About nut-free classrooms

Posted by Barbara F. Meltz  September 17, 2009 06:00 AM
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Hi Barbara,

Is there research about whether "nut-free" classrooms are really any safer for children with nut allergies, as opposed to their being educated about what to avoid or does it give the child and parents a false sense of security (i.e.: a child takes a nut-free lunch to his classroom because there is a nut-allergic child in the class, but his sister's class has no restrictions - so mom makes PB&J for her. Without anyone noticing, peanut butter may have gotten on the outside of the nut-free classroom child's lunch box....).

My child has celiac disease but we don't keep other families from bringing wheat, barley or rye products to her classroom -- we've educated her about what she can and cannot eat (she was diagnosed right before entering kindergarten and is now in 2nd grade). It seems to me that no classroom is truly safe for a child with nut allergies if nuts were ever allowed in the classroom previously. Is there any research out there?

I'd like to hear your response.

From: JLF, San Francisco

Hi JLF,

I contacted FAAN, the Food Allergy & Anaphylaxis Network which is a very comprehensive resource that I've only recently come to know.

Jennifer Love, their Marketing and Media Communications Manager, tells me that no research has been done comparing children's allergic reactions in schools with food bans and schools without food bans. Without this evidence-based research, the decision to ban or not remains unresolved and is decided school by school or, system by system.

Here's the conclusion one study, comes to. Love highlights this:

"Schools can develop policies based on age related risks of exposure by using an assumption that the younger the age, the more likely the children are to touch each other and contaminate each other's food and increase the risk of allergen exposure or to share foods. A large group of young children is also more difficult to monitor and control. For these reasons, the practice of banning peanuts from preschool age to lower elementary school age is not uncommon."

This same study goes on to say that because older elementary school children have better impulse control and can understand the importance of contamination for an allergic classmate, "' peanut-safe tables and bans should generally be unnecessary for upper elementary school
age and up."

It's interesting to note that allergic reactions are not confined to the cafeteria. Of the children registered with the US Peanut and Tree Nut Registry, 79 % of them reported reactions in the classroom, often during craft projects (whoa!!) or parties.

According to the study: "46% of anaphylactic reactions in Massachusetts schools occurred in the classroom compared with 9% in the cafeteria.Thus it is important to advise food allergen avoidance in the classroom (eg, crafts and parties), as well as in the school cafeteria."

Here are other FAAN links, this one to school guidelines for managing students with food allergies, and this one to the multi-media program that FAAN offers for sale.


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23 comments so far...
  1. Nut free classrooms do minimize the risk - my niece has an "airborne" peanut allergy, so simply educating her about what she can and cannot eat is not enough. Also, sometimes declaring it a nut free zone is the only thing you can do to get the parents of non-allergic students to wake up and smell the epi-pen.

    My sister-in-law is on her town's newly minted food allergy committee, a great forum where they can work out the latest problems and new research with the school nurses and staff to see what the best plan will be in that town moving forward. One of the biggest challenges is the use of food in the curriculum - using marshmallows & toothpicks to make geodomes, stringing fruit loops for craft projects, etc. Even seeds are processed in the same plants as many nuts, so there goes planting and growing!

    Some teachers are very resistant to find non-food alternatives to their time-tested good projects, and in their defense, it's a lot to ask for them to start scanning glue labels for potential food allergens that can irritate the skin.

    The other big problem is the birthday celebrations. Now all the kids seem to bring in treats for their birthday, which has numerous headaches for all involved with regard to food allergies. The parents of the allergic students would like to see this practice disappear, but other parents (and even in some cases, administrations) are hell bent on keeping it. Which is kind of funny considering the amount of talk and research about childhood obesity. Number of kids in the class celebrating birthdays with cupcakes divided by number of weeks the kids are in school equals a party in the classroom more than once a week! Necessary? Notsomuch, in my opinion. And my kids are not allergic to anything.

