Food and Allergy Awareness
At OGS we take food allergies and the potential consequences seriously. In an effort to make information about food allergies readily available, the Health and Wellness Committee has put together the following informational documents. If you have any specific questions regarding the health of your child, it is appropriate to contact the school nurse, Judith Finneran, or your child’s pediatrician. Please join us in maximizing the health and safety of the students at OGS by improving food allergy awareness in our community.
2 - Signs of an Allergic Reaction
3 - Anaphylaxis and Epinephrine
1 - Food Allergy Facts
A food allergy occurs when the body has a specific and reproducible response to a food. The body’s reaction may be life threatening. One way that the immune system causes allergies is by making a protein called immunoglobulin E (IgE) in response to eating the allergen. When exposed to the food allergen, the IgE antibodies signal cells to release substances, such as histamine, that cause symptoms of the respiratory system, gastrointestinal tract, skin, or cardiovascular system.
The prevalence of food allergies and associated reactions has increased 18% from 1997-2007. Food allergies affect 4-6% of children in the United States.
Studies reveal that 25% of the severe and potentially life-threatening reactions at schools are in children with no previous diagnosis of food allergy.
In the United States, the following eight foods cause 90% of serious allergic reactions: milk, eggs, fish, crustacean shellfish, wheat, soy, peanuts and tree nuts (i.e. walnuts, almonds, cashews, pistachios, pecans).
Reactions to food allergies accounts for 25-50% of cases of anaphylaxis in emergency departments.
The best method of cleaning food allergens from hands is by using running water and soap or commercial wipes; antibacterial gels are not sufficient.
Food proteins released into the air from foods being cooked can cause allergic reactions, but this is an uncommon occurrence.
Retrieved from:
2 - Signs of an Allergic Reaction to Food
How can you tell when someone is having an allergic reaction?
Mild symptoms may include one or more of the following:
- Hives (red, swollen, itchy areas on the skin)
- Eczema (persistent dry, itchy rash)
- Nasal congestion
- Sneezing
- Dry cough
- Nausea or vomiting
- Diarrhea
- Stomach pain
- Redness around the eyes
- Odd taste in the mouth
Severe symptoms may include one or more of the following:
- Obstructive swelling of the lips, tongue and/or throat
- Trouble swallowing
- Shortness of breath or wheezing
- Turning blue
- Chest pain
- Drop in blood pressure (feeling faint, confused, weak, passing out)
- Loss of consciousness
- A weak or “thready” pulse
- Sense of “impending doom”
Prompt recognition of an allergic reaction is critical for ensuring appropriate treatment. However, children may describe their symptoms very differently than an adult; their voices may change (e.g. become hoarse or squeaky) or they may slur their words.
Children may use phrases such as:
- "This food is too spicy"
- "My tongue is hot"
- "My tongue (or mouth) itches"
- "My mouth feels funny"
- "There’s something stuck in my throat"
- "My tongue feels full (or heavy)"
- "My tongue feels like there is hair on it"
- "My lips feel tight"
- "It feels like there are bugs in there" (describing itchy ears)
Mild to moderate symptoms are often treated with antihistamines and oral or topical steroids. For children at risk of experiencing a severe reaction (anaphylaxis), epinephrine is prescribed. Epinephrine is the only medication that can reverse the symptoms of anaphylaxis.
Retrieved from: http://www.foodallergy.org
3 - Anaphylaxis and Epinephrine
Anaphylaxis is a potentially severe or life-threatening reaction that occurs very quickly after exposure to an allergen. Symptoms of anaphylaxis can begin with mild skin findings (e.g. hives, flushing) and progress slowly or they may evolve rapidly. One may see a combination of the following responses:
- Airway narrowing and difficulty breathing
- Lowering of blood pressure, leading to change in behavior (e.g. agitation or anxiety)
- Hives
- Abdominal pain, vomiting, diarrhea
The recommended treatment for anaphylaxis is the rapid use of epinephrine. Epinephrine is a dose of adrenaline that helps to reverse the changes in the body that occur in anaphylaxis. Early use of epinephrine improves a person’s chance of survival and recovery.
It is important to know that the effects of an epinephrine injection are not long lasting and that additional doses are sometimes needed. After giving epinephrine for a serious allergic reaction, one should call EMS immediately for an exam and observation.
