You’ve bought classroom supplies, printed off the bus schedule and have a fridge full of lunch ingredients. But do you have a plan for managing your child’s allergies at school?

To keep your child safe, it’s critical to be prepared – and make sure teachers are informed early, said Dr. Erica Berger of Novant Health Pediatrics – Mint Hill.

Dr. Erica Berger

“The most important thing a parent can do is be diligent in making sure the teacher is aware of their child’s food allergy and what specific symptoms their child displays if they are having an allergic reaction,” Berger said. “Not all allergic reactions look the same.”

Berger said the most common food allergies she sees in her clinic are peanuts, tree nuts, fish and egg allergies. And allergies affect about two children in every classroom, according to Food Allergy Research & Education (FARE). She gave some helpful tips for parents of children with food allergies as they go back to school.

Be diligent

Berger said allergic reactions can vary and include:

  • Hives.
  • Trouble breathing.
  • Swelling of the face or lips.
  • Swelling of the throat.
  • Severe headaches.
  • Nausea and vomiting.

“In many cases of anaphylaxis, there are no hives or rash at all,” Berger said. “The symptoms may be internal, like swelling of the throat, but are still just as dangerous.”

She said parents should never assume a teacher has dealt with a food allergy before. It’s important to have a conversation with the teacher before school starts or as soon as possible afterward.

Be prepared

Berger said you should also make sure the school has all the necessary forms filled out by your child’s physician indicating the emergency use of medications, like an epinephrine auto-injector, and that there are plenty of medications on hand – in the classroom as well as in the nurse’s office.

“I can’t stress how important it is to be prepared ahead of time,” she said.

Don’t be afraid                                    

Berger said a common theme she sees when talking to parents is the fear of using the epinephrine auto-injector.

“At the end of the day, the medication is the difference between life and death,” Berger said. “If a child is having an anaphylactic reaction, they do not need oral medication like Benadryl – they need epinephrine. You shouldn’t be afraid to use it, and you should relay that to the school as well.”

Parents should seek to have a clear understanding of who will step in with the injector if their child has a bad reaction.  And that they should ask, “if a nurse is not there that day, who will handle this?”

Other good questions to ask:

  • Does the school ban peanuts or other common allergens?
  • Do children with food allergies sit apart from others in the lunchroom?
  • If foods my child is allergic to are brought to the classroom for rewards, birthdays or holidays, will I know ahead so I can provide a substitute?

New food allergy findings

For parents of children with peanut allergies, the future may hold some hope beyond day-to-day management.

A new study found that probiotics combined with peanut oral immunotherapy helped some children get rid of their peanut allergy and remain desensitized for at least four years.

Berger described immunotherapy as giving small amounts of an allergen to someone in increasing amounts over months or years to try to desensitize them to that allergen. Immunotherapy is usually performed by an allergist.

For more helpful tips or to find a pediatrician, visit .