    Posted by RH September 17, 09 07:19 AM
  1. I have a son with nut allergies and when he was 2 years old, he was in a daycare center. I told the school and the teachers about the dangers of anaphylactic reaction. Well, the teacher gave my son an oat bar that may contain traces of nuts and then lied and told me it didn't have a notice on it. Later that day, my son vomited and the school became scared and asked me to pick him up because it appears that she didn't read the notice correctly. I then told her to use his Epi-pen, and she said she was too scared. So I had to have my child's father run to pick him up and on the way home, he started having problems breathing. I am so lucky that he did vomited because had he went on the school bus, he wouldn't be here today. More schools need education on the matter of all food allergies. The life of a child is in the hands of the school and the teachers who are there with them half of their life.

    Posted by Tamika September 17, 09 11:51 AM
  1. How timely. I am in a heated discussion with the administration at my daughter's school. Preface: I get the very real and dangerous reality of peanut allergies.

    Here's my issue: In an effort to stave off diabetes while teaching my daughter to make healthy choices, she has adopted on her own a sense of healthy eating. She also knows what her body needs/craves. She also knows many prepackaged foods are not healthy and have a negative impact on the environment from the increased waste from the prepackaged materials.

    Her snack pack is loaded with healthy alternatives -- grapes, apple slices, celery, cheese slices, good deli meat. The other day I was told she could not eat the homemade chicken salad sandwich on wheat despite my copying the ingredient list from the bread bag and listing the ingredients in my chicken salad (chicken, celery, mayo).

    Reasoning - cross contamination. Hmmm ... can't I cross contaminate if I reach in pull out celery, grapes, or even one of the pre-approved, recommended snack packs? This nut-free school only checks classrooms with allergies.

    I mean really...

    Posted by nut free allergies causing problems with weight, diabetes ... may be September 17, 09 12:07 PM
  1. I will start by saying that we don't have this type of allergy issue in our family. I sympathize with those that need to deal with it, I really do.

    BUT, at what point to you stop relying on the rest of the world for your safety? I'm okay with nut restrictions in elementary school, because of the age of the children, etc., as stated by Barbara's expert above. It is inconvenient for me, to be sure, but I can deal with it.

    My issue is the huge restrictions all the way through HIGH SCHOOL. We're raising a bunch of kids that are going to be at risk in the "real world" because they've never figured out how to take responsibility for their own medical issue. Are they going to expect a nut-free workplace? Are they going to be looking to shop in a nut-free store? Also at issue are the restrictions, in my town all the way through High School, on anything that "may contain traces of . . . " Any company with a decent lawyer is slapping that puppy on every label they can to avoid the potential for lawsuits, which means that there are literally only a handful of "approved" snacks that I can pack in a lunchbox.

    I understand that these are serious issues, and I am okay with certain concessions, but at what point is enough enough? I'd be very curious about the results of a study of "ban" and "non-ban" schools. My niece and nephew live in a "non-ban" district, know kids with allergy issues, and have never seen anyone have a reaction, in the cafeteria or elsewhere.

    Posted by MP September 17, 09 12:52 PM
  1. I find the whole nut-free classroom/school concept absolutely ridiculous. There is a whole big world out there that is not nut-free and your child should learn sooner rather than later how to deal with the fact that they have allergies. My 3 yo can recite every allergy each child in her preschool class has and what they can/cannot eat. Do you keep your child in a bubble once they leave school? Do they never go to the mall, places of worship, amusement parks, libraries, movie theaters, etc, etc, etc.? The rest of the world should not be restricted in what they can/cannot eat for lunch due to another's allergies. And yes I am allergic to nuts and never received special treatment, special tables, special classrooms. I knew what I needed to do to keep myself safe.

    Posted by caml September 17, 09 02:11 PM
  1. My 5 y.o. has a life threatening allergy to peanuts and I write a blog, www.foodallergybuzz.com. That said, I am dumbfounded by the homemade sandwich situation described by "nut free allergies causing problems with weight, diabetes ... maybe".

    Wow! I would never expect the school or anyone else's parents actually to choose bread for sandwiches based on whether or not there might be cross-contamination with peanuts/nuts. We do that because our son is allergic, but ... I am flabbergasted by the school's reaction--did I read it wrong?

    Our school has a peanut-free, nut-free, sesame-free table, and while I wish that my son did not have to sit there, at least there is one spot in the caf that should be more peanut-free than other spots. As long as he stays away from peanuts and peanut products, and does not eat them, he will do very well. (I confess we do not know if he would have an airborne reaction but do not have reason to think he would.) Sounds like your school does not really understand cross-contamination and has gone wayyy overboard.

