Avery’s 2½-year-old brother Nolan has severe food allergies, and when she came home that afternoon she told my husband and me that “her heart was smoking mad.” She was so upset by her classmates’ attitudes that she had marched right up to her teacher and told him that she wanted to give a speech to the class on allergies.

That evening, using a lot of information from our allergist, Avery and I created a factual, child-appropriate presentation, complete with an EpiPen demonstration. Avery would usually have been frightened to speak in public or to give an oral presentation.

Yet armed with her cue cards and a heart full of passion, she not only gave the presentation to one class but was soon recruiting teachers in the hallway, requesting that they also allow her to come into their classrooms.

To our amusement and pride, Avery has even made changes and additions to her allergy speech. For example, after having been asked why she lists peanuts and tree nuts separately, she added a sentence or two explaining the difference between a peanut (a legume) and a nut. She has also added a question and answer segment at the end of her presentation, and has even been known to quiz her teachers about what they have learned from her presentation.

To date, Avery has done about two dozen presentations, including one to our local anaphylaxis support group. Avery transferred schools last school semester, but continued to give allergy presentations, and has already lined some more up for this school year.

Our daughter has amazed my husband and me with her strength and the depth of her love for her brother. She was 8½ years old with no health issues when Nolan was born. At six months, her brother suffered his first of many allergic reactions, to a peanut butter-laced kiss.

His entire body was covered in a rash and hives, his eyes were bloodshot and then his face swelled until his eyes were shut, and he began to make a low grunting sound. What did I do? I stripped him down and quickly got him into the tub. Never having seen an allergic reaction or heard one described, it didn’t even cross my mind that this was what was happening.

Nolan’s allergies include peanuts, tree nuts, sesame, gelatin, peas and other legumes and shellfish. He has asthma as well as multiple environmental allergies, and has outgrown allergies to eggs and fish.

Avery, who is now 11 years old, has never once whined or complained about the changes or sacrifices our family has to make in order to keep her brother safe. I even overheard her whisper on Santa’s lap a few years ago that she wished most of all for her brother’s allergies to go away.

Avery understands the reality of allergies and asthma, having witnessed her brother’s many reactions. She is the first to quizzically examine a new food product, she re-reads ingredient labels, she will not hesitate to question a grownup if it concerns her brother’s safety, and she is the first to block her brother from a stranger’s touch (and if they do touch, they should be prepared for an articulate girl’s allergy and cross-contamination lecture).

But our daughter is also aware that those who don’t deal with allergies personally may not mean to be insensitive. She knows that our own family was also unaware of allergy issues until our little man came along. What Avery also knows is that we can choose to make a difference. Her immediate goal is to continue to educate others about allergies and how to recognize if someone is having a reaction and administer the auto-injector. She hopes that, by explaining the seriousness of allergies, her peers will choose to help protect those children with allergies and make choices which could keep them safe.

When she grows up, Avery plans to be an allergist. She even has the floor plans of her office all drawn up, complete with hand sanitizer dispensers and automatic doors, so no germs get on the door handles. Above all, Avery’s goal and dream is to care for her baby brother and to cure his allergies.

Michelle Chow and her family are navigating the world of food allergies in Ottawa.

Angela Doody pulled open the front door of Priestman Street Elementary school two years ago, and strode across a shiny tiled floor on her way to the office to register her two children. Looking around, she was amazed at how clean and neat the kids’ new school was. “I thought, “We get to go here?” she recalls.

Aside from the friendliness of the staff, it was well organized and uncluttered. “It just seemed like a really good place to be educated.” Doody was not aware that day that Priestman Street has been a prototype: the first school to go through the New Brunswick Lung Association’s Healthy Schools program, the first in a province to vastly improve its indoor air.

Her 11-year old daughter, Katelyn, who has asthma, has been able to benefit from this program while in Grades 4 and 5 at the school. The previous school she attended was in an older, dusty  building, and that led to a “rough year for her,” says Doody.

