Addressing food allergies in school cafeterias
Amanda Steen | Herald-Standard
Anna Smith, 8, eats a sunflower butter and jelly sandwich, which she eats instead of regular peanut butter, due to a food allergy.
Amanda Steen | Herald-Standard
Anna Smith, 8, buys a sunflower butter and jelly sandwich which she eats instead of regular peanut butter due to a food allergy.
Amanda Steen | Herald-Standard
Sunflower butter and jelly sandwiches await Hutchinson Elementary School students with food allergies May 19.
Amanda Steen | Herald-Standard
Cafeteria worker Stephanie Filitsky prepares a sunflower butter and jelly sandwich at Hutchinson Elementary School for students with food allergies May 19.
Bonnie Ryan encouraged school administration officials in her Fayette County school district to change policies when it came to the use of nut products and educate students and parents alike about the dangers of food allergies.
Ryan’s daughter was diagnosed with nut allergies when she was 3 years old after eating peanut butter ice cream.
“Her neck and eyes swelled, and I had to take her to the emergency room for a shot of epinephrine,” said Ryan.
While she was a public school student, Ryan explored legal and educational options available to her daughter to keep her safe from exposure to nuts.
“The district would not make modifications. For four years she had to sit in a closet area (to eat), and I kept her home when there were class parties,” said Ryan.
A curious child once tested her allergy by rubbing a peanut on her arm, and that resulted in welts and Ryan later enrolling her daughter in a private school that is nut-free.
Ryan, a registered nurse, said she believes it’s not difficult for districts to be completely peanut- and nut-free, and it’s the only safe option. Many districts, Ryan explains, resist this option because they feel it’s an unfair policy that punishes students who are not allergic and enjoy foods made from, or that include, nuts.
“To tell kids not to eat peanut butter is not discrimination. They won’t die from not eating peanut butter, but my daughter could die from eating it,” said Ryan.
According to statistical information from Food Allergy Research and Education (FARE), 1 in 13 children, or 2 in every classroom, in the U.S. have food allergies. FARE estimates children’s food allergies have an economic impact of $25 billion per year.
In 2013, the CDC’s (Centers for Disease Control) “Voluntary Guidelines for Managing Food Allergies in Schools” was released showing studies that indicate 16 percent to 18 percent of children with food allergies have had a reaction from accidentally eating food allergens while at school.
CDC recommends schools and early childhood learning centers develop a Food Allergy Management and Prevention Plan should address the following five priorities: ensuring the daily management of food allergies for individual children; preparation for food allergy emergencies; providing professional development on food allergies for staff members; educating children and family members about food allergies; and creating and maintaining a healthy and safe educational environment.
In the guidelines, CDC notes, “Some schools have considered banning or have banned specific food across the entire school setting in an attempt to eliminate exposing a child with a food allergy to that food. But such an option cannot guarantee a totally safe environment, because there is no reasonable or fail-safe way to prevent an allergen from inadvertently entering into a building. Even with such a ban in place, a school still has a responsibility to properly plan for children with any life-threatening food allergies, to educate all school personnel accordingly and to ensure that school staff are trained and prepared to prevent and respond to a food allergy emergency. Schools may choose other alternatives to banning allergens, including the designation of allergen-safe zones, such as an individual classroom or eating area in the cafeteria, or designation of food-free zones, such as a library, classroom or buses.”
At least 143 students in the Laurel Highlands School District have reported having food allergies, and 56 of those, or 39 percent, have some sort of nut allergy.
“The biggest item that students are allergic to is tree nuts. Because of this, the food service department is nut-free,” said Randy Walker, food services director Laurel Highlands School District. “We do not serve any items that contain any type of nut whatsoever.” We offer sun (flower) butter and jelly sandwiches to students instead of peanut butter and jelly.”
There is no policy in the district prohibiting other students from bringing food items containing nuts, but parents are encouraged to exercise caution and awareness to the threat posed to children with severe food allergies, especially nut allergies.
Nurses in the district have a list of students with allergies and a plan of care that outlines each student’s medical needs in the event of an allergic reaction.
In Uniontown Area School District, the food services director also works closely with school nurses, maintaining a list of students with food allergies.
“The student must update their information on file on a yearly basis, complete with physician documentation,” said Chuck Brown.
In extreme cases where a special diet is required, Brown said districts must send a state Department of Education medical form home for parents to complete, which food service departments and contractors use to address specific needs.
“The diagnosis and recommended diet is passed on to our corporate dietician, and a menu cycle is developed tailored to the individual student,” Brown said.
School districts must exercise extreme caution when it comes to properly cleaning and sanitizing kitchen equipment and utensils.
Brown and Walker both acknowledge cafeteria workers take extra precaution, including frequent hand washing and glove changes and using separate utensils when handling and serving food.
In Uniontown, some schools have established “nut-free” tables for students with allergies to eat their lunches without worry of coming in contact with any food with nuts or peanut butter.
Walker has worked in the institutional food service industry for 15 years and has definitely seen an increase in food-allergy awareness.
“Many vendors specifically market their products as being made in a nut-free factory. In the past, parents were not as informed about what may be causing their child’s illness. Now, more and more parents pay close attention to what their children are eating and how their bodies react to it,” said Walker.
Menu planning has not been seriously impacted by food allergies, Walker indicated.
“We are just careful to choose items without nuts. Or [if] there is a specific item on a specific day that a child is allergic to (e.g. wheat, gluten, milk), we will substitute the item for the child with an item of similar nutritional value,” he said.
CDC recommends schools anticipate and prepare for food allergy emergencies in the same ways they approach emergency preparedness for other hazards — comprehensive emergency planning includes prevention, preparedness, response and recovery for any type of emergency. Guidelines suggest students have quick (within a few minutes) access to an epinephrine auto-injector or epi-pen, both at school and during school-related events. School nurses and other school staff members should be trained and prepared to respond to an emergency and, in addition, should reinforce (student) self-management skills for students with food allergies.
Uniontown and Laurel Highlands schools have epi-pens available should an emergency arise, according to their food services directors.
Ryan urges school leaders to recognize the importance of the issue and prepare a completely safe environment.
“We’re expecting a safe environment that’s not just safe for some, it should be safe for all.”