    MP, we don't rely on the rest of the world to protect my son. We have spent years teaching him what is safe to eat and what is not. He is, however, in kindergarten and his reading skills aren't what they will be in a few years. Therefore, I do think some extra help and guidance, such as peanut-free classrooms in elementary school, are good. I am grateful for them. There is definitely a learning curve with food allergies, and reading labels is a big part of staying safe.

    In addition, elementary school kids are not even allowed to carry their own asthma inhalers or epi-pens, so the schools have to be more protective of this age group. I am curious, where are these high schools with peanut bans? I can barely find an elementary school with one! When I try to do a Google search for them in Mass., I only find about 10 in the whole state.

    One more point I did not see mentioned. Peanut and nut allergies can cause anaphylactic (deadly) reactions. Celiac disease does not. This is a significant difference that should be considered.

    Posted by Jennifer B September 17, 09 02:25 PM
  1. "There goes planting and growing"?! Good grief, RH, I do hope your sister-in-law's school system realizes that seeds come from flowers/fruit not just from industrial processing plants.

    Posted by wg September 17, 09 03:43 PM
  1. To: MP -
    I agree that by high school the risks are greatly reduced with one caveat. You're making the assumption that kids develop and/or are aware of their food allergy early-on in life. Not always the case! You see where I'm going here?

    Posted by Stan September 17, 09 04:01 PM
  1. As a parent of a child with nut, peanut, and egg allergies this issue hits very close to home. My son is 11 now and we have been very fortunate to have school teachers, administrators, and school nurses who have very sympathetic to the situation.

    He has learned to ask questions, read labels and be aware of what is around him (like people eating peanuts at the ballpark). The people we visit with always ask about is this, that or the other thing safe or could I give him this instead.

    One of the biggest problems is with adult nit-wits who refuse to accept the gravity of the situation. Accidentally ingesting a peanut leads to anaphylactic shock for him (fortunately with eggs he just projectile vomits), that means swelling of face and neck, cutting off of air coming in and worse. Any parent who has lived through a child going through this will do everything in their power to prevent a repeat performance.

    There are always those who say, these allergies don't exist, or a little bit won't hurt him, or why should my kid not be able to eat a PB&J at lunch. They DO exist, a little bit can KILL him and if the roles were reversed you would not want a kid near your kid with a PB & J.

    Parents with allergic children cannot rely on everyone to be responsible, they have to advocate for their children and be aware. Many times a polite, excuse me but my son is allergic..., is all that is necessary, courtesy and information goes a long way.

    As my son has gotten older he has taken on the role of advocate for himself, and anytime we/he go anywhere we always carry epi-pens and Benedryl.

    By the way do not confuse allergies with food intolerance. Two different things. Food allergy can kill.

    Thanks.

    Posted by Rick September 17, 09 04:17 PM
  1. If schools did not have nut free zones, all of you litigious parents would be suing them. As if budgets are not tight enough.

    And for the parent of the child with celiac, wheat in the air does not cause a child to go into anaphylactic shock.

    And FYI, people with severe allergies are federally protected. So enough already.

    Posted by Knows better September 17, 09 08:09 PM
  1. Thanks Barbara for your response to this question and for your research.

    As the mother of a child with multiple life-threatening food allergies (peanuts included) and a food allergy educator and advocate, this issue of course is very near and dear to me and one that raises so many issues and debates.

    I would like to point out that not all children, food allergies, situations are created equal so there really is no one size fits all situation. For some children a peanut ban may be needed and it might not be for others. As your answer states, it is more likely to be needed for younger children who have poor impulse control and ofter touch each other, but in "some" instances it might also be needed for a high school student who has inhalation issues and could suffer a potential anaphylactic reaction to peanut protein in the air.

    I also want to point out that we hear more about peanut bans rather than other food bans due not only to the large number of those with peanut allergies but also due to the nature of peanuts and peanut butter. It is a very oily and sticky substance compared to say wheat from bread, and it can be difficult to remove the protein from tables, door knobs, toys in Kindergarten, etc. While any allergen can cause anaphylaxis, peanuts are one allergen that seem to consistently do so compared to say wheat. (I mention wheat as that was the allergen raised in the original question.)

