‘Bans do not work’: New national guidelines say education is key to managing food allergies

New allergy guidelines have recommended removing blanket bans on foods from schools and child care centres in favour of greater education and awareness around allergies and anaphylaxis.

Released on Thursday, the National Allergy Strategy — developed with experts — aims to clarify managing and preventing anaphylaxis in schools, with research suggesting up to 1 in 20 school-aged children in Australia have food allergies.

The strategy has been in development for two years and is underpinned by “best practice guidelines for the prevention and management of anaphylaxis in schools and children’s education and care”.

National Allergy Strategy co-chair Preeti Joshi said the guidelines would create a standardised national approach in what has traditionally been a “grey area”.

“While Australia is a world leader when it comes to anaphylaxis management in schools and children’s education and care, there are still differences in the policies, guidelines, staff-training requirements and incident reporting across Australia,” Dr Joshi said.

Inclusion ‘would be amazing’

Perth mother Haley McLean experienced every parent’s worst nightmare when her son Lincoln had an anaphylactic reaction to dairy at a childcare centre when he was two years old. 

He was diagnosed as being severely allergic to cow’s milk when he was just 12 months old, and the family was told to always carry an EpiPen. 

“At that time, he was still drinking a bottle before going down for a nap and they had filled his bottle with the incorrect milk, so instead of being given 250, 300 millilitres of his rice milk, he had just shy of a cup of cow’s milk,” Ms McLean said.

“At the time, the childcare … recognised all of a sudden they’d given him the wrong thing, they hesitated with the EpiPen. No-one gave him the EpiPen and an ambulance was called.

Ms McLean said the guidelines would make a huge difference to the lives of both parents and children whe have allergies like Lincoln, who is now aged five.

“Training is the key,” she said. “Something could always slip through the cracks and you’d rather have people prepared and understand how to deal with the situation than be oblivious.

“Being able to recognise the signs of anaphylaxis rather than not even considering that as a possibility would hands down be a better approach in our circumstances.

“The whole idea of inclusion within the community and being able to participate in the community would be amazing.

“The confidence that we could send him out in the world and experience everything with the innocence of a five-year-old and be able to discover without worrying and being anxious of the ‘what-if’ scenarios and have they washed their hands and if something went bad.”

‘Bans do not work’

National Allergy Strategy co-chair — and Allergy and Anaphylaxis Australia chief executive — Maria Said explained the national strategy recommends a shift away from blanket bans on foods in schools in favour of implementing a range of strategies to reduce risk.

“Bans do not work. When people focus on a ban, [it] can’t be policed,” she said.

“As a parent myself, back in the 1990s, we wanted to not see these foods on the face of the Earth, but that is not reality — [the] reality is that these foods will come in.

The strategy has been developed over the past two years, in conjunction with key stakeholder organisations, staff who work in the sector as well as with parents and guardians.

Its best practice guidelines aim to prevent and manage anaphylaxis in school and care settings, and take an “allergy aware” approach that instead focuses on risk-minimisation strategies.

There are 10 main principles that underpin the broader national strategy to reduce the risk of anaphylaxis in schools and child care settings, including having an anaphylaxis-management policy and ensuring staff awareness of children at risk of allergic reactions.

The strategy also focuses on providing age-appropriate education of children with allergies, and communicating how to manage anaphylaxis with staff and the broader school and child-care community. 

Strategy believed to be a world first

One potential measure that the strategy recommends in schools is having special zones where certain foods are eaten or prepared to reduce exposure.

“We can have measures in place, with very young children in particular, where messy foods, for example, grated cheese and egg and things like that, maybe that’s eaten on a separate table away from a child who might have a specific allergy,” Dr Joshi said.

“So, I think that we need to really look at practical, real world tools and this is what these guidelines do.”

Ms Said says the strategy is a world first.

“This is improving care for children and teens at risk of anaphylaxis, but also increasing safety for staff, and people working in school and childcare,” she said.

The full National Allergy Strategy is available on the Allergy Aware website.