Food allergies in children: school and canteen, how to manage?

The mistress of little Jahden, aged 6 and who died in 2018 after eating a pancake when he was allergic to dairy products, was tried for 'manslaughter'. However, an individualized reception project (PAI) had been set up at the school. Explanations and advice.

  food allergies'enfant : école et cantine, comment gérer ?

[Updated September 5, 2022] The food allergy would concern 5-7% of children under the age of 15 and three times more common in children than in adults, according to Asthma and Allergies Association . How do you help your child live with their allergies? How is the diagnosis going? And what support can be put in place at school ? Advice from Dr. Nhân Pham-Thi, allergist and clinical immunologist at Institut Pasteur.

My child has food allergies, what should I do?

If your child has some characteristic symptoms of a food allergy , it is important to consult an allergist who will carry out patch tests to test for different allergens . Concretely, he will apply the foods one by one to the child's skin to reproduce any allergic reactions. He may also test for antibodies in the blood directed against these foods to confirm the identity of allergens detected during skin tests. This dosage is also useful when patch tests are impossible to perform in children.

Food allergies in children: what symptoms?

We distinguish the symptoms of a immediate food allergy - skin rash, swelling of the skin, edema, eczema outbreak, hives, digestive signs (nausea, vomiting, diarrhoea, etc.) which appear within two hours of ingestion - of a delayed food allergy (often misused as a food intolerance): Constipation, mood disturbances, intestinal discomfort, gastric reflux, increased rhinitis or asthma ...

Why does my child have food allergies?

There are risk factors for food allergies: this is called atopy , a familial predisposition characterized by a immune system disorder . ' So-called 'atopic' children have fragile skin or mucous membrane barriers, and thus develop hypersensitivity to certain allergens (present in certain foods) which can manifest as asthma, rhinitis, allergic conjunctivitis or even , atopic dermatitis ', specifies the allergist. They would present a permeability and a cutaneous porosity which would allow proteins to pass more easily into their organism. ' Most certainly, the environment (infections, air pollution, stress...) of the child will play a role in this loss of tolerance vis-à-vis allergens, but this has not yet been established. brought to light by a study This genetic predisposition can be determined by looking at family history of eczema, atopic skin, asthma, rhinitis and of course allergies. Food allergy can appear very early, during the food diversification phase for example or a little later, around the age of 3,4 or 5 years.

School Food Allergy: What is PAI?

The PAI makes it possible to guarantee the child specific menus without certain allergens.

' The school can set up an Individualized Welcome Plan (PAI) allowing to adapt the child's school environment to their allergies ' , says Dr. Pham-Thi. This is a contract - drawn up by the school doctor, the child's allergist, their parents, the school administration, the teacher and sometimes the catering team - where are mentioned the conditions of the reception of the child as well as the specific warnings (precautions to be taken, warning signs and treatment to be given, arrangements to be made for outings or school trips). This document is usually done at the very beginning of the year, ideally before the start of the school year.

Food allergies and the school canteen: specific meals

As for children with diabetes or another chronic disease , the PAI allows, depending on the severity of the allergy, guarantee specific menus without certain allergens or to offer parents to provide a packed lunch. Otherwise, ' zero risk of accidental ingestion does not exist, the PAI (see a PAI model) invites parents to provide a first aid kit with medication in case of severe reaction. It usually consists of an adrenaline pen (in case of discomfort for example), a bronchodilator (if the child has asthma), antihistamines or corticosteroids “, he adds.

Food allergies in babies

Treatments, advice... How to accompany your child on a daily basis?

The care of allergic diseases consists in avoiding the ingestion of allergens highlighted during the diagnosis. ' In the supermarket, look carefully at the product labels and in the restaurant, ask for the composition of each dish “, advises the specialist.

Among the most common food allergies in children , we find :

  • cow's milk allergies,
  • goat's milk,
  • nuts (cashew nuts, peanuts, pistachios, etc.)
  • chicken eggs
  • Certain fish, seafood
  • Certain fruits or vegetables, or even mustard.

This eviction can be associated with taking antihistamines . These drugs relieve, but do not cure the allergy. Only the desensitization (also called allergen immunotherapy) makes a child tolerant to the allergen responsible for the allergy. It is a curative treatment (vaccine 'by shots', but most often by sublingual route: a few drops under the tongue, then swallowed) which consists of administering allergenic extracts (in increasing doses) for a long period ( 3 to 5 years on average). Finally, food allergy also depends on the environment of the child , it is therefore important to avoid as far as possible the passive smoking and avoid the polluted spaces (avoid walks near industrial areas or during pollution peaks). Thus, it is strongly advised not to smoke inside the house or near the child. Also be sure to ventilate your interior daily for at least twenty minutes.

Start a dialogue

Teach your child to clearly say which foods he cannot eat. For your part, you can inform the child's entourage (this may seem obvious to you, but explain to them that it is absolutely not contagious, but that it only occurs in certain people with genetic background ), for example classmates, parents of friends (especially if they organize tea parties anniversary at home) or their friends from extracurricular activities. This is a positive way to involve other children and avoid misunderstandings on their part. ' Especially since children quickly understand the specificities of others ', argues the expert. The child will feel more reassured both at school and with his friends.

Notify the teaching staff

Educational staff must also be particularly vigilant during Taste Week, the end-of-year fair, birthday parties or school trips, for example. Finally, to reassure you and the people supervising the child at school or during extracurricular activities, do not hesitate to slip a small sheet (see below) with the essential information, which the child can slip into his bag or coat.

Books to answer the questions of children with allergies

Food allergies

Gabriel, the hero of this book, can't eat peanuts because he's allergic to them. So it's not always easy! Intended for children from 3 to 6 years old, this little book answers all the questions of children who can identify with the character and understand more easily what an allergy is, how to treat it and how to live with it. Food allergies by Delphine Huguet, aux Editions Milan.

Joyful cooking for children with allergies

Joyful cooking for children with allergies

This playful and colorful book offers many recipes that the allergic child and his parents can prepare together. Alternatives to dishes containing gluten, eggs, milk or even peanuts to make food allergies rhyme with gluttony. Finally, a primer and practical advice will address organizational, social and psychological issues. Joyful cooking for allergic children by Patricia Barreau-Yu, published by Carrément Jouvence.