A number of changes occur as your child grows, and your child’s experience with food allergy will be unique. It is important to find a healthy balance between managing life with a food allergy and not having excessive restrictions control your child’s life. As your child moves into the toddler years they will often start to spend time outside of your care, at day care, with a baby sitter or at kindergarten. Both your child and their care givers (babysitters, day care staff, teachers etc.) will need education on how to prevent a food allergic reaction.
Even with the most careful planning, however, accidental exposures still occur. It also essential that your child’s care givers are able to recognise the symptoms of a food allergic reaction and know the steps to follow should this occur. For children with a confirmed food allergy, their doctor should complete an Action Plan for Anaphylaxis (for those children prescribed an adrenaline auto-injector) or an Action Plan for Allergic Reactions (when no adrenaline auto-injector has been prescribed)1. This written resource can be used to help educate your child’s care givers. An allergy card can also be created using the Neocate Village App and shared with any friends and family who may look after your child from time to time.
Talking to Toddlers and Young Children about Their Food Allergies
Food allergies are complicated. It can be difficult for adults to fully understand them, so it’s no surprise that many parents struggle with how to help their little ones to understand food allergy. Through clear communication, however, you can help your child appreciate what it means to have a food allergy and how manage it.
When talking to toddlers, it’s best to keep the message as simple as possible. Use words they can understand and try to only introduce one concept at a time2. Some parents are comfortable with using simple terms like “safe foods” and “unsafe foods”. Discuss with your healthcare professional or other parents of children with food allergies, as they may have good suggestions. In this guide we will use the words ‘safe’ and ‘unsafe’ to describe foods.
Help your child to understand that there are certain foods that will make them sick. Use terms they know, for example this food will make your tummy hurt and this food will not. Every child is different in his or her level of understanding. The goal at this stage is to help teach your child to distinguish between safe and unsafe foods.
Basic points to communicate2:
- You have a food allergy and certain “unsafe foods” can make you very sick.
- Educate your child on the names of unsafe foods and what they usually look like. For example, you could point out bottles of milk at the supermarket, show them pictures in books or make up flash cards with pictures from the internet.
- Teach them not to eat, touch or smell any food unless it has been given to them by their parents or another trusted adult, i.e. a designated family member/caregiver.
- Also make sure they know that if they feel sick, if their tummy hurts, or they just feel funny, then they should let a grown up know right away.
As your child gets a little older additional questions about food allergies can start surfacing. It can be difficult to adequately communicate the seriousness of food allergies without causing excessive anxiety. Remember, many children will outgrow their food allergies and you don’t want them to be so afraid of that food that they still avoid it, even if they outgrow the allergy. It’s important to remember to reassure your child that as long as they are careful to avoid unsafe foods, there is nothing to worry about.
Sometimes books, videos, music and games can help to communicate complex information to kids in ways that they understand. Check with your healthcare professional for recommendations. Allergy support organisations, like Allergy and Anaphylaxis Australia also offer many great resources to help teach kids about food allergy3.
Starting child care or kindergarten
The first day of kindergarten or daycare is an exciting time for young children. Introducing a child with food allergies into a new environment, however, can be a little scary for parents. If this situation is one you’ll be facing soon, it is important to be prepared. Prevention is always better than a cure.
The risks can be best managed by working together with the child care centre or kindergarten to design a management plan for your child. If the strategies from this plan are implemented and the staff have the right education, then the risks of an allergic reaction are minimised4. If an accident does occur, this education will also make sure that the staff know how to manage the situation and use an adrenaline auto-injector (if needed).
Many parents of children with food allergies would like to ban the food allergen from their child’s care centre. In reality, however, this method does not really work4. Blanket food bans will not guarantee that the facility is allergen free and may give a false sense of security for parents5. Restricting, rather than banning certain food allergens (like nuts) may have a role in reducing the risk for very young children5. For example, asking parents of all children at the centre not to send nut products in their children’s lunch boxes can help to minimise the risk. This is not the same as banning the food completely. Children that are too young to understand the need to avoid certain food allergens may benefit from these types of policies. It may also reduce the risk of cross contamination from toys and play surfaces5. It is important to speak with your child’s doctor about whether this is an appropriate management strategy for your child.
The following steps can help make the transition to a new environment a safe one for your child.
