Starting Kindergarten with Food Allergies

Kindergarten. Gosh, I can remember dreading the day he would leave my safe-as-can-be-bubble for kindergarten since the day he was diagnosed with food allergies at just a few months old.

The night his pediatrician first called me with his blood test results that showed a substantial egg and peanut allergy, I immediately stopped eating peanuts myself (because I was exclusively breastfeeding) and we emptied our house of peanut products. We had no idea that his peanut allergy was actually mild compared to what it would become five years later, but we knew that we didn't want to risk anything happening.

Hudson has only ever really stayed with aunties or his Grammie and Papa when we step out for a few hours, and even then I've been known to nervously give the allergy run-down just to make sure no one ate peanuts that morning, their dog didn't have any peanut treats that day, and there weren't any out of the packaging in the house. And that's with his family, who knows the full risk of his allergies and love him almost as much as I do, but you can never be too safe, right?

I wasn't sure I could ever trust a complete stranger to make sure he was safe, while watching 27 other kids in the classroom, especially at a school that wasn't nut-free. Hudson's peanut allergy is not just to ingested food - it is also to contact with peanut oil and residue so it was a bit more complicated at school. I didn't even know if his doctor thought it would be safe for him to attend under those circumstances. We had many conversations with his doctor about the school, the allergy-safe measures that the school typically follows, and how those might need to be changed to accommodate Hudson. We also had his peanut numbers retested at the beginning of the summer so we knew exactly what we were contemplating when we made the decision. In the end, his doctor felt it would be safe for him to go to school, with proper precautions taken.

I knew that orchestrating a safe school environment for Hudson was going to take a lot of work, and it wasn't going to happen overnight. Essentially, any person that would come into contact with Hudson at school needed to know of his allergies. This included his teacher, principal, librarian, campus supervisor, speech therapist, and everyone in between. I began the conversations about Hudson's situation with the principal at the end of the last school year so I could catch a few people before they headed out for summer break. Thankfully, we have a very kind and accommodating staff, so I was also able to start having early discussions with the district nurse prior to summer starting.

The week before school, we had another meeting with me and Hudson, along with the school principal, district nurse, school nurse, and his teacher. We spoke about his allergies, previous reactions, current treatments, and what my expectations were. There happened to be another child with severe food allergies that had already been in school so we were able to pull from his health care plan and customize it with what we all thought was necessary for Hudson. I was so grateful that his teacher took his allergies seriously and asked questions throughout the meeting so the nurse and I were able to provide clarifications for her.

I know every child, school, and family is different, but here is some of the process that we went through when preparing for the school year to start. Maybe it can help one of you navigate the school transition too.

Here are a few things included in our health care plan, which is attached to his pre-existing IEP:

1. Hudson will sit at a completely separate table, away from other non-allergy children during snack and lunch time.

2. Children who play on the same playground with Hudson will wipe hands with a baby wipe and use sanitizer after eating, and before playing on playground. (I realize that baby wipes and sanitizer don't remove food protein, but it is better than nothing when washing hands with soap and water was not an option.)

3. A letter was sent home to all of the parents in Hudson's classroom during the first week of school explaining his severe allergies. The letter requested that, when possible, peanut-free foods would be sent to school for snack and lunch.

4. Hudson's doctor signed a document stating that he should self-carry his Epi-pen at all times. He had to demonstrate to the district nurse that he knew how to use it and he has to carry it on his body at all times. We let him pick out a fanny pack at Legoland over the summer, and he uses that to carry it inside his insulation pouch (very necessary for those 110* school days out here).

During our discussions with the district nurse, she reviewed some general public healthy safety procedures that would be in place across the school due to Covid. (For reference, we are located in LA county.) In a bizarre way, some of it was a bit comforting as a food allergy parent.

A couple ways in which Covid precautions have helped protect Hudson from potential food allergy risks at school:

1. Social distancing means less contact in general. The children are *supposed* to be further apart from each other (3 feet) and are only allowed to play with toys in designated area and not share communal toys daily, along with staying in specific play zones on the playground.

2. No sharing of personal items, food, etc. means less risk of cross-contamination on surfaces.

3. Washing hands upon returning to the classroom after recess and lunch is hugely helpful.

I'm no expert - just a food allergy mama trying her best to keep her son safe at school, but here are a few of my suggestions that I've learned in the first year.

1. Start discussions and prep early. School admin, teachers, and nurses can more easily dedicate full attention to you and your child's needs when it's several weeks before school, rather than a couple days before when they are bombarded with tons of parents.

2. Encourage your child to be bold enough to speak up for himself. Hudson told me that there was a little boy who accidentally sat at the allergy table the first day of school and had a peanut butter sandwich. Hudson saw this and immediately got a campus supervisor to move the boy to the other table. Hudson's personality type has been a huge comfort for me while he is at school because I know he will always speak up for himself.

3. Tell your kids what types of foods their allergen can be hidden in. Bars, granola, trail mix, candy, sandwiches, cookies, etc. Show them pictures of common foods. If they've been restricted in your house, chances are, they may not be familiar with what they look like. A while back, we realized that Hudson didn't even know what an actual peanut looked like out of its shell because we don't let them anywhere near him.

4. Review symptoms that would require them to use their Epi or tell someone they need help, if possible.

5. Tell your child's teacher what their previous reactions have looked like. Not that all reactions will be the same, but I realized that some teachers have never experienced reactions first hand and don't know that not all result in "typical" anaphylaxis that everyone assumes it will look like.

Hudson has been in school for two months now and has been perfectly safe. Everyone has followed the guidelines that were set for him at the beginning and we are so thankful for that. I have only received a couple phone calls from the nurse so far and they were both for his eczema. Since reintroducing milk into his diet after conducting food challenges and gradually increasing his dosing of it, we have noticed that he has developed eczema on his arms. The teacher told me that when Hudson came up to to tell that he was itchy she practically ran him over to the nurse because she didn't know if it was from an allergy problem. We laughed about it after school that day, but I told her how much I appreciated that she took it seriously. I would always rather someone escalate the concern and find out it was not urgent, than wait to see how bad it got.

We plan to continue keeping Hudson in public school, even though it is not a nut-free campus, until we feel he is no longer safe there, or until it does not make fit into our family's plans for him. I am much less anxious today than I was the first few days. Most of that is due to the teacher, nurse, and campus supervisors demonstrating that they take the risk to him seriously as well. I'm sure that I haven't done everything right. I did as much research as I could beforehand, but it's still my first go at it. We will continue to pray for safety for that kiddo every day and try to let him participate in as many "normal" activities as possible.

I'd love to hear any suggestions from other food allergy mama veterans so we can keep him as safe as possible. Please leave a comment below and let me know what's worked for you and your family so far!

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