradley). If unable to
do so the parent should discuss food dos and don’ts with the child and provide a safe alternative
treat.
Proposed Changes to the Current Jordan District Policy
Proposal #1
With allergies being on the rise and many more incidents of life threatening anaphylactic
shock happening each year some of the current policies are inadequate. When a child’s life is in
the balance having three staff members being trained in allergic reaction recognition and EpiPen
administration is insufficient. What happens if those three require staff members who are trained
are away from the school, or a student is on a field trip? Because of the inadequate required
number of staff trained a child might have a serious health incident or could die.
The Jordan School District Policy should be changed to reflect the following:

All teaching staff, cafeteria staff, office staff, classroom assistants and playground
assistants should be trained to recognize allergic reactions.

Teachers of a student with an allergy should be trained in EpiPen administration.

Cafeteria staff, office staff, classroom assistants and playground assistants should be
trained in EpiPen administration. Many of these positions are part time so all personnel
should be trained to provide adequate coverage.

All bus drivers should be trained to recognize allergic reactions. Jordan District
Transportation Department and Educational Support Services (Nursing) should work in
cooperation to create an emergency plan of action in case of allergic medical emergency.
The cost of these training would be minimal and could be handled during normal monthly
faculty/staff meetings. The only cost would be of photocopying documents regarding allergies,
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anaphylactic shock, and EpiPen information. Each training session could be accomplished in
approximately a half hour according to Sharee Merkeley the Jordan School District Nursing
Team Leader, but by having the instruction it could save the life of a child. This instruction
would also include hands on training with a practice EpiPen that does not have a needle. Nurse
Merkeley also explained that there would not be any addition cost of nursing personnel since part
of the job description is providing adequate training and support to the assigned schools.
Manufacturers of the EpiPen provide school districts with training devises at no cost to the
schools.
Proposal #2
Jordan District Educational Support Services currently provides several classroom
presentations about health issues. At the current time the district only provides a one-page
document letting faculty and staff know the warning signs of anaphylactic shock, and a very out
of date video. Most teachers and staff are not even aware the district has this information.
In cooperation with the nurses a program should be established called “Share Toys, Not
Treats.” This simple program would explain to children in a class why it is important not to
share food with a child diagnosed with food allergies. The program would be able to give
information, without scaring the children, but at the same time would be fun and informative. It
would be helpful to the teachers and reassuring to the parents to have a prepared program
showing the dos and don’ts of living with an allergy. If handled properly a child with a food
allergy would feel special and not feel singled out and bullied. Included in the presentation
could be fun worksheets that each child could take home to share with their parents.
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This presentation can be presented in two different ways. First a Jordan School District
nurse can come in and teach the children in their classroom. This type
of program would only incur the cost of photocopying since part of
creating a health care plan by the nurses is to provide required training.
The second method would be to develop a PowerPoint presentation or a short video produced by
Educational Support Services. This type of presentation would have a greater startup cost but
would be much more accessible to the classroom. Currently each district nurse services eight or
more schools and teachers would not have to wait to schedule a presentation. Each school could
have a copy of the PowerPoint or DVD.
Parents of the child with the allergy should be invited to the classroom presentation.
They may be able to share helpful insights into their child’s reactions. By being in attendance
the parents can also discuss with their child, at a later time, the key points of how to keep safe
around food.
Following the class presentation a document will be sent home to all the parents
explaining that a child in their student’s class has a life threatening allergy. It would include a
suggestion of alternatives to bringing a food treat for birthday. Children would be just as happy
with a simple toy or book as with a donut or cupcake. Many parents would be happy to make
sure to have safe prizes for each child in the class. There will always be some parents who
would still prefer to send a food treat. In that case it is important that a parent has taught their
child with allergies to say “No thank you.” and ask for an alternative treat from the parent
provided treat box. Teachers should also be aware of the situation and can suggest getting a safe
treat. Teachers should not have the responsibility to read food labels for the child. There are
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many hidden allergens and teachers have not had the training to detect those. Parents must
remain the primary source of safe treats in the classroom.
Jordan School District has an obligation to provide a safe and secure learning
environment where all children can have the opportunity to learn and grow. Education is not
only the traditional studies such as reading, science and math but includes how to be accepting of
others unique challenges. Teachers and other district staff can provide a situation that a child can
feel included and yet safe while attending our schools. Although the primary advocate for a
child is there parent, a child’s welfare is a cooperative effort between parents and educators and
providing some simple changes our public schools can be a much safer place to attend as well as
a place of learning.
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References
Bradley, Jeanette. "How to Be Inclusive of a Child with Food Allergies."
About.com Food Allergies.13 Mar. 2011. Web. 4 Mar. 2012.
<http://foodallergies.about.com/od/children/a/Inclusive-Child-With-Food-Allergies.htm>.
Bradley, Jeanette. "Strategies for Food Allergy Safety At School."
About.com Food Allergies. 17 May 2011. Web. 10 Mar. 2012.
<http://foodallergies.about.com/od/children/a/Food-Allergy-Safety-At-School.htm>.
Cone, Richard A., and Emily Martin. "Corporeal Flows." Ecologist. May/June 1997:
107-111. SIRS Issues Researcher. Web. 08 Feb 2012.
Durbin, Barbara. "When Food Bites Back: Part Two." Oregonian (Portland, OR).
25 Jul 1995: FD1+. SIRS Issues Researcher. Web. 08 Feb 2012.
"Food Allergy: A National and Deadly Problem." American News Report. 21 Feb. 2012.
Web. 23 Feb. 2012. <http://americannewsreport.com/food-allergy-a-national-anddeadly-problem-8813227.html>.
Gustafson, Timi. "Food Allergies Among Children Dramatically on the Rise." Web log
post. Seattlepi.com. Seattle Public Information, 11 June 2011. Web.
Hyman, Mark. “How to Stop Attacking Yourself: 9 Steps to Heal Autoimmune Disease.”
Drhyman.com. Dr. Mark Hyman. Web 07 Feb. 2012.
Jordan School District. "Documents & Forms." Nursing Services. Web. 4 Mar. 2012.
<http://departments.jordandistrict.org/educationalsupport/nursing/forms.html>.
Jordan School District. "Meal Accommodations for Students." Jordan School District.
Web. 4 Mar. 2012. <http://departments.jordandistrict.org/nutritionservices/mealaccomodations.html>.
Jordan School District. "Peanuts and Tree Nuts Allergies." Jordan School District.
Web. 4 Mar. 2012. <http://departments.jordandistrict.org/nutritionservices/allergies.html>.
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Korn, Danna. Kids with Celiac Disease: A Family Guide to Raising Happy, Healthy,
Gluten-free Children. Bethesda, MD: Woodbine House, 2001. Print.
Korn, Danna. Wheat-free, Worry-free: The Art of Happy, Healthy Gluten-free Living.
Carlsbad, CA: Hay House, 2002. Print.
Lalande, Gerard. "FOOD ALLERGIES CAN BE DEADLY." The Nation. 5 Jan. 2012.
Web. 23 Feb. 2012. <http://www.nationmultimedia.com/life/FOOD-ALLERGIES-CANBE-DEADLY-30173169.html>.