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Food Allergies - Keeping Children Safe in Schools 2017

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Food Allergies - Keeping Children Safe in Schools 2017

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For educators and school staff, Food Allergies in Schools focused on:
1. Facts about Food Allergies
2. Food Intolerances and Allergies
3. How to Figure Out Safe Foods
4. Avoiding Cross Contact Contamination
5. Creating a Food Allergy Plan of Action

For educators and school staff, Food Allergies in Schools focused on:
1. Facts about Food Allergies
2. Food Intolerances and Allergies
3. How to Figure Out Safe Foods
4. Avoiding Cross Contact Contamination
5. Creating a Food Allergy Plan of Action

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Food Allergies - Keeping Children Safe in Schools 2017

  1. 1. Food Allergy Research & Education (FARE) Nebraska Extension Food Allergies – Keeping Children Safe at School
  2. 2. Do you have a food allergy?
  3. 3. Do you have a family member or friend with a food allergy?
  4. 4. Do you have a student in your classroom with a food allergy?
  5. 5. 15 million
  6. 6. Includes 5.9 million children (1 in 13)
  7. 7. Putting Food Allergies Into Perspective If the food allergy community were a state, it would be the 5th largest state in the U.S. by population! The number of people with food allergies in the U.S. is greater than the entire populations of New York City, Los Angeles, and Chicago combined!
  8. 8. Food Allergy Facts: • Food allergies among children increased approximately 50% between 1997 and 2011. • The economic cost of children’s food allergies is nearly $25 billion per year. • Allergies to peanuts, tree nuts, fish or shellfish are generally lifelong allergies. • Cow’s milk, egg and soy allergies typically begin in childhood and eventually may be outgrown.
  9. 9. Food Allergy Basics • A food allergy is an abnormal response by the immune system to a food protein. • When the food is eaten, the immune system releases histamine and other chemicals to “attack” the food. • This results in the symptoms of a food-allergic reaction.
  10. 10. Food Intolerances • Digestive system response • More common than food allergies • Easy example would be a lactose intolerance
  11. 11. Symptoms of Food Intolerances • Nausea • Stomach pain • Gas, cramps, bloating • Vomiting • Diarrhea
  12. 12. Gluten Intolerance • Celiac sprue, Nontropical sprue; Gluten-sensitive enteropathy • Condition that damages the lining of the small intestine. • Most avoid gluten - wheat, barley, rye, and possibly oats
  13. 13. What does it mean to have a food allergy? • No cure for food allergies • Allergic reactions begin within minutes or up to two hours after the food is eaten • Anaphylaxis • Food allergy, stinging insects, medication, and latex allergy • Epinephrine • Biphasic reactions
  14. 14. How is a food allergy diagnosed? • Interview with an board-certified allergist or primary care doctor • Two most commonly used tests: • Prick skin test • Blood test • Other tests: • Oral Food Challenge • Elimination Diet
  15. 15. Food-allergic reactions occur within what time period after ingestion? Reactions can happen in minutes, days or hours, depending on the severity of the allergy.
  16. 16. Symptoms of Food Allergies
  17. 17. What is Anaphylaxis? • Serious allergic reaction • Rapid in onset • Can cause death • Requires immediate medical treatment • Involves multiple systems in the body.
  18. 18. Epinephrine • Epinephrine is the only medication that can reverse the symptoms of anaphylaxis. • Antihistamines should not be used to treat anaphylaxis, but can be used for localized reactions, such as hives. • Prompt administration of epinephrine is critical • Epinephrine is prescribed as an auto- injector devise • Epinephrine is a safe drug, with the risks of anaphylaxis outweighing any risks of administering the medication
  19. 19. How a Child Might Describe a Reaction • “This food’s too spicy.” • “My tongue is hot.” • “It feels like something’s poking my tongue.” • “It (my tongue) feels like there is hair on it.” • “There’s a frog in my throat.” • “ It feels like there are bugs in there.” (to describe itchy ears)
  20. 20. Major Food Allergies
  21. 21. Wheat Allergy • Wheat allergy is most common in children, and is usually outgrown before reaching adulthood, often by age three. • Look for alternate grains such as amaranth, barley, corn, oat, quinoa, rice, rye, and tapioca. • Wheat has been found in some brands of ice cream, marinara sauce, play dough, potato chips, rice cakes, turkey patties and hot dogs.
