Child care facilities are places where children receive care before they start kindergarten or grade one, or before or after school. For information about allergy-safe schools, visit the BC Ministry of Education anaphylaxis resources at www.bcsta.org/anaphylaxis.
Although child care facilities can not be food allergen free, they can aim to be allergy safe. For a child care facility to be allergy safe it must ensure the following:
Each child with a food allergy has a care plan that facility staff and the child’s parent have developed together.
The care plan includes an anaphylaxis emergency plan in case of an accidental exposure to a food that causes a severe allergic reaction.
The child can avoid the food that causes an allergic reaction.
All staff understand the child’s allergy and they are trained to deal with an allergic reaction if one occurs.
What is a food allergy?
A food allergy occurs when the body mistakes a particular food (called an allergen) as harmful. An allergic reaction is the body’s immune system fighting back. A severe allergic reaction is called anaphylaxis (anna-fill-axis), which can happen quickly and be life-threatening.
What are the symptoms of a severe allergic reaction?
Symptoms of a severe allergic reaction or anaphylaxis can vary and include any of the following:
Skin: hives, swelling (including throat, tongue, lips or eyes), itching, warmth, redness, rash, pale skin or blue colour.
Breathing: wheezing, trouble breathing, cough, change of voice, throat tightness or chest tightness.
Stomach: vomiting, nausea, abdominal pain or diarrhea.
Other: weak pulse, feeling faint, trouble swallowing, runny nose and itchy watery eyes, sneezing, anxiety or headache.
A severe reaction can occur without hives. Symptoms can occur within minutes of eating or being exposed to the food, but they usually occur within two hours.
How do I treat a severe allergic reaction?
When a reaction begins, it is important to respond right away. A severe allergic reaction should be treated with a medication called epinephrine (eh-puh-NEH-fren). Epinephrine helps reverse the symptoms of an allergic reaction and saves lives.
Steps for treating a severe allergic reaction include:
Inject epinephrine right away into the muscle of the outer thigh.
Call 9-1-1 or the local emergency number right away.
Have the child lie down, unless they are throwing up or having trouble breathing.
Do not leave the child alone.
A second dose of epinephrine can be given 5-15 minutes after the first dose, if symptoms do not get better or occur again.
The child must be taken to a hospital.
What training should child care providers have?
Staff should have a valid CPR certificate, first aid training, and be aware of how to treat a severe allergic reaction. Every child should have immediate access to a staff member with this training and knowledge.
Staff should also receive additional training and know:
Each child’s allergy and how to help the child avoid the allergen.
Signs and symptoms of a severe allergic reaction or anaphylaxis.
The child’s care plan and anaphylaxis emergency plan and be able to access them.
The location of and how to use the child’s epinephrine auto-injector.
To call 9-1-1 or local emergency number when signs of a severe allergic reaction occur and be able to communicate the health concern.
Training services are available through some public health units and allergy associations. Please see “For more information” below.
What steps can I take as a child care provider to create an allergy safe facility?
Keep each child’s care plan and anaphylaxis emergency plan handy, while respecting the child’s privacy.
Keep each child’s stored auto-injectors in a secure unlocked place that is easy to access by all staff.
Children with severe food allergy should not eat if their auto-injector(s) is not available.
Always supervise children while they are eating.
Place dishes and utensils on a napkin, not directly on the table, when serving meals.
Provide a specific eating area for young children with food allergies to minimize exposure to allergens.
Do not allow children to trade or share food, utensils or food containers.
Store food out of reach of young children.
Talk to parents about activities that involve food.
Parents should approve all foods offered to their children. If you are unsure whether a food is safe, do not offer it to the child. If needed, ask parents to bring in a substitute.
All foods brought in to the facility should have complete ingredient lists.
Take precautions when buying and preparing foods.
Read and understand food labels each time you buy a food and before you serve it. Ingredients can change without notice. Do not assume that a food you have served before is safe. For more information, visit the Canadian Food Inspection Agency at
www.inspection.gc.ca/english/fssa/labeti/allerg/allerge.shtml.
When preparing food, prevent cross-contamination with allergens. Even a tiny amount of an allergen can cause an allergic reaction. Wash hands, utensils and surfaces fully in between preparing different foods.
All children and staff should wash their hands before and after eating to help avoid getting food on toys, clothing, or other surfaces.
Clean and sanitize tables and surfaces where children eat before and after eating.
Ask parents, visitors and older children to help keep the facility allergy safe.
As a parent, how can I help make a child care facility allergy safe for my child?
Help your child learn how to avoid allergens. Teach your child to tell someone right away if an accidental exposure occurs or if she is having a reaction or symptoms. When your child is mature enough, he can carry his own epinephrine auto-injector. Also, provide your child with identification, such as a MedicAlert® bracelet.
Steps to create an allergy safe environment:
Provide the facility with the anaphylaxis emergency plan written by a medical doctor.
Let staff know if there are any changes to the foods your child can eat.
Provide non-perishable foods in case lunch is forgotten or for special occasions.
Discuss your child’s needs when away from the facility, such as on a field trip.
Provide prescribed epinephrine such as EpiPen®
or Twinject®
auto-injectors, and replace it before the expiry date.
Provide a signed consent form allowing staff to give the epinephrine when needed. Do not sign anything that releases the facility of responsibility if epinephrine is not given.
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