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Managing Food Allergies in Schools
By David Yeager

The CDC’s New Guidelines: How much of an impact will they make?

For the first time last fall, the Centers for Disease Control and Prevention (CDC) released Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs. While school districts across the country already are following various federal, state, and local laws related to food allergies, these new guidelines stand to foster improvements and make the most impact on those who don’t work directly in school foodservice, such as other administrators and even parents.

The new guidelines, based on best practices in food allergy management, were developed by the US Department of Health and Human Services and the US Department of Education in response to the FDA Food Safety Modernization Act of 2011. They highlight five priority areas: ensuring the daily management of food allergies in individual children, preparing 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. The guidelines also include a summary of federal laws and regulations that govern food allergies in schools and early care and education programs and a list of food allergy resources.

Where the Guidelines Will Make an Impact
Because the guidelines are voluntary, they don’t require schools or early care and education programs to follow them. As a result, Deborah Beauvais, RDN, SNS, district supervisor of school nutrition for Gates Chili, East Rochester, and East Irondequoit schools in New York and a spokesperson for the Academy of Nutrition and Dietetics, says she doesn’t expect the guidelines to have a noticeable effect on school lunch programs since many districts already are adhering to regulations governing food allergy management. “I honestly think that those of us who work in school [foodservice] around the country are very in-tune to allergies,” she says, “so I don’t think the guidelines are going to have a huge impact on school foodservice because I think we’re ahead of the curve.”

The new guidelines likely will have more of an impact on those working outside of foodservice. Often, people who don’t work in foodservice don’t know how to properly manage food allergies, Beauvais says, which is why everyone who’s involved with the school, including the students, must know how to prevent food allergy reactions, recognize symptoms, and respond appropriately. This especially is important because allergic reactions can occur in classrooms, in rooms shared with multiple classes, in rooms shared with the public, on the bus, or on field trips, she says.

“It’s not just about school lunch, and it never has been, and it shouldn’t be about just school lunch,” says Sherry Coleman Collins, MS, RD, LD, a nutrition, food safety, and food allergy expert. “Managing food allergies is a much bigger issue. Most reactions actually happen in the classroom, not in the cafeteria. With that in mind, it’s important to create a comprehensive plan that covers the whole school community.”

While many schools and early care education programs already have a food allergy plan in place, not all do. Even schools that have allergy plans may not have standardized protocols for preventing and handling allergic reactions, Collins says. Standardized procedures and even standardized forms can reduce the risks and harms of food allergies, she adds. The new guidelines provide a systemwide framework for schools and early care education programs to address food allergy issues, from kitchen staff to the superintendent and bus drivers.

Educating staff about food allergy management enables them to educate the students. Collins says one of the most important and most overlooked steps in preventing allergic reactions is reading the label of any food that’s consumed every time it’s consumed. Because food ingredients can change, it shouldn’t be taken for granted that a particular item is safe. It also can be challenging to identify which foods may contain an allergen.

“Even patients, when they’re first diagnosed with a milk or egg or wheat allergy, don’t consider all of the foods that those ingredients could be in besides the obvious sources,” says Audrey Fendley, MS, RD, CSP, LD, a clinical dietitian at Arkansas Children’s Hospital who specializes in children’s food allergies.

Educating Parents
Besides staff and students, the guidelines also can help educate parents. Because parents are an integral part of the school community, they, too, should be made aware of how to prevent allergic reactions. Food allergies always should be taken into account when classroom snacks and treats are served, and parents who help with school activities can help ensure that the risk of an allergic reaction is as low as possible.

“I think the guidelines make some good points that we don’t always get to share with parents about keeping tables clean, washing hands, and making sure snacks are kept separate,” Fendley says.

The guidelines may be voluntary, but they provide a resource that most schools and early care and education programs will find helpful, Beauvais says. They’re based on best practices, so administrators can gauge their programs against the most up-to-date knowledge in the field to not only manage food allergies but reduce their incidence.

— David Yeager is a freelance writer and editor based in Royersford, Pennsylvania.