Retrieved from: http://www.cdc.gov/healthyschools/foodallergies/pdf/13_243135_a_food_allergy_web_508.pdf
4 - Reading Food Labels
Hosting your son's food allergic buddy at a birthday party? Planning a sleepover date with your daughter's food allergic friend?
One way to help reduce risk to food allergic children is to carefully read ingredient labels before providing food for that child. The Food Allergen Labeling and Consumer Protection Act (2004) dictates that food companies label products for the eight major allergens (peanuts, tree nuts, eggs, milk, wheat, soy, fish and shellfish). These allergens are outlined in bold print in the ingredient list on the package and must also be listed underneath that list followed by the word “CONTAINS”. Of note, food allergy labeling laws do not apply to certain egg products, sesame and other seeds, molluscan shellfish (oysters, clams, mussels, scallops), and gluten containing grains other than wheat (barley, rye and oats).
Many food companies also voluntarily put the following allergen advisory labeling on their packaging:
1. May contain:
2. Processed in a facility that also processes:
3. Made on shared equipment with:
Some children cannot eat food containing these labels because they could have an allergic reaction to food that is present in small amounts through cross-contamination.
It is important to remember that you must check labels EVERY time you buy a product because labels are constantly changing. Furthermore, when buying food for children with food allergies, it is always best to communicate directly with the parent of the food allergic child regarding the items you will be serving.
5 - Peer Advocacy
Did you know that 1 in 13 kids in the United States has a food allergy? That’s about 2 kids in every classroom. For kids with food allergies, even a tiny amount of the food to which they are allergic can make them very sick.
Since food allergies affect so many kids, it is good to learn how to Be a PAL to a friend with food allergies! Here’s how:
Know that food allergies are very serious.
If someone with a food allergy eats something they are allergic to, they can get very sick and sometimes have to go to the hospital.
If a friend or classmate has a food allergy, don’t tease, bully or make fun of them. Tell an adult right away if you see other kids picking on someone with a food allergy.
Don’t share your food with friends who have food allergies.
You can share jokes and laughs with your friends with food allergies, but don’t share food. Why? Because it may have something in it that could make them very sick or hurt them.
Wash hands after eating.
Washing your hands with soap and water after you eat is very important. It’s the best way to clean off any food that is on your hands.
Help all of your friends and classmates have fun together!
There are lots of ways to have fun without food! Listening to music, playing board or video games, making crafts, going for a bike ride and playing sports are just some of the cool things you can do together. This way, everyone stays safe and has fun!
If a friend with food allergies feels sick, get help right away!
If your friend feels sick or thinks they may have eaten something they are allergic to, tell an adult right away or dial 911! They will make sure your friend gets help and gets the medicine they need to feel better.
Retrieved from: http://www.foodallergy.org
What A Food Allergic Child Would Like Peers to Know
Children living with food allergies need to be conscious about everything that goes into their mouths. They have to think before eating anything. If we teach compassion and consideration around this issue, children can be advocates for their friends with food allergies. Here are some things a child with severe allergy may want peers to know:
- I can't share food with others. Please accept my "no thank you" as I'm not trying to be rude, just keeping myself safe.
- It would be fun to buy lunch whenever I want, but I can only do so when I know that safe foods are being offered that day.
- I (or an adult) must read all food labels before I eat anything.
- Sometimes I may feel different or left out if I can't eat what everyone else is eating.
- I can't always sit at the same table if kids are eating foods I'm allergic to.
- If I'm having an allergic reaction, I may need help but may not be able to communicate it well. Please help me by getting the attention of an adult.
- Aside from my food allergies, I am a typical kid just like you!
6 - Food Allergy Myths vs. Facts
- Myth: Allergies are a fad and they are not dangerous.
Fact: Severe food allergies do exist. A reaction to an allergy can have a sudden onset and be fatal in minutes. Prior reactions don’t predict future reactions. The only way to prevent reactions in those with a history of anaphylactic allergies is strict and complete avoidance of the allergen.
- Myth: “Food allergy” is the same as “food intolerance”.
Fact: Food intolerance is not an allergy. Lactose intolerance, for example, does not involve the immune system. Intolerances may be unpleasant but they are not potentially fatal.
- Myth: “May contain” warning labels just provide legal protection for companies. Those foods are fine for those with allergies.
