As the mother of a dairy-allergic 8-year-old, I am often asked: “How can anyone be allergic to milk?” From an early age, we’re taught that milk is good for you. It’s hard for people to fathom living without it, and then you explain that the allergy is not just to cow’s milk, but to a protein in every dairy product. Whether milk, cheese or whey or casein ingredients in a packaged food – it’s all dangerous and to be avoided.

When we registered our daughter for Junior Kindergarten back in 2001, my husband and I heard all about anaphylaxis plans for peanuts and tree nuts. But school officials seemed to have a hard time grasping that milk could be just as deadly to a child allergic to dairy. The school had a monthly Pizza Day, and the allergist had recommended that  our daughter not go to school on those days, as the risk of a reaction from the melted cheese (which smears so easily) was high.

Since she missed many events, I asked the school to reconsider the importance of Pizza Day. To my great relief, the new principal was most understanding and promptly dropped the “day”. Not all parents have accepted this easily, but that’s OK. My primary job is to protect my child physically and psychologically; I want her formative years in academia to be positive. Four years into our journey with dairy allergy and the school, the awareness-building continues. Along the way, we have learned much that’s worth sharing.

Next Page: Keeping the Child Safe

She was indignant and didn’t know what she’d done wrong. “They can’t treat me this way,” she said.

Her mother wasn’t pleased to hear of a student disciplining another student, but she had a more immediate concern. Her severely peanut-allergic daughter had been alone while eating.

“Where was your EpiPen?” Cameron asked. The reply: “In my backpack.” And where was that? “In the classroom.”

“If she’d had a reaction in the hall, no one would have been there to help her,” says Cameron. The previous fall, Cameron first learned that adults weren’t supervising the lunch breaks at the Ottawa public school. Instead, pairs of Grade 5 or 6 students oversaw the younger children as they ate at their desks. In case of an emergency, these monitors would have to run and seek out an adult.

Thousands of miles west, in Victoria, B.C., Caroline Posynick can relate. She became a convert to allergy advocacy in 2006 over the issue of student lunch-monitoring.

She had been blissfully unaware that, in a school that ran from kindergarten through Grade 7, lunch for younger grade children was supervised by kids from the eldest grade. She also didn’t realize that the teacher had decided to keep her son Griffin safe by isolating the 7-year-old at the crafts table.

On Valentine’s Day in 2006, “my son was sitting at this special table. A kid who was really, really active got up and put some peanut butter on his finger and then put it on Griffin’s arm,” Posynick says. “He wanted to see what would happen. This occurred with kids watching kids, so they couldn’t stop it.”

There was panic in the room, Griffin froze, and the monitors hustled him off to the teachers’ staff room to get his arm washed.

When Posynick and her husband got to the school they found Griffin with a huge hive on his arm. Benadryl was enough to handle the contact reaction. But the boy’s sense of upset did not go away nearly as quickly.

Incidents with lunch supervision are not hard to find among the parents of food-allergic children. They illustrate that, for all of the advances such as Sabrina’s Law in Ontario (an act to protect anaphylactic pupils) or B.C.’s ministerial framework on anaphylaxis, and for all the allergic community’s advocacy on risk reduction and readiness for emergencies, gaps remain in the protection of food-allergic children.

Within Canada’s public elementary schools, there’s a patchwork of student monitors and adult lunch supervisors, but even with the latter, the person in sight line of the child may not be trained on giving an epinephrine auto-injector. Who’s watching the kids depends on a school board’s policy and then, in turn, on how an individual principal handles (and applies budget to) lunch supervision at his or her school.

For instance, in Vancouver, the norm today is paid lunch assistants, but a ferry ride away in Victoria, students not old enough to babysit frequently patrol lunch in the class.

In 2005, Anaphylaxis Canada did a survey of its online registry about allergy policies in Canadian schools. Of the 678 parents who responded about their child’s public elementary school, 28 per cent said the school relied on student lunch monitors, 43 per cent said school staff supervised (sometimes in combination with students) and 33 per cent had paid lunch supervisors. At some schools, there were also a small percentage of parent volunteers assisting.

Most public elementary students (73 per cent) ate lunch in their class as schools often lacked the space for lunchrooms. “You do have to consider what the principals are dealing with,” notes Laurie Harada, executive director of Anaphylaxis Canada. “They’ve had cutbacks, the best that many principals can do is to have someone to wander the halls and poke their head in and monitor the kids.” That said, she adds: “too much of this is ad hoc, and schools need to think through this.”

U.S. ‘All Over the Map’

In the United States, student lunch volunteers are less the issue, but again – despite a growing number of anaphylaxis laws among the states, there are gaps. Lunch is usually eaten in a cafeteria or lunchroom, making it possible for fewer adult eyes to survey a larger group of kids.

Yet anaphylaxis prevention practices and auto-injector training can vary from district to district, and cafeteria to cafeteria.

