Food allergies at school: Your top 10 questions answered

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By Madelyn Fernstrom

Food allergies are on the rise in children, and an estimated 13 percent of kids in the United States have one or more. And while there’s plenty of information out there, many TODAY viewers still had questions for our #OrangeRoom chat.

Even if you don’t have a loved one with a food allergy, these answers can help provide practical strategies to create a safer and more socially comfortable environment for kids with food allergies. Always check with your child’s doctor for specific advice.

My child is at a “nut free” table at school and feels so isolated. What can be done?

This is a very fixable problem. “Nut free” doesn’t mean “friend free.” Be proactive – and have your child invite different friends to eat with him at the nut-free table. You can provide lunch for both children, or speak with the parents of the non-allergic friend to make sure an acceptable lunch is packed.

How can I best prepare my allergic child for school?

Dr. Gary Pien, a pediatric allergist and immunologist and Director of Research at the Summit Medical Group in New Jersey, suggests this four-step plan to inform the whole school team: (1) speak with your child’s teacher and the school nurse, and provide a detailed summary of the types and severity of the food allergy; (2) talk to the cafeteria supervisor for acceptable menu options; (3) have an emergency allergy plan on file at the school; (4) teach your child age-appropriate facts about the food allergy, including not to share snacks with other children.

And make sure to provide your child’s teacher with some non-perishable snacks, when an unexpected party or class celebration occurs, so your child doesn’t feel excluded.



Are there any kid-fashionable alert-bands my daughter would be willing to wear to make sure others know about her food allergy?

Kids can now have allergy alert bands that look just like standard jewelry. Many include beads and snap on decorative disks in many colors; stylish necklaces and “dog-tags” are a popular choice for both boys and girls. Temporary tattoos are also available. And some bracelets can add medical information, with a password and pin number engraved, for a special link in case of an emergency.

I’ve read about desensitizing your child to foods like peanuts. Can I try this at home?



The science for desensitization is solid, but Dr. Pien says “don’t try this at home.” He adds “depending upon the severity of the allergy, your doctor can try a desensitization technique in a medically-supervised setting."

Can I use an EpiPen past its expiration date?

Dr. Pien recommends following the expiration date guidelines. But to avoid wasting money, he suggests calling the pharmacy before purchase and find those with the longest expiration date. But he adds “In an emergency, an expired pen is better than no treatment at all. While the potency of the dosage might be reduced, it is still safe to use”.

What’s the difference between a food allergy and a food intolerance?



A food allergy is related to an immune system response, while a food intolerance is usually a digestive issue. These can be diagnosed by a visit with an allergist who can provide an effective treatment plan.

My child has a soy allergy. Does that mean he needs to avoid soybean oil and soy lecithin?

Typically, soybean oil and soy lecithin can be safely consumed. But avoid ingredients listed as soy flour, soy protein, or textured vegetable protein. Always read labels of packaged and processed foods carefully.

For a dairy allergy, how do I make people understand this is more than just milk?



Dairy products include any foods containing “casein” and “whey”, two proteins found in dairy products (milk, cheese, butter, yogurt, ice cream). A food label might not list “milk” as an ingredient, but these two dairy components. Make a list of these foods for friends and family for future reference.

My child has a severe egg allergy, and even eggs cooking in the kitchen can provoke a response. What can I do?

Rarely, a person's allergy can be severe enough to react to airborne particles of the allergen. This most often happens when that food is being cooked such as roasting peanuts or frying eggs. Avoid cooking these foods around highly allergic individuals. Keep the kitchen well-ventilated while cooking, and be sure to clean off all surfaces and tables after the cooking is done. It is always best to discuss these potential reactions with your allergist, and establish avoidance guidelines and an emergency plan.

Our family has multiple food allergies. While my toddler has no obvious food allergies, should I get her tested, to be proactive?

Dr. Pien suggests testing for food allergies only if there is a reason to be wary, such as a family history of food allergies, or the child has shown other allergic features such as eczema, environmental allergies, or asthma.