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When your child has food allergies, the world beyond your front door can seem daunting. As your youngster's life expands to include all kinds of new situations, how can you best continue to keep them safe without diminishing their freedom and fun?
First up, remember you're far from alone, says Maria Said, CEO of national not-for-profit allergy support organisation Allergy & Anaphylaxis Australia (A&AA). "Australia has one of the highest incidences of food allergies in the world. One in 10 babies born today will develop a food allergy before their first birthday."
With so many people affected by food allergies, she adds, support and resources have increased. "Parents can get online and access information, they can seek support from an allergy clinic with nurses, dieticians and other qualified experts, and generally people have a much higher understanding of food allergy management," she says.
Daycare or kindergarten is often a child's first extended time outside home without parental supervision. At this age, when little ones are still working on their verbal skills, it's important that they know their allergy foods, how important it is to avoid them and how to communicate this in simple ways.
Some food allergy support groups recommend using colour-coded (red for 'danger' foods and green for OK) flashcards or photos to help your child memorise their allergy triggers and safe foods. There are also many accessible and fun resources for pre-schoolers, including A&AA's interactive storybook app Jeremy's Cake Designed to foster self-management in young children, the story features a cute wallaby allergic to egg and nuts.
Sunshine Coast mum Jackie Nevard has turned her family's food allergy experiences into a lifesaving resource for families. After her son Thai, now nine, was diagnosed with seven food allergies at nine months old, Jackie discovered that there was a lack of allergy education material specifically for children. To fill that crucial gap she created a series of engaging books, featuring Thai, a lovable young character with allergies.
Jackie says: "I wanted a book about a real person, and I wanted to talk about real medicine so children knew the name of their medicine and what to ask for. Kids who aren't reading can learn through pictures and stories," she says. The text is colour coded, with red meaning danger, and green safe, to aid visual learning.
The books deal with challenges including trips out, attending birthday parties and starting kindy and school, and the message is one of inclusivity, which Jackie says can be a real problem for allergy kids. "I feel strongly that no child should be excluded in the classroom because they have allergies," she says. "We've dealt with exclusion from food rewards, most school celebrations or fundraisers. No-one one ever thinks to include students with allergies. More recently this year we have had to deal with cooking lessons and camp."
Sailing through school
Jackie's allergy experiences quickly taught her that allergy management needed to reach far beyond the family. "Food allergy is the only medical condition that actually relies on others to keep a child well," she says. She created a programme for schools called Food Allergy SMART, aimed at educating all kids about food allergies and how to take care of each other. The programme emphasises five key safety rules for every child – with or without allergies: don't share food or drinks with people that have allergies; don't touch other people while eating; wash your hands after eating; tell an adult or teacher if your friend is having an allergic reaction, and include your friends that have allergies.
A&AA's Maria Said agrees that the most successful allergy management involves reaching out to others. "Management of food allergy is not just between the parent, the child with the food allergy and the school principal and the class teacher – it really is a community effort."
The most successful allergy management, she believes, comes down to three key factors: communication, planning, and education. "First, it's important that you communicate your child's needs clearly," she says. "Don't just turn up on the first day of orientation and say: 'my child has an allergy. As soon as you enroll, make an appointment to talk to the principal or key person about your child's allergies."
Planning ahead means being prepared as much as possible for special events, excursions and celebrations, and also the possibility of an allergic reaction. "Children at risk of anaphylaxis need to have their medication with them at all times," says Maria. "Although the best outcome is to avoid an anaphylactic reaction, you need to be fully prepared if one occurs."
Empower your child to ask for help at school, she says. "Mum and Dad won't be around, so your child needs to feel OK and confident about telling a teacher or another adult if they don't feel well."
The A&AA has created a schools education programme called Be a M.A.T.E (Make Allergy Treatment Easier), designed to help parents and educators teach students and staff about food allergies and how to help their friends who are at risk of anaphylaxis.
Teach your child not to accept food from anyone apart from you, and to check with you before trying any food offered at group get-togethers.
Have your pre-schooler carry a note, medallion or sticker (or all of the above) with your mobile number and a warning about their food allergies, as a safeguard in case you're separated.
Keep allergy-safe treats, such as cake slices or cupcakes, individually wrapped and stored in the freezer ready for your child to take to special occasions. If possible, give some to your child's educators to be stored ready for birthday celebrations at school.
Talk to your pre-schooler's daycare educators in detail about supervision of kids during mealtimes, storage of food containers and how they address food sharing and swapping among the little ones.
At daycare, kindy or school, ensure your child at risk of anaphylaxis always has an emergency medical kit, containing an EpiPen, other required medication and an individualised Action Plan for Anaphylaxis.
The A&AA website allergyfacts.org.au has a wealth of detailed resources for every life stage, as well as access to respected health professionals and a network of community support.
The Australasian Society of Clinical Immunology and Allergy (ASCIA) is the peak body of allergy and immunology medical professionals. www.allergy.org.au
Allergy Pal is a new, free smartphone app from the Murdoch Children's Research Institute (MCRI), developed in collaboration with A&AA and ASCIA, to help increase the safety of children with food allergies. https://mcriallergypal.com.au
If you suspect that your child may have food allergies, always consult your GP or paediatrician before taking any further action.