Food allergies are a concern for school food programs. Unlike food intolerances, food allergies affect the immune system and can be mild or serious. For some students, exposure to a food allergen can cause anaphylaxis (for the most common allergens see here). Anaphylaxis is a sudden and severe allergic reaction which can be fatal and requires immediate medical attention.
Boards of education must maintain policies and procedures relating to anaphylaxis, and each school should refer to their School District’s policy. However, the prevention and management of anaphylaxis is a shared responsibility, with roles and responsibilities for parents/guardians, children with allergies, and the entire school community. For more information, schools and districts can visit Anaphylaxis – Province of British Columbia (gov.bc.ca).
While schools are expected to create “allergy-aware” spaces, it is not possible to guarantee “allergy-free” environments. Therefore, policies should always include strategies related to education, awareness, and training to minimize risk of exposure and respond effectively to an emergency.
Consider the following questions to help guide your planning:
Has school staff reviewed and do they understand the student’s personal Anaphylaxis Emergency Plan?
Make sure this form is in a safe and confidential place, easily accessed by staff who need it. All staff, teachers on call, food services staff, coaches, and bus drivers, should know which children have severe allergies and be prepared to treat them as per their emergency plans.
What strategies does the school use to reduce the risk of food allergy exposure?
These could include basic food safety rules such as handwashing, or other prevention strategies such as creating “allergy aware” zones.
Do staff receive ongoing training about food allergies and anaphylaxis?
The free online Anaphylaxis in schools course teaches the basics of anaphylaxis prevention and management.
How does the school let parents know about food allergy policies?
School newsletters and bulletin boards are great places to post reminders and share handouts such as Peanut and Nut Aware Lunches & Snacks.
How will school food programs be inclusive of students with food allergies?
Aim to offer foods that all students can safely enjoy, and/or provide safe alternatives for students with allergies. Share your menus and ingredient lists with parents and caregivers and inform them of any changes.
Recognizing the signs and symptoms of anaphylaxis is another important strategy. Anaphylaxis generally includes two or more of the following body systems (from Food Allergy Canada):
- Skin: hives, swelling (face, lips, tongue), itching, warmth, redness
- Respiratory (breathing): coughing, wheezing, shortness of breath, chest pain/tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny itchy nose and watery eyes, sneezing), trouble swallowing or breathing (due to swelling of the airways)
- Gastrointestinal (stomach): nausea, pain/cramps, vomiting, diarrhea
- Cardiovascular (heart): paler than normal skin colour/blue colour, weak pulse, drop in blood pressure, passing out, dizziness or lightheadedness, shock
- Other: anxiety, sense of doom (the feeling that something bad is about to happen), headache, uterine cramps, metallic taste
Epinephrine is the first line of treatment for anaphylaxis and should be given at the first sign of a known allergic reaction. Again, schools should refer to their District’s policies and procedures to ensure that safety plans and procedures are in place.
Food allergies differ from food intolerances in that they can be life-threatening. It is important that school food practitioners are aware of the different allergies in their school community, as well as the protocols around treating anaphylaxis.
Resources to support schools in providing allergy aware programs
Food Intolerances
Food Intolerances are not life-threatening but can still be a barrier to participation in your school food program. For example, lactose intolerance is very common among non-European populations. Having non-dairy alternatives available is a good strategy for inclusivity. Having gluten-free alternatives for students with celiac disease and gluten intolerance is another example.
A food intolerance is when a person has difficulty digesting certain foods or ingredients. Food intolerances will not cause anaphylaxis but can make a person feel unwell. Symptoms include abdominal pain, diarrhea, gas, bloating, headaches, migraines, or nausea. The most common food intolerances are lactose and gluten.
Lactose intolerance
People with lactose intolerance don’t make enough of the enzyme lactase to break down lactose, a sugar found in milk and dairy products. Some people with lactose intolerance can not tolerate milk but can tolerate small amount of yogurt or cheese
Foods to Avoid: dairy products (cheese, milk, butter, yogurt, cream)
Alternatives to offer: lactose-free dairy products, fortified plant-based beverages, plant-based alternatives (e.g., soy-based yogurt)
Gluten intolerance
Gluten is a protein found in wheat and other grain products and derivatives including rye, spelt and barley. Gluten intolerance is not the same as celiac disease, which is an autoimmune disease that requires life-long abstinence from any sources of gluten.
Foods to Avoid: any product containing wheat, barley, spelt, rye and their derivatives (breads and bread products, crackers, cereals, pastas that are not labelled “gluten-free”). Gluten is also found in most brands of soy sauce and many soup bases and sauces.
Alternatives to offer: look for “gluten-free” products, such as products made with rice, corn, or gluten-free oats or lentils*.
*Oats and lentils are naturally gluten-free, but in Canada, they are often processed in the same factory as wheat products. This means they may have traces of gluten. This may not be a problem for someone with gluten intolerance but could negatively affect someone with celiac disease.
Visit Healthy Schools
Because the Health and
Well-Being of our Students Matter.