Allergy alert

Allergies can take so many forms that when symptoms occur, people could be unaware there could be an allergic link. When it comes to food allergy, anaphylaxis – the most immediate and severe of all allergic disease – is well understood, however, the more chronic types of allergy related conditions are not. It is often more difficult to ensure that the child is in an environment where their symptoms can be both minimised and well managed.

Asthma, eczema and allergic rhinitis can be triggered by allergens in the environment such as pollens, house dust mites, mould and even animal allergens. All of these are present in any normal school environment, and may cause symptoms such as wheezing, runny nose, sore, itchy, watery eyes, sneezing and associated respiratory difficulties.
In the case of food allergy, most people immediately think of anaphylaxis, where the child can develop life threatening symptoms very quickly, some children however, will have less severe symptoms that might not be so easily spotted. Rashes, hives (nettle rash), vomiting, even symptoms that the child can find difficult to describe, such as feeling ‘odd’, or going very quiet can be because they have been exposed to something they are allergic to, and should not be dismissed.  
Food allergy can also be a trigger for eczema flare ups, whilst not an immediate reaction such as anaphylaxis, it is still a cause for concern.

Children can be exposed to allergens in an everyday school environment, just as they would be outside of school. So, where would the most likely triggers of an allergic reaction be found?
The most obvious places for food allergens would be in communal eating areas, the canteen, or the playground. This may be more of a problem in secondary schools where children are allowed snacks at break and aren’t supervised as they would be in a junior school. Food Technology lessons can be difficult as children with an allergy to milk or egg for example may react, even if they aren’t actually touching or consuming a food, if their allergies are severe enough.  
Respiratory allergens, are everywhere and it is unrealistic to believe that we can avoid them totally, however, symptoms can be kept to a minimum, if simple measures are in place.

House dust mite allergens can be found in most soft furnishings, no matter how clean they are. Carpets can be the worst offenders, and children with asthma, allergic rhinitis and eczema will often react if they have been sitting on mats during assembly, or at story time. Bringing in a blanket from home, or being allowed to sit on a chair can make a substantial difference in keeping symptoms under control.

The summer months can be a nightmare for children with hay fever (Seasonal Allergic Rhinitis). Although not so much a problem at this time of year, sitting next to an open window, being on a playing field, even just outside in the playground when the pollen counts are high will result in itchy, streaming eyes and runny noses, and can literally impact on their learning ability.
Hay fever symptoms make it difficult to sleep, and some medications can cause drowsiness, both taking their toll in the classroom. In a research study carried out in 2007, it was found that children taking their exams in the summer months at the height of the hay fever season, actually dropped a grade as a result of their symptoms affecting their ability during the day.  
There is also a risk of allergic reactions from wasp and bee stings. Most stings will cause a localised reaction, however there is also a number of children that will be anaphylactic.
The most important thing for staff to consider when looking after an allergic child, is knowing what they are allergic to, and what they should do if they become unwell.  

Every child with an allergic condition should have a protocol in place before they start school. Unfortunately at present in the UK, and the EU, there is no child specific protocol that is mandatory for all schools. However a lot of schools will have developed a management plan for most health conditions, and this can be adapted for children with allergies.
Allergy UK advises parents of allergic children to liaise with the school well in advance of their child starting, informing them of all health issues. Allergies can vary from child to child, as can the severity of an allergic reaction within in the same child. It really isn’t a case of one size fits all.

A well-documented protocol/management plan is invaluable to staff to enable them to be able to care for an allergic child, just as it is for a child with any other medical condition. Most schools also find it helpful to have photo of the child in the teacher’s staff room with details of what to do in emergency.
If you or the parent are not sure where to start, an example can be found on the Allergy UK website ( this should list the child’s type of allergy; any medications such as antihistamines or inhalers that may need to be administered; how their reaction might look (remember sometimes it isn’t always immediately obvious); whether the child would need emergency medications such as an adrenalin auto-injector or whether emergency services would need to be called; and of course any emergency contacts. A GP or the child’s allergy nurse would be able to help the parents with this.  

There are also Allergy Action Plans for children at risk of anaphylaxis, which have been designed to help facilitate first aid treatment of anaphylaxis, so that it can be delivered by people without any special medical training or equipment apart from access to an adrenalin auto-injector. Although these must be completed by a child’s health care professional, they provide quick, easy instructions for emergency situations. Parents can speak to their GPs who will be able to download this information from the British Society for Allergy and clinical Immunology. (  

So, how can schools help children cope with their allergies? Interestingly most allergic children cope extremely well, learning from a young age what foods are safe for them, for example, and how to to get this across in new environments. Parents will naturally worry especially when children first start school, but if all the correct procedures have been put in to place, this is reassuring to the parent.

Something that should be considered is bullying. Teasing about an allergic condition sadly does happen and can lead to, a normally outgoing child, becoming isolated and introverted. Awareness of any social behaviour might indicate this and should be investigated.

Allergy UK frequently gets enquiries as to whether schools should have a ‘no nut policy’ in place if there are nut allergic children in the school. This may seem like the best way to protect a child, but can in fact give a false sense of security to a child, so that they will stop being vigilant, and it would be impossible to ban every type of food that every child is allergic to.
The most important thing for an allergic child is that they should always be listened to, and not dismissed if they are feeling unwell. Prompt action in an allergic reaction can literally save a child’s life in a worst case scenario, or in a less severe situation can make a child more comfortable and reassured that staff understand how they are feeling. For more advice visit the Child Carers and Teachers section of the Allergy UK website.