Getting the Most Out of Food Allergy Management Programs in Schools

Graphic courtesy of Nosneezezone.com.

ALEXANDRIA, Va.- Food allergies are a growing concern in school nutrition. “It has been estimated that about 11 million Americans have a food allergy, representing about two percent of adults, and six to eight percent of children under the age of three,” said Jeannie Sneed, a food safety specialist with the USDA Food and Nutrition Services.

Ms. Sneed gave her comments during the first session of the School Nutrition Foundation’s three-part webinar series. In this first session dealing with managing food allergies in schools, Ms. Sneed added that, “school nutrition personnel are being asked more and more frequently to accommodate food allergy needs, so we believe that it is important to provide opportunities to dialogue about the role of school nutrition in meeting these demands.”

According to Ms. Sneed, approximately 90 percent of all food allergies are the results of an immune response, such as an anaphylactic reaction, to the following foods/ingredients: peanuts, tree nuts, milk, wheat, soy, fish, and shell fish.

Graphic courtesy of Kidsfoodallergiesblog.com.

When a student’s food allergy meets the medical criteria for a disability and this “prevents them from consuming a school meal as prepared, meal accommodations must be made. Such meals are reimbursable at the free, reduced price or paid rates, even if they don’t meet the meal patterns,” said Melissa Rothstein, a program analyst in child nutrition with the USDA Food and Nutrition Services.

Ms. Rothstein adds that for a parent to be able request food substitutions for a child with an allergy, that allergy must meet the medical level of a disability “supported by a statement signed by a licensed physician.”

The doctor’s statement must have five key elements:

• the child’s disability.
• an explanation of why the disability restricts the child’s diet.
• the major life activity affected by the disability.
• the food or foods that must be omitted from the diet.
• the food or foods that must be substituted in the diet.

“Essentially, this is a prescription from a licensed physician. Schools should not be relying solely on information from a parent, and should not be interpreting or changing these physician prescriptions.

“Once a school food authority has a completed statement containing all needed elements, the school must provide the student the meal in accordance with the physician’s instructions. It is not up to the school food authority to question whether a condition is a disability or not,” said Ms. Rothstein.

She goes on to say that for students with food allergies that do not have a disability as defined by law- those that don’t have anaphylactic reactions- schools are not required to make accommodations, though they may choose to do so.

In these situations as well, the regulations require a statement from a recognized medical authority, which:

• identify the medical or other dietary conditions which restrict the child’s diet.
• the food or foods to be omitted from the child’s diet.
• the foods to be substituted in the diet.

According to Ms. Rothstein, if the school food authority chooses to provide substitutions in these situations, they must do so at no extra cost to the child, and may use the funds from the non-profit school service account, just as they do for the disability situations.

Mara McElmurray, also a program analyst in child nutrition with the USDA, added that “the physicians statement doesn’t have to be submitted every year, however schools must check with the family to insure that the statement that they have on file is up to date, and they must note and date that the information has been checked.”

The closing speaker of the event was Cindy Hormel, child nutrition director of the Liberty School District, Kansas City, Mo. Recounting her district’s recent experience with food allergies, she said, “Over the last two years, we have seen the number of students with anaphylactic allergies increase from 72 at the end of the 2006 school year to over 142 today.

“Seeing the increasing prevalence of life threatening allergies among our student population, and recognizing the risk of accidental exposure to allergens, Liberty Public Schools are committed to working in cooperation with parents, students, and physicians to minimize risk and providing a safe educational and learning environment for all students.”

Ms. Hormel went on to say that, “During our early meetings, it was established that we are not a peanut-free school district. I caution any district that would embrace this, as we are not a peanut-free society and you open yourself up to potential lawsuits.

“We recommend controlled peanut-free zones, for example, the lunchroom and the classroom. They can easily be cleaned and controlled. In addition, the cafeteria manager receives an allergy chart with a student’s picture and the known allergen at the beginning of the school year, and it is updated throughout the year.”

Additional Resource

• Healthline - The Effects Of Anaphylaxis On The Body 

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