While Katelyn did have some trouble with asthma control in her first year at pristine Priestman – “she picked up a lot of viruses,” says her mother – this past year was far better. “She didn’t miss many days of school last year because of her asthma,” says Doody.

Missing school is a big problem for students with asthma. Too often the school environment itself is a culprit, causing symptoms like wheezing or coughing that are exacerbated by the colds spread by classmates. Science is showing that air quality in schools can have a significant impact on health, and this becomes especially important when there are children attending with asthma or environmental allergies.

Back in the 1980s, asbestos in the schools became a focus (and is still a concern in some schools), but what our school systems have been slower to address are a huge number of allergen triggers and irritants. In classrooms and portables, mould can be a festering issue, antiquated ventilation systems can lead to stagnant air and recycled allergens, while old carpeting can harbour a double whammy of dust mites and mildew.

The janitor may inadvertently spark an asthma attack by using potent cleaning chemicals, so might rodents being shown for educational purposes, while a teacher’s fragrance can aggravate a child with a sensitivity to scent. Even tools as seemingly harmless as chalk and supplies for arts and crafts can be problematic.

Children are particularly susceptible to chemicals, dust and other allergens in the air; they are not simply mini-adults. Their skin absorbs toxins at a higher rate and they breathe more air per pound of body weight than adults do.

Students with asthma, in particular, benefit from an environment free of allergy triggers. Making improvements to a school’s air quality can at times be simple, such as switching to dustless chalk. Other changes, such as overhauling ventilation systems, are a lot more costly and may require lobbying at the school board level for funding.

However, in schools where air quality improvement plans have been made, the difference has been profound. At Priestman Street Elementary, change began with a simple walk through the school.

Donna Bliss, Priestman Street’s principal, worked with a team that surveyed the one-level school’s four wings, which contained classrooms, main offices, the gymnasium, and the music room. They worked from a checklist from the Lung Association’s Healthy Schools program, which includes a range of potential problems, such as cleanliness, pest control, moisture, ventilation, furnishings, parking zones and storage and use of art and science supplies.

Bliss and the committee identified a number of issues. “We had plants in classrooms that had mould; we had to put air monitors in a couple of rooms because we thought the air was stagnant; we had to check piping because at one point they had been wrapped in asbestos,” she begins to list.

“Our service that gives us custodial supplies was just going through the transition to environmentally friendly products, and we still had some old products, so we had to dispose of them appropriately.” They also examined their outdoor grounds, which are beside a busy intersection in an area of Fredericton known as “Top of the Hill.” They found the yard lacked green space and that school bus drivers and parents were idling their vehicles on school grounds.

Next page: School Ventilation

An anaphylactic reaction includes more than one of the body’s systems, such as the respiratory tract, gastrointestinal tract, the skin and cardiovascular symptom. Symptoms of an allergic reaction include tingling in the mouth, swelling of the tongue and throat, itchy skin or hives, difficulty breathing, abdominal cramping and vomiting. In a severe anaphylactic reaction, a person may experience a drop of blood pressure, loss of consciousness and even cardiac arrest and death.

One of the issues in managing peanut allergy is that symptoms can vary. A person may have had minor symptoms, only to suffer anaphylaxis on a subsequent exposure.

Because peanut allergy reactions can be severe, it is important that a person with this allergy carry an epinephrine auto-injector (EpiPen or Twinject) with them at all times. Peanut allergy is often considered a lifelong allergy, but research has shown up to 20 per cent of children may outgrow it by the time they reach school-age.*

*Source: 2010 FA primer. JACI

Prevalence

In the United States, the rate of peanut allergy in children increased by 3.5 times from 1997 to 2008, to a rate of 1.4 per cent. In Canada, it is estimated that 1.68 per cent of children and 0.71 per cent of adults have peanut allergy.

More on Peanut Allergy Statistics

Next Page: Not a Nut!

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