    Pair that with the fact that some are allergic by touching their eyes, nose, and/or mouth and that young children are constantly doing so and you have a recipe for disaster.

    For those that don't know I'd like to mention that life threatening food allergies are considered a hidden disability under law; section 504 and ADA specifically. This means that children are entitled to receive the necessary accommodations they need in school to keep them safe and included. This in fact also applies to adults (ADA) in a work situation. For example if an adult is inhalation allergic to a food he or she is entitled to accommodations to keep him/her safe. This could mean a cube away from the office cafe or kitchen right down to a potential food ban depending upon the allergy sufferer.

    Food allergies are something that affects us all and unfortunately something that for the time being seems here to stay. I personally recognize the inconvenience that it may cause for others and sincerely appreciate those that try hard to keep our food allergic children safe and included in school.

    Posted by Ruth Smith of Best Allergy Sites September 17, 09 10:26 PM
  1. An upper elementary school in our neighboring town had nut-free classes, and other typical protocols to protect nut-allergy kids, but the school overall was not declared nut free. Then a truly sensitive student arrived on the scene. Within two months that child ended up in the ER - from her nut-free classroom - twice. The board voted unanimously to declare the entire school nut-free, and that child hasn't been to the hospital since. Indeed, when a parent makes a nut-free lunch and a nut-safe lunch at the same time, both lunches are contaminated, but the intended nut-safe lunch is far less dangerous than the PB&J or the oat bar, etc. It's a rock and hard place, but the bottom line is that we cannot eat as we like if it's going to kill an 11/-yr-old.

    Posted by Tammy September 17, 09 11:15 PM
  1. My kindergartener has a life-threatening peanut/treenut allergy.

    Tamika, you're doing a great job with your daughter. I'm working hard to get my picky little eater to follow your model. I'm baffled by your school administration's restriction on a chicken salad sandwich. Bakeries do put a cross-contamination warning on many of their non-nut products, but that doesn't mean bread in the classroom poses an unacceptable risk, as long as the children are warned that they cannot share or trade food. Bread, granola, and energy bars that do have nuts in their ingredient list would cross the line, but that doesn't sound like your situation.

    MP, Every time we sit at a cafe table, attend a birthday party, go to a fair, trick-or-treat, or even visit family, we are in the "real world", where everyone enjoys nuts. The only way I could possibly blow off raising my daughter to be aware of her risk would be if we lived in a bubble. We've been advised to treat the risk of contact the same way we treat the risk of ingestion. High school kids who have severe allergies do take responsibility for their risk, but they should at be allowed to learn in an environment free of lethal (for them) substances. The restrictions are about preventing situations where cross-contamination could occur outside of a child's ability to avoid it. Try to imagine a situation where your child inadvertently was the source of a lethal reaction in another child.

    I do appreciate your sympathy. Even more, I would appreciate support.

    Posted by stone September 18, 09 10:57 AM
  1. Having grown up in a "non-ban" district, I am shocked to read that MP's school bans foods that "may contain traces of..." I have food allergies (milk, egg, nuts, sunflower seeds) and I ignore these labels because, as MP pointed out, they are on EVERYTHING. Their ubiquity completely undoes their utility. My understanding of the rationale behind peanut bans past early elementary school is that some people are so sensitive that they react to small peanut particles released into the air upon opening a package. The chance that a product that even genuinely did contain traces of peanut would contain enough to be released into the air must be infinitesimally small.

    I do take issue with the claim that nut bans are preventing allergic people from taking responsibility for their allergies. I hope that no one expects a kindergartener who can barely read to check the labels on everything he eats -- we don't expect kindergarteners to cross the street by themselves, and that's much less complicated (and equally dangerous to the food allergic kid).

    But even as allergic kids grow up, a nut ban in school is not going to make them complacent. Speaking from experience, it is truly impossible to grow up allergic without taking responsibility for what you eat. It is always necessary to read labels and ask questions. Our overprotective parents drill it into us from a young age.

    Posted by EG September 18, 09 07:44 PM
  1. is that a girls only class?