  22. 22. Peanut • One of the most common food allergies. • About 25-40% of people who have peanut allergy also are allergic to tree nuts. • Peanuts and tree nuts often come into contact with one another during manufacturing and serving processes. • Peanut allergies tripled from 1997- 2008. 20-25% of those children do outgrow it.
  23. 23. Eczema Hives Asthma Runny nose Digestive symptoms Anaphylaxis
  24. 24. Tiny Little Peanuts Can Trigger • 1/250 of a peanut is enough to trigger a reaction (cutting a peanut in half 125 times!) • High cross-reactivity to tree nuts (almonds, walnuts, etc.) • Peanut or tree nut allergies and asthma appear to increase the risk for fatal reactions. Estimated that at least ½ of deaths are result of peanut/tree nut • Reaction may occur in minutes OR hours – so it’s not just a lunch-room event.
  25. 25. Tree Nut • Tree nuts include, but are not limited to, walnut, almond, hazelnut, cashew, pistachio, and Brazil nuts. • These are not to be confused or grouped together with peanut, which is a legume, or seeds, such as sunflower or sesame. • Tree nut proteins may be found in cereals, crackers, cookies, candy, chocolates, energy bars, frozen desserts, marinades and barbeque sauces.
  26. 26. Milk • Most common food allergy in infants and young children. • Nearly all infants who develop an allergy to milk do so in their first year of life. Most children eventually outgrow a milk allergy. • Individuals who are allergic to cow’s milk are often advised to also avoid milk from other domestic animals like goats.
  27. 27. Milk might be found: • Deli meat slicers • Some brands of canned tuna fish • Many non-dairy products • Some specialty products made with milk substitutes are manufactured on equipment shared with milk • Some processed meats
  28. 28. Egg • One of the most common food allergies in children. • Sometimes found in: baked goods, egg substitutes, lecithin, macaroni, marzipan, marshmallows, nougat and pasta.
  29. 29. Soy • Allergy to soy generally occurs early in childhood and often is outgrown by age 3. • People with a soy allergy are not necessarily allergic to other legumes. • Soybeans and soy products are found in many foods: baked goods, canned tuna and meat, cereals, cookies, crackers, high-protein energy bars and snacks, infant formulas, low-fat peanut butter, processed meats, sauces, and canned broths and soups.
  30. 30. Fish and Shellfish • Finned fish and shellfish do not come from related families of foods, so being allergic to one does not necessarily mean that you must avoid both.
  31. 31. Other Allergies • A person can be allergic to virtually any food. • Allergic reactions have been reported to: • Corn • Gelatin • Meat (beef, chicken, mutton, and pork) • Seeds (sesame, sunflower, and poppy being the most common) • Spices (caraway, coriander, garlic, mustard, etc.) • Other common causes of severe reactions include: • Medications • Latex • Insect Stings
  32. 32. Day-to-Day Avoidance Tips • Strict avoidance of the food • Careful and constant label reading • Avoid cross contact • Minimize risks in classroom setting
  33. 33. Label Reading • Read every ingredient statement • Ingredients can change • Use the toll-free number on products • Websites many not be up-to-date
  34. 34. Which of These Contains Milk? • Sherbet • Hot dogs • Cake mix • Non-dairy creamers • Tuna fish • Quick breads • Gravy mixes • Sauces • Dips • Chocolate • Margarine • Luncheon meat
  35. 35. Ingredients in Unexpected Places • Food examples: • Sauces • Hot dogs and deli meats • Imitation butter flavor • Potato chips/ popcorn/ rice cakes • Water-added hams • Low-fat peanut butter • Read all food labels very carefully!
  36. 36. Ingredients in Unexpected Places • Other examples: • Animal pellet food • Beanbags • Birdseed mixtures • Tropical fish food • Hermit crab food • Read all labels very carefully!
  37. 37. Craft Supplies • Soaps – may contain milk, wheat, soy or nut extracts • Dried pasta – contains wheat and may contain egg • Crayons – may contain soy • Finger paints – many contain milk or egg whites • Modeling clay – may contain wheat
  38. 38. “Contains” Statements
  39. 39. “Contains” Statement Policy  Only required for allergens not clearly stated in the ingredient list.  Chef Boyardee Pizza
  40. 40. Warning Labels May also say “manufactured in a facility that also processes peanuts”
