Food allergies commonly affect around 1 in 20 children. Ninety per cent of allergic reactions to foods in children are caused by eggs, cow’s milk, peanuts, tree nuts, sesame seeds, soy, fish, shellfish and wheat.

A child with a food allergy is unlikely to have parents with a food allergy. However if one child has a food allergy then their siblings have a slightly higher risk of developing an allergy.

Many children grow out of their allergies, for example most children with an allergy to cow’s milk will grow out of it by school age. Allergies to peanuts, tree nuts, seeds and seafood tend to persist through to adulthood.

Rates of peanut allergy have at least doubled in the last ten years. Peanut allergy is now seen in approximately 1 in 50 children and 1 in 200 adults in developed countries, although the exact reason for this is unclear. Research includes a vaccine preventing peanut allergy and immunotherapy to help desensitize the cause of the allergy is being undertaken. In the last few days an asthma drug has been shown to help desensitize people from multiple food allergens which is encouraging.

Skin prick allergy tests or allergy blood tests help to confirm or exclude triggers. Sometimes a temporary elimination diet under close medical supervision will be needed, followed by food challenges to identify the cause.

Those with food allergy may be ordered and antihistamine or adrenaline auto-injector with an Action Plan.

What are the signs to watch for?

Signs of a mild to moderate allergic reaction:

• Swelling of the lips, face, eyes
• Hives or welts appearing on skin
• Tingling mouth
• Abdominal pain and vomiting which can also be a sign of a severe allergic reaction to insects

Treatment:

• Stay with the person and call for help. Follow their action plan, which may include giving an anti-histamine medication. Ensure their adrenaline auto-injector (epipen) is ready in case the reaction worsens.

Signs of severe allergic reactions include any ONE of the following:

• Difficult/ noisy breathing
• Swelling of the tongue
• Swelling and tightness of the throat
• Difficulty talking
• Hoarse voice
• Wheeze or persistent cough
• Persistent dizziness or collapse
• Pale and floppy (for young children)

Treatment:

• Lay the person down, give the adrenalin auto-injector and call 000 stating the person is having an anaphylactic reaction. Another auto-injector can be given in 5 minutes if there is no response. CPR may be required.

Remember a severe life threatening reaction can occur without any mild symptoms displaying first. Keep the person lying down to prevent their blood pressure dropping even if they seem to improve.

Some children with anaphylaxis also have asthma and so you may be unsure if the child is suffering from asthma or anaphylaxis. In this case give the epipen first and then the asthma inhaler and of course call the ambulance. Evidence has shown that asthma has often been a major component of food induced fatal anaphylaxis.

It is important that the boys

• Carry their adrenalin auto injector and action plan
• Know the signs to watch for and know what to do
• Read and understand food labels
• Be confident when dining out and tell restaurant etc about their allergy
• Be aware of cross contamination when preparing food.

Where can I find an adrenalin auto-injector (Epipen)?

They are available in the clinic, pool office, cafeteria and staff common room.

The cafeteria is not a ‘nut free’ area as food bans are not recommended. The staff will help with appropriate choices. I encourage the boys to come to the clinic if concerned about anything they have eaten or if they have any symptoms. If I am called to a student I carry an epipen in my bag.

In the clinic there is a trainer epipen sitting on my desk for all the boys to try. Some like to remember ‘blue to the sky, orange to the thigh’ to remind them of how to use the epipen.

Feel free to contact me if you have any concerns mbates@newington.nsw.edu.au

Sister Margaret Bates
School Nurse