Lunch supervision “is an all over the map situation in the U.S.,” says Deb Scherrer, vice president of education for the Virginia-based Food Allergy & Anaphylaxis Network. “Sometimes it’s a teacher, sometimes it’s a food service worker, sometimes it’s a parent – it may be paid staff or volunteer.”

*Name changed by request.

UNITED STATES

FAAN’s Back-to-School Tool Kit
FAAN’s Food Allergy Action Plan
Food Allergy Initiative’s Authorization of Emergency Treatment Form
FAAN/FAI e-learning resource, comprehensive tool for teachers. www.allergyready.com
Federal 504 Plan
AAFA on the Americans with Disabilities Act (ADA)
National Assn of School Nurses’ Anaphylaxis Provision of Care documents

CANADA

Comprehensive resource - Allergy Safe Communities site.

• Allergy Safe Communities’ Emergency Plan for EpiPen
• Allergy Safe Communities’ Emergency Plan for Twinject
• Sample letter from principal
• Sample letter from teacher
• Steps for school anaphylaxis plan
  

Also: Canadian School Boards Association publication:
Anaphylaxis: A Handbook for School Boards (New Edition)

Asthma Action Plans

• Alberta’s Asthma Action Plan (Canada)
  
• The Lung Association’s Action Plan (Canada)
• AAFA’s Student Asthma Action Card (USA)
• American Academy of Family Physicians Asthma Action Plan (USA)

Allergic Living‘s School Articles

• Food in the Classroom – click here
• Allergic Living’s award-winning article – Sabrina’s Law
• Hear Sabrina – Her moving CBC radio documentary – A Nutty Tale
• FAAMA: Inside the U.S. Food Allergy Law here
• Laurie Harada: Talking to School Officials here
  
• Laurie Harada: Off to Kindergarten - here
• Laurie Harada: If Your Child is Bullied - here
• Food Allergy and the Risky Teenage Years - here
• Sabrina’s Law: The Girl Who Inspired Change - here
• Who’s Watching Lunch at School? New excerpt here
  
• Off to College with Allergies - here
• Teens Talk: Life with Allergies - here
• Samantha Yaffe: Grade 1 and Letting Go – click here
• Kids, Anxiety and Anaphylaxis - here
• Backlash Against School Accommodations - here
• Air Quality at School - here
• The September Asthma Spike - here
• Sara Shannon’s Journey with Sabrina’s Law - here
• Reader’s Story: Sabrina’s Law Success - here
• Sabrina’s Law in Context – For a Kid, Dairy Allergy is a Life Changer

State and Provincial anaphylaxis laws, policies and guidelines, click here.

On the Hunt

There’s no hiding Vadeboncoeur’s mouthwatering peanut- and nut-free caramel bunnies and milk chocolate Easter treats. Select stores in Canada, $4.36-$5.49. Hollow chocolates also available. U.S. customers can purchase at PeanutFreePlanet.com

Bunny Delight

The kids will be hopping with joy over Divvies’ peanut-, tree nut-, milk-, egg-, and gluten-free gourmet chocolate bunny. $8.50 US/4 oz. Also available: Easter-colored jelly beans. Order online.

Cute, To Boot

Guardian Angel Foods has adorable chocolate eggs and bunnies free of peanut, tree nut, dairy and egg. Bunnies: $9.99/200 g or $12.99/300 g. Chocolate eggs: $5.99/100 g. Select stores in Ontario and Quebec order online.
Big Haul

Baskets of chocalate-y goodness from Vermont Nut Free are sure to impress. Filled with bunnies, eggs and more. Large: $59.99 US; Small: $42 US. Ships to U.S. and Canada. Order online.

Candy Crazy

Gimbal’s Gourmet Jelly Beans are free from peanut, tree nut, milk, egg, soy, and gluten. Look for at Rexall/PharmaPlus, $6.99/500 g. Or order online.

Basket Filler

Need something to pile into a basket or stuff in a plastic egg? Look no further than Dare’s Rabbit Ju Jubes and Marshmallow Eggs, made in a peanut- and tree nut-free facility. Around $2.00 per bag (200-500 g) at Canadian retailers. Order online at PeanutFreePlanet.com

Also look for:

• Florida’s Natural Easter eggs filled with fruit treats. Labelled gluten-free, also free from peanuts, tree nuts, milk and egg.
• Jean Talon hollow chocolates. Labeled peanut-free.
• Allan’s Hoppy Hunt Ju Jube Bunnies. Peanut and nut free.
• Mr. Mallow Easter Bunny Long Legs. Gluten-free

*Note: Allergic Living cannot guarantee ingredients in the above products. Always remember to read labels and call the manufacturer if you’re uncertain if an ingredient is present.

Recipe: Lucy Waverman’s allergy-safe chocolate Easter eggs from More magazine.