  41. 41. Ingredients: ENRICHED FLOUR (WHEAT FLOUR, NIACIN, REDUCED IRON, THIAMINE MONONITRATE {VITAMIN B1}, RIBOFLAVIN {VITAMIN B2}, FOLIC ACID), SUGAR, PARTIALLY HYDROGENATED SOYBEAN AND/OR LIQUID SOYBEAN OIL AND/OR PARTIALLY HYDROGENATED COTTONSEED OIL, HIGH FRUCTOSE CORN SYRUP, GRAHAM FLOUR, BROWN SUGAR, COCOA (PROCESSED WITH ALKALI), BAKING SODA, CORNSTARCH, SALT, CHOCOLATE, MILK (ENZYME MODIFIED), NATURAL AND ARTIFICIAL FLAVOR, SOY LECITHIN (EMULSIFIER).
  42. 42. Cross Contact • Cross contact occurs when proteins from one food are transferred to another food through: • Food preparation tools • Work surfaces • Breading • Fried foods • Spatter or steam from cooking foods • Unclean hands or gloves • Double dipping into jars
  43. 43. Causes of Accidental Exposures • Not reading ingredient label to be sure food is allergen-free • Cross-contact during cooking • Food trading • Inaccurate labeling
  44. 44. Minimize Risks • Ask parents to provide a complete lists of foods and ingredients to avoid • Prepare food for the child with allergy first • Designate two people responsible • Designate a shelf in the pantry/ refrigerator • Keep “safe” snacks/ nonperishable “safe” lunch
  45. 45. Minimize Risks • Create an allergy-free table • Place “neat-eaters” by the child with allergies • Discourage trading food • Wash hands with soap and water after eating
  46. 46. U.S. Federal Government Releases Guidelines for Food Allergy Management in Schools and Care Centers
  47. 47. Create a Plan • Have clear medication instructions from the child’s parents and doctor • Have written procedures/ post emergency numbers • Practice your plan/document trainings • Check medications regularly • Get medical help immediately • Evaluate plan after a reaction occurs
  48. 48. Create a Plan • 3 Rs for handling an allergic reaction • Recognize the symptoms • React quickly • Review what caused the reaction and how well the emergency plan worked
  49. 49. Be Prepared • Practice injection technique using an auto-injector trainer • Review Food Allergy & Anaphylaxis Emergency Care Plan frequently • Every state in the U.S. has legislation in place allowing students, with appropriate consent, to carry their prescribed epinephrine at school.
  50. 50. Minimizing Liability “The best protection against liability is to focus on risk reduction, not waivers.” Ellie Goldberg, Education Rights Specialist
  51. 51. Minimizing Liability • A food allergy is considered a disability under the law • Students that have certified food allergies do not need to receive all meal components. • Schools may not charge more for meals for children with a certified food allergy for meals or snacks • Federally funded food programs • Signed medical statement
  52. 52. Minimizing Liability • Meet with the parents • Speak to school staff • Meet with emergency medical personnel • Create a written plan • Best protection against liability is staff training and education • Teach the children • Accidents are never planned; develop a plan for handling them before you need them
  53. 53. Create a Positive Climate • Make children feel secure and safe • Address bullying • Avoid isolation • Have clear rules and expectations • It’s NOT OK to share food! • Strategies to reduce exposure to allergens
  54. 54. Resources: • Food Allergies and Anaphylaxis, The Food Allergy and Anaphylaxis Network • Food Allergy Training Guide for Restaurants and Food Services, The Food Allergy and Anaphylaxis Network, 2004 • Child care and Preschool Guide to Managing Food Allergies, The Food Allergy and Anaphylaxis Network, 2005 • (www.foodallergy.org) • Managing Food Allergies in Schools – The Role of School Teachers and Para-educators, National Center for Chronic Disease Prevention and Health Promotion, 2013 • Managing Food Allergies in Child Care, National Food Service Management Institute, University of Mississippi, 2014
  55. 55. Questions?
  56. 56. Extension is a Division of the Institute of Agriculture and Natural Resources at the University of Nebraska–Lincoln cooperating with the Counties and the United States Department of Agriculture. University of Nebraska–Lincoln Extension educational programs abide with the nondiscrimination policies of the University of Nebraska–Lincoln and the United States Department of Agriculture. Amy Peterson MS RD Extension Educator – Polk County amy.Peterson@unl.edu
  57. 57. Extension is a Division of the Institute of Agriculture and Natural Resources at the University of Nebraska–Lincoln cooperating with the Counties and the United States Department of Agriculture. University of Nebraska–Lincoln Extension educational programs abide with the nondiscrimination policies of the University of Nebraska– Lincoln and the United States Department of Agriculture.

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