Thursday, August 13, 2009

Back to Preschool and Daycare Food Allergy Tips

Lately I've gotten a lot of feedback and e-mail from parents with children who are preschool age or younger. I've talked a lot about elementary school tips and will have more of those in coming days, but I want to welcome these new readers to my blog by sharing some preschool and daycare tips that worked for me and my daughter.

When my daughter entered preschool after her first allergic reaction, she was the only student the school had with nut allergies at that time. Still, we did very well and had wonderful teachers, although there were a few bumps in the road (luckily, minor ones.)

By the time her sister followed her (two years later) students at the preschool had a multitude of different food allergies and dealing with allergies had become the norm.
Even at a nut-free school, understanding of food allergies varies. Some preschools and daycare centers have mandatory meetings about how to use epinephrine auto-injectors and how to avoid allergic reactions. Be sure to ask for a face-to-face meeting with key people such as the preschool director and top staff, including any staff member who will be caring for your child

 One thing that makes preschool and daycare difficult is that you rely almost entirely on the teachers and staff to keep your child safe. Depending on your child's age, they will not be able to communicate as effectively about their allergies.

Now, the bright spot. Things are getting better. Peanut-free and nut-free policies have become more of a standard at many preschools and daycare centers and I would strongly recommend that you try to get your child into a nut-free preschool. Food allergy training is widespread and many schools are more aware than ever before. That doesn't mean you can let your guard down, it just means that you may not have the be the "pioneers" at your school, which, take it from me, is very reassuring.

If your school currently is not nut-free and you can't or don't want to leave, log on to the FARE (formerly FAAN) website to get stats and information to share with your school. If they have the facts, they will be more able to understand why you want the nut-free policy and why it benefits them, the school, in the long run. Preschool is too young to expect children to manage their own life-threatening medical condition; it's easier to prevent a reaction than to treat one.

Parents are often asked to give a presentation to the preschool about their child's allergies and to outline emergency plans. This is your chance to educate and advocate for your child, so embrace it! In my experience, you want to give enough information without overwhelming people. If you present your info in easy-to-read format using bullet points and lists, they'll be more likely to read and absorb the information. Beyond a Peanut flashcards are perfect to share with your preschool -- this amazing resource helps teachers and kids understand nut allergies in an easy-to-use format. I also like the Linda Coss food allergy books. My new e-book is another good resource, very concise and easy to follow. Please feel free to share it with your preschool too...they might want to download it. Several preschools follow my blog already, so see if they are interested!

When I presented my preschool/daycare info, I provided a brightly colored (easy-to-spot) binder with my daughter's name, my name and contact info and her photo. It included a brief description of symptoms to look for (provided by my allergist), a Food Allergy Emergency Action Plan (signed by my doctor) and also doctor's contact info. I included a diagram instructing them on how to use an epinephrine autoinjector (available online at FARE as part of their Food Allergy Action Plan docs). I also included a list of "safe foods" or foods that I would allow her to eat. This is a short list--and much easier to follow than an "unsafe foods" list. Update the lists as necessary--important, since labels change!

If your child eats snacks or meals at preschool/daycare, consider sending your own lunch or meals to school. You should definitely have a chat with the school cook, but sometimes it's hard to know what has cross-contact and what doesn't. Even the school may not know; the suppliers may not have that information readily accessible.

Because of this, I always sent my daughter to preschool and daycare with the following: alternative snacks (just in case, remember my school was nut-free), a homemade lunch and "safe" treats for when kids brought in birthday food.

Birthday treats are another problem. These are almost never nut-free (or dairy-free, egg-free, whatever your allergy is--you know what I mean.) My daughter ate her "safe" treats alongside the other kids, but a much better option--especially because so many kids have multiple food allergies these days, not just peanut--is a non-edible treat. I also like to suggest crafts to teachers instead of birthday food. Your motto should be: Exclude the food--not the child. For ideas on how to do this, check out this article I wrote for Chicago Parent in which I suggested alternatives to food during school celebrations.