- Schedule a check-up with your pediatrician or allergist before the first day6.
This is the perfect opportunity to make sure that your child’s current allergy Action Plan is still effective (see more on this in point 2). It will also ensure you can provide the most up to date medical information for the staff at the child care or kindergarten. The healthcare team will also ask the right questions to make sure you’re prepared.
- Obtain an up to date Action Plan from your child’s doctor6.
All children with food allergies should have an allergy Action Plan completed by their doctor. This written document includes an identification photo of your child plus contact details for yourself (the parent) and your child’s doctor. The form outlines your child’s allergic triggers, the first aid response and any medications. If your child has been prescribed an adrenaline auto-injector (AAI) this will also be documented on this form.
- Meet face-to-face with the manager or principal of the care centre/kindergarten6.
Notify the child care centre or kindergarten about your child’s allergy as early as possible4. Provide specific details regarding what your child is allergic to. This is also the opportunity to discuss strategies to reduce the risks for your child. Provide the manager with a copy of your child’s Action Plan. You can also assist them to educate their staff by providing details on where to access training and further information4.
- Work with the child care centre or kindergarten to develop a management plan4.
Ensure that all staff are aware of allergy prevention strategies and that these strategies are implemented. For children that suffer from severe allergic reactions (anaphylaxis) make sure that the staff at their facility are trained in the recognition, management and emergency treatment of anaphylaxis. This includes regular practice using an adrenaline autoinjector.
- Enquire about potential risks4.
Each state in Australia has guidelines regarding how to manage anaphylaxis (severe allergic reactions) in schools7. Check with the care centre if they are aware of these guidelines and what preventative measures they currently have in place.
- Supply the child care centre or kindergarten with your child’s medication (if necessary)4.
If your child has been prescribed an adrenaline auto injector (AAI) make sure this is kept with a copy of your child’s Action Plan for Anaphylaxis. All medications should be stored in an easily accessible spot, out of direct sunlight. It should also be clearly labelled with your child’s details. Keep a record of when your child’s AAI is due to expire so you can provide replacements before this happens.
- Teach your child to only eat food provided by you (their parents) from home6.
Provide your child with a safe lunch box that is clearly labelled. Educate your child about not sharing or swapping food with their friends.
- Plan ahead for special occasions where food is shared or food allergens are present6.
If there is a special cultural event or birthday party where food is shared, speak with the child care centre about bringing from home an allergen free treat for your child. It is also important to discuss the use of certain food allergens in arts and crafts class, like the use of egg cartons (for children with an egg allergy) or playdough (for children with a wheat allergy).
It is essential that your child’s care givers are able to recognise the symptoms of a food allergic reaction and know the steps to follow should this occur.
- 2016. ASCIA Action Plans for Anaphylaxis. Australian Society of Clinical Immunology and Allergy. Viewed 14 July 2016. http://www.allergy.org.au/health-professionals/anaphylaxis-resources/ascia-action-plan-for-anaphylaxis
- 2016. Talking to children about their food allergies. Food Allergy Research and Education Inc. Viewed 6 July 2016. http://www.foodallergy.org/talking-to-children
- Allergy and Anaphylaxis Australia. 2016. Allergy and Anaphylaxis Australia. Viewed 14 July 2016. https://www.allergyfacts.org.au/
- 2016. Food allergy FAQ. Australian Society of Clinical Immunology and Allergy. Viewed 7 July 2016. http://www.allergy.org.au/patients/food-allergy/faqs
- Allergy and Anaphylaxis Australia. 2016. Schooling and Childcare. Allergy and Anaphylaxis Australia. Viewed 7 July 2016. https://www.allergyfacts.org.au/how-to-manage/schooling-childcare
- 2015. ASCIA guidelines for prevention of anaphylaxis in schools, preschools and child care: 2015 update. Australian Society of Clinical Immunology and Allergy. Viewed 6 July 2016. http://www.allergy.org.au/health-professionals/papers/prevent-anaphylaxis-in-schools-childcare
- Allergy and Anaphylaxis Australia. 2015. Parent 10 point plan for school. Allergy and Anaphylaxis Australia. Viewed 7 July 2016. https://www.allergyfacts.org.au/living-with-the-risk/life-stages/5-12-years