    Posted by sally September 18, 09 08:44 PM
  1. JLF -

    Parents of kids with life-threatening food allergies (especially peanut) never feel safe. They, like their kids, live in a constant state of fear - this is why kids with peanut allergies have higher stress levels than even diabetic kids the same age.

    Of course a peanut-free room is more safe for a child with a peanut allergy. A wheat allergy is nowhere near as sensitive - your child will not have a reaction if someone else is eating a sandwich. My husband has a life-threatening allergy to seafood - he can eat at the same table as someone with a plate of clams. Some peanut-allergic kids can't even be in the same room as a peanut. It's just not even the same class of thing.

    So ... accept peanut-free classes as a way of being, and wash that lunchbox really well, please. You would hope someone would do the same if it was for your child.

    Posted by vegmom September 18, 09 09:30 PM
  1. this nut allergy nonsense is getting out of hand. nut allergies cause fewer deaths every year than lightning strikes or insect stings. so let's get rid of all flowers surrounding playgrounds, right? this is nothing more than a hysterical reaction - very few food allergies are serious enough that death can result. this is over-protective parenting at its worst.

    Posted by common sense September 18, 09 10:44 PM
  1. What gets my goat is when those of us without allergic kids try our very best to be sensitive to others' needs, and get flack. There was no need to throw out that kid's sandwich at all. That's just another form of ignorance.

    I went out of my way to find nut-free granola bars to send with my kids to a summer day camp. The first day, they had their snacks taken away because "they could have had nuts". I suppose that list of ingredients that did not contain nuts, or a statement saying they weren't processed around nuts, wasn't enough of a clue.

    Then the next day the counselor snatched my kids' sances on the way in to inspect them for the dreaded Nut Free Granola Bars of Death. It was really rude and obnoxious. Totally unnecessary, too, as I had packed fruit on the second day, lest someone who had some rare plastic wrapping allergy drop dead from the granola bars.

    As a mom of vegetarian kids, I sometimes have to bend over backward to find something to send with them that isn't going to trigger someone's nut/seed/soy/dairy allergy. I do my best. But my kids need to eat too, and I'd appreciate some rationality from the allergy crowd now and again.

    Posted by BMS September 19, 09 05:23 PM
  1. I have two sons - my eldest one w/out food allergies and the younger one w/ severe sesame and nut allergies. When my eldest (the non-allergic one) was younger, I admit that I would get somewhat irritated at the "allergy moms" that seemed almost militant about banning nuts in shared snacks/scrupulously checking labels etc. But being an RN, I, of course, complied with their requests to ensure their child's safety. It was just their approach that rubbed me the wrong way.

    Then I had my youngest, who we found out the hard way had food allergies. He was given ONE kashi cracker at preschool when he was 3 years old. We had suspected that he had sesame allergies and had informed the school, but the teachers neglected to read the ingredient list for that snack. After eating the cracker, my son immediately felt funny, thick-tongued, vomited, and became listless. The preschool was also afraid to give the epi pen (since this would have been his first dose of it), but did give Benadryl. When I arrived to pick up my son, he was pale and listless. I was alarmed. I rushed him to the hospital, where he received the epi pen and revived very quickly, right before my eyes. After spending several hours in the EW for observation, we brought our exhausted son home.

    I agree, once you witness your child suffer an anaphylactic reaction, you NEVER want to see them suffer it again. And to give you a sense of severity, my son tested an "8" (defined as high) on the RAST (allergy testing) blood test to sesame .... he is a "48" to nuts on that test. If he reacted the way he did to sesame, I never want to see how he'll respond to a peanut/nut exposure. That said, I do allow my eldest (non allergic son) to eat peanut butter/nuts in our home, often times side by side to my allergic son. My eldest son knows to inform my younger one when he's eating a nut product and to wash his hands well once he's done. My youngest son also knows to avoid eating anything he's not sure of or that I haven't packed in his snack/lunch bags.

    BUT, due to other children's food allergies, our school is NUT FREE and in my son's classroom, they also ban sesame. Our teachers are vigilant in checking snacks and reinforcing the food bans and I truly do appreciate all the support and help. I know there's a big world of allergens out there and realize I can't protect my son from all dangers, but while he's still young and very vulnerable, I'll do all I can to protect him.

