How You and Your Child Can Lower the Risk of Anaphylaxis at School

Successfully managing your child’s anaphylactic allergy at school requires teamwork between you, your child, and the school staff.

Whether your child is allergic to bees, latex, or certain medications or foods, sending them to school with an allergy that can cause anaphylactic shock can be anxiety inducing — for you and your child.

Although serious, anaphylaxis can be managed effectively with proper planning and communication with the school. And you can even get your kiddo involved. Here’s what you can do to help keep your child safe this school year.

While your child is in school, you entrust their safety to the staff, which makes it that much more important to build a strong rapport with your child’s teachers and other school administrators. These steps can help you stay in close contact and align on safety precautions.

Ensure the School Has an Allergy Action Plan for Your Child

You are the primary coordinator of your child’s allergy care, especially if they are young. “Part of this role is working with school health providers and your child’s doctor to create a comprehensive allergy plan,” says Michael Pistiner, MD, director of food allergy advocacy, education, and prevention at Massachusetts General Brigham Hospital for Children in Boston and a fellow at the American Academy of Pediatrics (AAP).

Before school starts, find out what forms you need to submit, so the school has an emergency plan in place for your child. If the school does not have a standard form or accepts additional documentation, the AAP offers a comprehensive form on allergy and anaphylaxis emergency protocol.

Identify Your Points of Contact

Your child’s teacher (or homeroom teacher if they do not have a single teacher) is a great place to start. But it may also be helpful to have other go-to staff members to reach out to for information or if you run into an issue. This may include the vice principal and the school nurse or another member of the school’s healthcare team.

Understand School Policies and Training

Nearly half of severe allergic reactions in school start in the classroom, 20 percent in the cafeteria, and 10 percent on the playground, indicating that allergy management should be a school-wide responsibility.

Yet, just 3 in 10 schools provide training for staff on identifying anaphylaxis.

Talk to your child’s school administrator about how staff are trained and what their allergy policies are.

This can give you a sense of how prepared staffers are to manage an anaphylactic reaction and help you determine your level of involvement. For example, if recess monitors and lunchroom staff are trained to identify and treat anaphylaxis, you may not need to make recess precautions a focal point of your conversations with the school.

Ask About Epinephrine

Because epinephrine (administered by auto-injector or nasal spray) is the first-line treatment for anaphylaxis, it’s crucial for your child to have access to it at all times. Most states have laws allowing schools to stock auto-injectors, but not all states require this, and only a few keep nasal spray epinephrine on hand.

Before the academic year starts, ask about the school’s epinephrine policies: Do they stock it? Where is it located? Are all school personnel allowed to administer epinephrine if needed?

If your child’s school does not stock epinephrine, explore getting a few to keep in your child’s classroom, in addition to one they keep with them at all times. Even if the school does keep a supply of epinephrine, it’s a smart preventive measure to ensure your child has access to their own, too.

Discuss Grade-Level Expectations

As your child gets older and becomes more independent, school staff may expect them to play a greater role in managing the allergy.

For example, according to the nonprofit organization Food Allergy Research & Education, students in kindergarten through fifth grade are generally capable of telling people what they’re allergic to and washing their hands before they eat. From grades six to eight, they can likely monitor their own dietary restrictions, check food labels, and know when they’re having an allergic reaction. Finally, in high school, students can help develop their allergy action plan.

You and school personnel should align on what is expected of your child, given their age and comfort in managing the allergy.

Your child can play an active role in managing the allergy, and their confidence in doing so will grow over time. Here’s where to begin.

Review the Allergy Action Plan Together

With your child and their pediatrician or allergist, create and review an age-appropriate allergy and anaphylaxis emergency plan. Some important details to cover include what triggers the allergy and signs of a reaction.

Talk About When to Get Help

Make sure your child is comfortable asking for help. For example, help them identify trusted adults (such as teachers, lunchroom monitors, and other staff members) and encourage them to get help if they think they’re having an allergic reaction, says Dr. Pistiner. One strategy for building confidence is to practice asking for help. You might sit with your child and say, “Pretend I am your teacher. What would you say to me if you think you’re having an allergic reaction?”

Educate Them About Allergy-Safe Behaviors

Children with food allergies should learn not to eat classmates’ food, says Pistiner, and to always wash their hands before and after eating. In addition, reading labels is a valuable skill they’ll develop with age and reading ability. At first, this might mean your kindergartner asks their teacher “if the food is meant for them or not,” Pistiner says. “As they start reading, they can start practicing reading labels and, with time and confidence, will be able to do it for themselves.”

If your child has an anaphylactic insect sting allergy, talk to them about the importance of staying calm if they encounter a bug. And remind them to steer clear of areas that may attract bugs, such as wooded areas surrounding a playground.

For a medication allergy, teach your child to list off what they are allergic to when the school nurse or their teacher gives them medicine. As they get older, they can also learn how to visually identify the pills they can’t take. School administrators should know which medications your child is allergic to, even if they don’t provide them. It’s still helpful to get your child in the practice of discussing allergies.

Teach Your Child How to Use Epinephrine

This should be done gradually. Start by teaching your child the signs and symptoms of anaphylaxis when they’re young. Next, show them how to administer epinephrine while you demonstrate on a training device. Finally, help them develop the confidence and competency to do it themselves.

There is no hard-and-fast rule about when children should be expected to self-administer epinephrine. One study that consulted allergists suggests children should be able to carry and use an epinephrine auto-injector themselves by 12 to 14 years old. But a survey indicates that caregivers believe children should assume this responsibility between ages 6 and 11.

The truth is, transferring the responsibility of administering epinephrine depends on your child’s maturity, development, comfort, and knowledge of the condition. That said, the American Academy of Allergy, Asthma & Immunology recommends that children be able to self-administer before they reach their teen years.

Empower Your Child to Speak Up and Ask Questions

Walk your child through potential scenarios and how they can respond. For example, if someone hands them a packaged bag of cookies, they can ask an adult if it contains the allergen. Or, if a classmate offers a snack, you can help your child come up with a go-to response to turn something down.

It’s understandable to be worried about your child’s anaphylaxis risk at school. And while it takes vigilance and planning, the allergy doesn’t have to define their school experience. Maintaining a line of communication with your child’s school can help you feel confident that a safe plan is in place. And educating your child will help empower them, so they feel more capable and less stressed at school.