Allergy Safe Child Care Facilities

HealthLinkBC File Number: 
Last Updated: 
May 2016

What is an allergy safe child care facility?

Managing food allergy in a child care setting is a shared responsibility and includes staff, parents and children. While child care facilities cannot be expected to be completely free of the foods that cause allergic reactions, they can aim to be safe environments for children with food allergy. Creating an allergy safe child care facility involves:

  • Following policies and procedures to reduce the risk of accidental exposure to foods that are known to cause allergic reactions among the children in its care.
  • Having a care plan for each child with food allergy that contains a copy of their Anaphylaxis Emergency Plan. The plan explains what to do in case of allergic reaction. To get a blank copy of an Anaphylaxis Emergency Plan, visit Canadian Society of Allergy and Clinical Immunology
  • Regularly training staff to ensure they have the knowledge and skills to respond to and care for a child who is having an allergic reaction.

What is an allergic reaction?

An allergic reaction occurs when a person’s immune system acts as if a protein (an allergen) in a food is harmful. Allergic reactions can be mild or severe. A severe allergic reaction is called anaphylaxis (an-nah-fil-axe-is). It often happens quickly and can cause death if left untreated.

What are the symptoms of a severe allergic reaction?

Symptoms of a severe allergic reaction can start within minutes of eating or being exposed to the food, but usually occur within 2 hours. Do not ignore early symptoms. When a reaction begins, it is important to respond right away.

Symptoms can vary from person to person. The same person may have different symptoms each time and they can include any of the following:

  • Skin: hives, swelling (including of the tongue, lips or face), itching, warmth, redness, rash, pale or blue coloured skin.
  • Breathing: coughing, wheezing, shortness of breath, chest pain or tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (such as runny, itchy nose, watery eyes and sneezing), trouble swallowing.
  • Stomach: vomiting, nausea, abdominal pain or diarrhea.
  • Heart: weak pulse, feeling faint, dizzy or lightheaded, passing out.
  • Other: anxiety, headache, metallic taste, or uterine cramps in teenage girls.

A severe reaction can take place without hives.

How is a severe allergic reaction treated?

When a reaction begins, it is important to respond right away. Do not wait. Give the prescribed medication called epinephrine (eh-puh-NEH-fren). Epinephrine will not cause harm to the child if it is given unnecessarily.

Epinephrine comes in a pre-loaded syringe called an auto-injector. Epinephrine helps reverse the symptoms of an allergic reaction and can save the child’s life.

Steps for treating a severe allergic reaction:
  1. Use the auto-injector right away. Give the shot of epinephrine into the muscle of the outer-mid thigh, through clothing if necessary.
  2. Call 9-1-1 or the local emergency number.
  3. Lie the child down with their legs raised slightly. If they are nauseated or vomiting, they should lie on their side. Keep them lying down. Do not make them sit or stand up. If they are having difficulty breathing, let them sit up.
  4. Do not leave the child alone.
  5. If the child’s symptoms do not get better or come back, give a second dose of epinephrine within 5 to 15 minutes after the first injection.
  6. Ensure the child gets to a hospital.

The above section has been adapted from: Anaphylaxis in Schools and Other Settings, Copyright 2005-2015 Canadian Society of Allergy and Clinical Immunology..

What training should child care providers have?

Staff should have the knowledge and skills to respond to and care for a child who is having a severe allergic reaction. A child care provider with this training and knowledge should be immediately available for every child with food allergy.

Every child care provider should know:

  • each child’s allergy and how to help the child avoid their food allergens;
  • where to find each child’s care plan and Anaphylaxis Emergency Plan;
  • where to find each child’s epinephrine auto-injector;
  • the signs and symptoms of a severe allergic reaction; and
  • when to call 9-1-1 or local emergency number and how to communicate the health concern.

As a child care provider, what can be done to create an allergy safe facility?

Care Plans and auto-injectors

  • Create a care plan together with the parent of every child with food allergy. Include a copy of the child’s Anaphylaxis Emergency Plan.
  • Keep each child’s care plan and Anaphylaxis Emergency Plan handy, while respecting the child’s privacy.
  • Store each child’s auto-injectors in a secure unlocked place that is easy for all staff to access.
  • Ensure the auto-injector of a child with severe food allergy is available before serving foods.

Meal time

Even tiny amounts of an allergen can cause an allergic reaction.

  • Have all children and staff wash their hands with soap and water before and after eating. This helps prevent food from getting on toys, clothing, or other surfaces.
  • Clean all tables and surfaces well before and after eating.
  • Place dishes and utensils on a napkin, not directly on the table.
  • Supervise children while they are eating.
  • Do not allow children to trade or share food, utensils, napkins, or food containers.
  • Ask parents of children with food allergy to approve all foods offered to their child.
  • Do not offer a food to a child with food allergy if you are not sure it is safe. Ask parents to provide a substitute.
  • Store food out of reach of young children.
  • Talk to parents about activities that involve food.

Buying and preparing foods

  • Learn how to recognize food allergens on product labels. For more information on allergen labelling, visit Canadian Food Inspection Agency
  • Read the ingredients list each time you buy a food or receive a food delivery. Ingredients in packaged foods can change without notice. Do not assume that a food you have served before is safe.
  • Ensure all foods prepared or stored on site are clearly labelled with a list of ingredients. This includes leftovers, foods made from scratch, and any foods brought in by parents and staff.
  • Wash hands, utensils, and surfaces well in between preparing different foods. This prevents cross-contamination with allergens.
  • Ask parents, visitors and older children to help keep the facility allergy safe by not bringing in foods that could cause an allergic reaction.

As a parent, how can I help make a child care facility allergy safe for my child?

  • Give the facility a copy of your child’s Anaphylaxis Emergency Plan completed by your child’s health care provider.
  • Provide written consent for staff to give your child epinephrine when needed. Do not sign anything that releases the facility of responsibility if epinephrine is not given.
  • Supply the facility with auto-injectors for your child. Replace auto-injectors before the expiry date.
  • Consider having your child wear MedicAlert® identification.
  • Provide the facility with foods for your child that do not spoil in case they are needed.

As your child matures, they can learn to take some responsibility for their safety. When your child is ready, teach them:

  • How to avoid their food allergens. This includes teaching your child not to put objects like pencils or toys in their mouth and only eating foods approved by you.
  • To tell someone if they think they are having an allergic reaction.
  • To carry their epinephrine auto-injector with them and how to use it.

For more information about food allergies in children, see HealthLinkBC File #100a Severe Allergic Reactions to Food: Children and Teens.

For More Information

If you have questions about food allergies, call 8-1-1 to speak with a registered dietitian.

For more information about understanding and managing anaphylaxis, visit:

Is it an emergency?

If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately.
If you are concerned about a possible poisoning or exposure to a toxic substance, call Poison Control now at 1-800-567-8911.

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