    Posted by nurse1985 September 19, 09 07:01 PM
  1. Common sense, did you even read the previous posts? Give it a whirl and then re-read your own post.

    Posted by Cordelia September 19, 09 09:55 PM
  1. BMS, you stated it so eloquently. I do my best to feed my children without endangering other children, as do most of the parents I know. While many of the parents of children with allergies are great, those few who are obnoxious about it really taint the others. It's the difference between "I'd like to see the label, please" and snatching it out of my hands. Or quietly removing the unsafe item from the table vs. loudly commenting about how awful it was that someone couldn't be bothered to read the fine print on a jar of sprinkles and was clearly out to murder her child.

    Posted by akmom September 20, 09 10:14 AM
  1. For those that feel that bans are unnecessary for older children, I've just learned of an allergic reaction in our town of an 8th grader who bought a vending machine product and failed to read the label. She was given the epi-pen and sent to the hospital.

    While she clearly should have read the label, teens are unpredictable and often make very poor choices regardless of medical conditions. Many reactions happen in older children who are just learning/gaining independence. That doesn't even take into account older children who are not neuro typical and might need extra help in a variety of ways. Most older kids do not need the extra accommodations, but some do.

    Regarding the post by common sense #17. I trust you are not an allergist. Making a classroom nut-free is an accommodation and safety net/precaution for those allergic to certain foods. These accommodations are what keep our children from having reactions and dying. Without these precautions that we as food-allergic parents take, who knows how many children would die from their allergies.

    You bring up deaths by lightning strike. The schools also take precautions for those. Would you want your child left out on the playground during an overhead lightning storm? After all, death by lightening strike is pretty rare right?

    It seems that some schools are out of control with their precautions, but honestly, I truly question whether these scenarios mentioned are true, having worked with so many parents of food-allergic kids and advocating for the food allergy community.

    But if they are, in fact, true, I don't know the food-allergic kids those accommodations are there to protect and can only assume they are necessary. Since health information is private and protected by law, I can also assume that those parents who feel the accommodations are too strict also do not know the extent of the person's medical condition those accommodations are there to protect. So I'm not sure how any of us can judge whether something is appropriate or not, or going overboard or not.

    Are there some parents that do go way overboard? Of course there are, just as there are some NON food-allergic parents who go way overboard in being insensitive and lacking compassion, i.e. the parents who say, "I don't care about the ban; my child is entitled to peanut butter and we are bringing it and let's see if the child really has a reaction." I assure you those parents are out there - I've met them.

    Are they the norm? Of course not, just like the food allergy moms who go overboard are not the norm.

    Children can die from their allergens. I'll repeat that: Children can die from their allergens. Parents of food-allergic children and schools put precautions into place to prevent that. Schools are required to do so by law. Thankfully these precautions have saved lives.

    Posted by Ruth Smith of Best Allergy Sites September 21, 09 12:33 AM
  1. Stan-
    Okay, so they haven't developed their allergies by high school, so we keep it out of high school. Okay, they haven't developed their allergies by college, so we keep it out of college. Okay they made it though college, so what's next, nut free job placement?
    I know that I'm being flip, but see my point? I said in my original comment that I GET the restrictions in ELEMENTARY school. The kids are young and it makes sense. They are not ready or able to deal with this on their own. My point was that at what point does the rest of the world stop being responsible for it?

    I'm careful to not send foods that would cause a problem, but but my daughter has had food taken away from her at lunch because of the "may contain traces of" labeling. She came home very hungry that day. She can eat all of the lard filled Oreos she wants, but can't have a relatively healthy cereal bar because of the fine print. My daughter doesn't eat meat, and is pretty particular about what she will eat, so my lunch choices for her are pretty limited.

    Honestly, from what I've read, I think things may be worse now then they were when I was a kid because of the lack of any exposure to the allergens. They seem to be making great progress in controlled, medically supervised desensitization. I hope that progress continues.

    Posted by MP September 22, 09 01:10 PM
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Barbara F. Meltz is a freelance writer, parenting consultant, and author of "Put Yourself in Their Shoes: Understanding How Your Children See the World." She won several awards for her weekly "Child Caring" column in the Globe, including the 2008 American Psychological Association Print Excellence award. Barbara is available as a speaker for parent groups.

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