Nursery & School

Nursery

 

Choosing a nursery or pre-school for your child is a difficult decision for any parent but when you have a child with FPIES it makes the decision that much harder. The thought of leaving your child with severe allergies in the hands of other people is very daunting. Hopefully this information will help make that transition a little easier for you.

 

Once you have decided on a childcare setting, you need to ask them what their policy is on allergies and what experience they have dealing with them. If you’re happy your next step (once you have enrolled your child) is to make an allergy management plan with the nursery manager and draw up an allergy poster and action plan to be placed in every room your child has access to. Ideally this should have a photograph of your child at the top. An example poster can be downloaded in the handouts section.

 

The allergy management plan should consist of :-

  • What your child is allergic to - list every single thing your child is allergic to and how they react to it detailing what symptoms they get.
  • An Allergy action plan : If your child also has immediate IgE allergies they should be listed as well as FPIES foods. Example allergy action plans can be dowloaded in the handouts section..

 

Some allergy consultants will provide patients with an action plan once diagnosed. It should contain :-

  • How to recognise a reaction
  • What action to take
  • When the action is required
  • How your child's allergies will be managed on a day to day basis.
  • Any potential problems with messy play items, paints, playdough, food containers etc.
  • What will happen at meal times to safe guard your child. For example only eat food you have provided or sit next to a member of staff at the dinner table.
  • If any daily medications are needed e.g. cream for eczema.
  •  If you have an A&E letter or a Children’s ward access card give them a copy of this also.

Several copies of your allergy poster and action plan should be provided for each room your child may visit.

 

Before Your Child Starts

 

  • If possible arrange a staff meeting and ideally speak to everyone who works at the nursery.  
  • It is a good idea to draw up plans with regards to meal times so that all staff are clear on the procedures needed to keep your child safe. see example in our handouts section.
  • If they are providing meals or snacks you may need a separate meeting with the kitchen staff to explain the risks of cross contamination and the importance of clean utensils, work surfaces and food storage. 
  • Explain what FPIES is and what happens when a reaction occurs.
  • Play them the FPIES video so they can see a reaction for themselves. Or give them the FPIES UK web address and ask them to watch the video here.
  • Take along useful handouts for them to read on FPIES .
  • go through the management and action plans and tell them how your child reacts to each food and what to do in an emergency.
  • Explain how and when to use any medication.
  • Explain that just because a food isn't on the list does not mean it's safe, it could be you have not trailed it yet so they have to be vigilant at all times. 
  • Finally explain what other items may contain your child's allergens for example paints, playdough, messy play items, empty food cartons, contact with other children after eating.

If your child has many restrictions it may be a good idea to  give them a list of all safe foods, and update it regularly.

 

Ask them to let you know in advance if they are going to be doing any sensory/ messy play/ cooking/ parties involving food so you can check if it is safe or provide your own ingredients so your child can be included.

 

If possible let them know they can contact you (or a family member) anytime if they are unsure or have any queries. Severe food allergies can be daunting for childcare staff too and they may need some reassurance from you.

 

Once Your Child Has Started

 

You need to update the allergy plan as soon as you find out any new allergies and these also need adding to the allergy poster. It's also useful to review the management plan termly just to ensure everything is still relevant or if anything needs changing.

 

If your child does have a reaction at the childcare setting, it is important to arrange a meeting with the manager and relevant staff to discuss what happened and how it can be prevented in future.

 

If repeated reactions occur and they provide the food for your child it may be best to provide all your own food to prevent further reactions. Many parents have found this is the only way to prevent reactions in a childcare setting and you may choose to do this from the outset. It is important if you are providing your child's meals that you ask about any other allergy restrictions within the nursery such as peanuts or tree nuts.

 

If accidental reactions continue despite your best efforts it is advisable to contact SENCO (Special Educational Needs Co-ordinator) for your area to arrange a further meeting.

 

There are a few situations where a nursery or pre-school just don’t work for a particular child and if things don’t work out it may be worth moving to another one or trying to find an understanding registered childminder in your area or a trusted family member to care for your child instead.

 

More useful advice and posters can be found here

 

School

 

When your child is due to start school it's a good idea to look around as many settings as possible. During your visits talk to the Head Teacher about FPIES and what they can put in place to support your child whilst there. Also give them handouts on FPIES so they have a better understanding of what it involves. Once you have visited several settings and found one you feel is best suited to your child's health care needs go back for a second visit to discuss further how they can inclusively accommodate your child.
 

Once your child has been allocated a school ring your local school nurse team and inform them of the school you have been allocated. You can then work with the school nurse and school staff together and complete a health care plan.

 

If your child is in school or due to start, FPIES UK have put together a template for an Individual Health Care Plan. This can be found in our handouts section.

This is not the same as an Educational Health and Care Plan (EHC) which is tailored towards those with special educational needs. An individual healh care plan is recommended if your child has a potentially severe or complex medical problem or needs specialist care. Food allergies fall into this category. It is designed to be completed together with the school and any other healthcare profesionals who will be involved in your child's care. We have provided it as a Word document so it can be tailored to each individual. e.g. For those children with no IgE allergies certain boxes can be deleted or left blank.  

 

Further resources:

 

European Academy of Allergy and Clinical Immunology (EAACI )/ TACS have devised a document which sets out your child's rights in an educational setting and how you can help the nursery / Pre-School / School to help manage your child's allergies and keep them safe. Allergy Management PDF. They also have a useful document on managing food allergy in the community here

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