New international recommendations for managing food allergies in childcare centres & schools
An international panel of food allergy experts and stakeholders has published evidence-informed recommendations for managing food allergies in childcare centres and schools.
Published in the Journal of Allergy and Clinical Immunology, the research offers guidance for personnel training, stock epinephrine, food restrictions, and other interventions aimed at managing the risk of allergic reactions to food.
“This study aims to provide the best available evidence to inform school policies and practices to protect allergic children from accidental exposure to food allergens,” says Dr. Susan Waserman, an allergist and professor of medicine at McMaster University, who chaired the guidelines panel.
Panel members conducted a systematic literature review to collect data on the impact of select interventions on preventing and managing allergic reactions to food in childcare centres and schools. They also collected and synthesized data on the resource requirements, feasibility, and acceptability of these interventions across stakeholder groups.
The guidelines conditionally recommend that childcare centers and schools provide food allergy training for personnel; implement allergy action plans and protocols; and use epinephrine to treat anaphylaxis.
They further recommend that stock unassigned epinephrine autoinjectors (EAI) be made available to treat anaphylaxis on site, rather than requiring allergic students to provide their own EAIs.
“We also suggest that childcare centres and schools do not prohibit specific foods or establish allergen-restricted zones, such as a ‘nut-free classroom’ or ‘milk-free table’,” adds Dr. Waserman.
“However, it may be appropriate to implement allergen-restricted zones in situations where students lack the developmental capacity to self manage.”
The authors state that due to the lack of high-quality evidence available in the literature, the recommendations are rated “conditional” and policymakers are encouraged to adapt the guidance to fit their local circumstances.
The guidelines were developed with support from the Allergy, Genes and Environment (AllerGen) Network and have been endorsed by AllerGen’s partner the Canadian Society of Allergy and Clinical Immunology (CSACI).
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