Thursday, February 9, 2012

Food Allergy Deaths At School: The 10 Commandments

A child dying from a food allergy at school. It's every parent's nightmare, and every school administrator's job to prevent. Then why is it always so difficult to get our schools to take the steps that would keep our children safer?

There are a handful of schools who have a heartbreaking, but incredibly valuable, perspective to share: those that have already had a death happen on their watch.

These schools have had time to consider what they did right and what they did wrong. They have had to process the emotional and legal turmoil that followed each event. And, each of them has had to find a way to continue to educate students: but with a much broader and realistic view of what is truly needed to keep a food-allergic child safe.

Nine-year-old Nathan Walters died while on a field trip after eating a peanut butter cookie provided in his (supposedly safe) school lunch. After his death, the school took the following actions:
  • Instituted staff training about anaphylaxis
  • Changed the field trip lunch order form to ensure allergies are highlighted and double checks are in place
  • Eliminated some peanut-containing foods from their menu entirely 
  • Created a district-wide task force to examine what went wrong
The school district's  resulting food allergy guidelines are now a model for schools worldwide.

13-year-old Sabrina Shannon died after eating school-made French fries contaminated by a utensil that had also been used to serve cheese-containing food. As one of the outcomes from this tragedy, Canada now has Sabrina's Law. What does the law require?
  • Schools have to develop "reasonable procedures", including keeping foods out of classrooms and eating in designated areas only
  • School personnel receive mandatory training on handling anaphylaxis
  • Anyone who gives treatment or epinephrine is covered by a "Good Samaritan" clause, meaning as long as their approach was reasonable, they are protected 
A beautifully-simple statement from the brochure sums up the approach: "While recognizing the parents’ rights to food choices for their child, most parents acknowledge the right to life and safety as greater, and will support procedures which protect the allergic child."

13-year-old Katelyn Carlson died after she ate the Chinese food her teacher ordered in for a holiday party. As a result, the Chicago Public School system implemented a system-wide policy:
  • Each school must stock Epi-Pens, regardless of known allergies 
  • Administration and teachers are permitted to administer a shot to any student in need
A simple policy change like that could have been lifesaving for 7-year-old Ammaria Johnson, who died earlier this year.

Let's sum up The 10 Commandments of Food Allergies these schools have learned and implemented:
  1. Create a district-wide task force to discuss, implement and review plans and procedures.
  2. Ensure the plan includes training teachers and administrators in how to recognize and treat anaphylaxis.
  3. Simplify forms used to order meals for allergic students and create multiple-checkpoint food service procedures to catch errors.
  4. Eliminate peanut-containing foods from universal menus, particularly where foods can be "look-alike" (e.g., cookies).
  5. Keep food out of classrooms.
  6. Confine eating to designated areas that can be decontaminated after use and require students to wash hands after eating.
  7. Ensure emergency caregivers are covered by a "Good Samaritan" provision so they will not hesitate to offer assistance.
  8. Have an Epi-Pen available at all times, regardless of known allergies in the student population.
  9. Administer a shot to any child in need, regardless of known allergy status.
  10. When faced with parental or staff opposition, promote the principle that the right to life and safety for the allergic child takes precedence
Has your school implemented these 10 Commandments?    If not, ask them WHY. Remember: these are not YOUR suggestions on how to handle food allergies. These are rules established by the schools themselves that have already experienced a food allergy-related death. 

There is absolutely no acceptable reason to refuse to learn from — and act upon — their bitterly-earned experience. 


  1. Beautiful post! I'm emailing the link to both my kids' schools and the school nurses right now! So far both schools have been beyond fabulous when it comes to FA but I just want them to remember that does not mean they can relax about it!

  2. Fabulous post. As a professional in education and a parent of an allergic child, it would be certainly easier to share this post if you took the "bitch" out of your title... I am not a "prude" but that will seriously stop some people from reading such valuable, researched, and well-articulated information. Just a thought. Like the suggestions re: policy and task force.

  3. GP, I appreciate the feedback and I will think about it. The blog name came out of my frustration with being the "good girl" for so many years when it came to food allergies. I needed a place to vent and the "bitch" part (I thought) gave other food allergy moms permission to be bad and embrace those thoughts we stamp out most of the time. I actually find the name a little shocking each time I see it. :)

    In the meantime, for any of you who are embarrassed by the "bitch" or are concerned your school may have a profanity filter, please feel free to LIFT this post and paste it into a Word doc to distribute to them. (Most of the formatting should come over intact.)

    I think the information is more important than the "copyright."

  4. Wonderful post. I am on a mission of my own right now to urge lawmakers to include SCHOOL BUS DRIVERS in any new policies they make. SO many areas around the country do not permit bus drivers to administer an EpiPen. It is absurd, but because in areas like mine, buses are part of the DOT and not the school system, they fall outside the guidelines for schools.

  5. How would these "commandments" have helped Sabrina Shannon, who is thought to have died from a reaction to traces of cheese mixed in with her french fries?

    The common features of all the stories of these deaths you've cited is:

    1) The child ate something new or different they thought would be safe.

    2) The child did not have an epipen on their person and neither did adults who were with the child.

    It seems to me the greatest safety can be achieved in the most practical ways by 1) the child and teachers always carrying an EpiPen; 2) parents and teachers making it clear to kids with allergies that they can't try any new or remotely suspect foods -- perhaps even nothing that hasn't been specifically prepared for them by known and trusted sources.


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