Fact: “May contain” labels should be taken seriously. A recent study of products labeled with “may contain peanuts” contained detectable levels of peanuts 8.6% of the time.
- Myth: Benadryl can be helpful for anaphylaxis.
Fact: The only treatment useful for the management of anaphylaxis is intramuscular epinephrine (e.g., Epi-pen). All other treatments, such as antihistamines like Benadryl, inhalers, and steroids are secondary treatments and do not replace the need for the immediate administration of epinephrine.
- Myth: “I was exposed to an allergen, but I’m fine. Maybe I’m not going to have a reaction.”
Fact: Maybe, but maybe not. Anaphylactic reactions do not always appear immediately, and can be delayed by minutes or even hours. Reactions can manifest in different ways.
- Myth: All anaphylactic reactions have skin symptoms.
Fact: 10 to 20% of anaphylactic reactions have no skin symptoms.
- Myth: Food additives and artificial flavors cause the majority of food allergic reactions.
Fact: Natural foods account for the majority of allergic reactions. The foods that cause 90 percent of allergic reactions are: peanuts, milk, eggs, wheat, soy, tree nuts (i.e. almonds, walnuts, pecans), fish, and crustacean shellfish.
- Myth: Each allergic reaction to food becomes increasingly worse.
Fact: The severity of a reaction is based on a number of factors, including the amount of food ingested. A food-allergic individual may experience a mild or severe reaction at each exposure.
- Myth: A food allergy is either lifelong or is always outgrown.
Fact: Children often outgrow allergies to milk, eggs, soybean products and wheat. People usually do not outgrow allergies to nuts, fish, and shellfish.
- Myth: The use of antibacterial hand sanitizer is an effective way to remove peanut allergen from your skin.
Fact: For removal of peanut allergens from hands, liquid soap and bar soap are very effective. Rinsing hands with plain water and the use of antibacterial hand sanitizer are not effective ways to remove allergens.
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7 - Safe Celebrations
Having a birthday party for your child or organizing a holiday celebration for the class?
- In accordance with the Greenwich Public Schools Wellness policy and procedures, OGS encourages the sharing of healthy treats or non-food items.
- When bringing in food items for the class, please reach out to the teacher to understand what allergies are present in the classroom and try to avoid those allergens. Avoiding allergens promotes a safer environment for our friends with allergies and it is kind to make sure everyone is included in our celebrations!
- A good resource for peanut, tree-nut and egg free snacks is the Snack Safe Guide available at http://snacksafely.com/safe-snack-guide/.
Baking at home or picking something up from a bakery for the class?
- When baking at home it is important to look at all the ingredients and labels to see if there is anything that may contain allergens.
- Cross contamination is also a concern. When you do make something at home, use a clean surface (wiped down with a disinfectant) and wash hands well with soap and water before handling any food or ingredients. Always use clean utensils and pots and pans.
- Bakeries and store bought baked goods can be difficult due to cross contamination risks. Even though there may be no allergens in the product there are usually nuts, dairy, and egg used in the facility and cross contamination may occur.
- There are several cake and cookie brands made in allergen-free facilities and sold at local stores.
- Izzi B's makes cupcakes and specialty cakes that are nut, egg, dairy and gluten free. You can get this product at Whole Foods or special order them from their website (http://ibcakes.com) for delivery.
- School-Safe cupcakes by Treasure Mills (http://www.treasuremills.com/products/) are peanut and tree nut free and available at Fairway, Whole Foods, and Costco.
- LoftHouse (http://www.lofthousecookies.com) cookies has several varieties of cookies that are made in a peanut and tree nut free facility and identified with a “nut-free” logo on the package. Many are decorated for holidays such as Valentine’s Day and St. Patrick’s Day. These can be found at Stop and Shop, Acme, and other local stores.
8 - Books About Allergies (for Kids)
Patty's Secret: A Tale About Living with Food Allergies by Leneille Moon
The Bugabees: Friends With Food Allergies by Amy Recob
Food Allergies and Me: A Children's Book by Juniper Skinner
My Food Allergies: A Children's Book by Amber DeVore
What Treat Can Ruben Eat? A food Allergy Story by Stephanie Sorkin
For additional resources please view the following helpful links:
http://www.kidswithfoodallergies.org/page/shop-to-support-food-allergies.aspx