Currently my kids get a free paperback book of their choice for their birthday. This is paid for by the PTO. Daycare and preschool work a bit differently, but see if anyone would contribute $1 to a class b-day book fund. Daycare/preschool teachers can get great deals from the Scholastic Book Club so the cost should be relatively low.  Or how about stickers or colored pencils? Cupcakes may be traditional, but they don't have to be the only option.

Occasionally, preschool craft projects or activities can involve food. At the beginning of each month, ask about these projects and see if non-food items or "safe" foods can be substituted.

Understand that educating preschool staff will not be a one-shot deal. It's a good idea to check in, keep in touch and make sure everyone is on the same page. A friendly check-in can save a world of trouble. Since the understanding of food allergies varies from person to person and school to school, you may have to keep bringing your point home all year. If you remain upbeat, positive and compliment the staff on the efforts they make, you'll see that soon it will become second nature for your child's teachers. If it doesn't, speak up to the teachers directly before you go to the school director. Usually they want to help and just may need reminders. If your preschool director needs to be contacted, don't hesitate. We need to work together.

Many preschools are conducted in multipurpose buildings, including places of worship. Here is a link to a preschool held in a temple and the excellent nut-free policy they provide. Note that they say they can't control the entire building, but they give detailed steps on how they keep the classroom safe for nut-allergic children. For anyone seeking a "nut-free policy" model, check this out.

Preschool should be a wonderful, happy time for your child and even with nut allergies it can be just that. Work with your child to help them understand allergies, work with the school and then watch your child blossom!


Mindful Merchant said...

Really good information. I'm going to check out the Linda Coss series you recommended. I have a niece & nephew with life threatening allergies (and several friends too). We all need to learn more about how to keep everyone safe. I really like your blog - thanks very much!

Mom to 4C boys said...

Thank you for the information. My son will be startng preschool this fall and I am really nervous about how to handle things. The school is nut free, but from past experience I know that some parents don't really know what that means. I have to talk with the director this week so this list will really help.

Ali said...

I just wanted to say thank you for your blog! My daughter was diagnosed at 18 months and has had 2 major reactions that were very scary! I came across this blog while searching for any resources and it has literally been a life saver!! really been a huge help!! She is starting preschool this year too so I am glad to have this information!! thanks again for taking the time to do what you do!!

Jenny said...

Ali, (and everyone who commented) Thank you so much! I'm glad this blog helps.

Liz said...

Love, love, love this post. Thank you for sharing it, Jenny. I'm off to buy a bright-colored binder right now! Love the idea of a diagram in the folder and we have one of the DVDs, so if our pre-school doesn't have it, I can share it with the teachers.

Jennifer said...

We are in the process of confirming my son's nut allergy. I came upon this blog looking for support and help with so many new issues in our life. THANK YOU for providing links to older posts. You are providing so much support and important information. THANK YOU!

Jennifer said...

Thank you for providing links to previous posts. I am new to the allergy world (my son is only a year old) and I came hunting for information and support. The links have been so helpful. THANK YOU for all you are doing. You are making a difference!

Anonymous said...

Thank you for this information. I am happy to hear about the Linda Coss series. I have been looking for ways to help educate family members. My daughter is allergic to peantus and had her first reaction at daycare. She is starting preschool which is nut free on Wed and had a reaction over the weekend so I am feeling very nervous. After reading your post I think I will ask to speak with the school chef. It is great to hear about the daycare preschool setting since so much of what I read is about school age kids. Thank you!!

stephanie said...

Hi all. My son is 3 1/2 and was diagnosed with peanut and walnut allergies after having a reaction when he was 14 months old. Starting at age 2 he went to a preschool that was not strictly nut-free although his room was. There were signs and parents of the kids in his class were educated and asked not to send any food for their children that contained any nuts or was processed in a facility that also processed peanuts or tree nuts. Unfortunately we had to relocate. Out of seven preschools I visited, ONE has nut-free rooms. The preschool that I love and would love to send him to does not. They ensure me that they are "very observant" and would be able to keep him safe by separating him from children eating peanut butter. That sounds terrifying to me. I'm wondering if anyone here has a child with food allergies who goes to a preschool with similar policy. Thanks.