Food Allergies in Early Childhood

Did you know that our youngest students face the highest risk of reacting to a food at school? Over 60 percent of food allergy reactions at school take place in preschools and child care facilities. 

For children with food allergies, providing a safe and nurturing environment at a child care center, daycare or preschool requires planning and effort on the part of the school and parents. The Centers for Disease Control and Prevention (CDC) created voluntary guidelines to help schools manage children with food allergies. Guidelines specifically for early-care settings start on page 77 and can be viewed here.

• All children with food allergies should have an emergency care plan in place. This plan will provide detailed instructions about which food(s) the child is allergic to and a plan of what to do if an allergic reaction occurs.
• What about children with no history of food allergy? Learn the signs and symptoms of allergic reactions, including anaphylaxis, and have a plan in place for how to handle a food allergy emergency. Identify staff who will be delegated and trained on how to give epinephrine.
• Does the Americans with Disabilities Act -- or "ADA" -- apply to childcare centers? Yes. Privately-run childcare centers -- like other public accommodations such as private schools, recreation centers, restaurants, hotels, movie theaters, and banks -- must comply with title III of the ADA. Childcare services provided by government agencies, such as Head Start, summer programs, and extended school day programs, must comply with title II of the ADA. Check out these commonly asked questions about childcare centers and the ADA.
• Preschools and daycare centers that receive federal funds are required to comply with Section 504 of the Rehabilitation Act of 1973. Section 504 allows you to create, in collaboration with the school, a 504 Plan, which is a written management plan outlining how the school will address the individual needs of your child throughout the day. If your child has an Individual Education Plan (IEP) for special education services, the IEP can also include accomodations needed for his/her food allergy.
• If the school is a private center, as opposed to federally funded, there should still be a written plan for your child in place. You will want to review the elements of it thoroughly with the preschool, including who has anaphylaxis training and is authorized to give medication.
• Children at the preschool age frequently put hands/objects/shared toys in their mouths, making cleaning and prevention strategies critical. Check out these cleaning methods to make the environment safer for children with food allergies.
• Use appropriate hand-washing procedures that emphasize the use of soap and water. Plain water and hand sanitizers are not effective in removing food allergens.
• Hands-on learning and motor skill development activities are excellent for all children. Talk to the adult in charge and remind them to look for allergens when gathering materials for lesson plans, sensory table activities and when making doughs and clays as some of these items can potentially contain allergens. Working with the teacher, school staff and other caregivers is key to preventing exposures and including the child.
• Another great way to prepare the environment is by hanging posters, reminding children and staff about handwashing, responding to anaphylaxis, and more.
• Reactions are never planned. Make sure that medications are kept in a secure place and that staff who are delegated and trained to use epinephrine auto-injectors can get them quickly and easily.