Back to School with Food Allergies: What the School Community Needs to Know

| Posted On Sep 20, 2011 | By:

Close to 56 million American children are now back to school, settling into new routines and starting another year of learning.  As the school year kicks off, both parents and their children are diving head first into the school social scene: playdates are getting scheduled, after school activities are beginning, and the invitations to birthday parties are soon to arrive.  For many, the school community is central to their social life.  The kids get to know each other, as do their parents, and for many, these relationships last from kindergarten until high school and even beyond. 

Having a food allergy (for the kids) and having a child with a food allergy (for the parents) can complicate the relationships that develop between families in the school community.  According to a recent study supported by the Food Allergy Initiative, about 8% of American kids less than age 18 – or roughly 2 kids per classroom – have a food allergy. Needing to appropriately manage food allergies in the school community and the school social scene adds some complexity when filling up the lunch bags, planning the play-dates, and getting the parties started.   And it is all too often that you hear of schools divided and ill will sparked because of differing opinions about food allergy management.

Knowing why it is that kids with food allergies need to do things a bit differently can go a long way to keeping school communities from dividing over food allergy issues.  Communication and understanding is key for everybody, because managing food allergies cannot be the sole responsibility of the child and the parents – some children are too young to communicate what they need, and parents are not physically at school or at all playdates.  It therefore requires understanding and effort on the part of the surrounding community as well as the families of kids with food allergies to help prevent allergic reactions from occurring, recognize allergic reactions when they do occur, and know how to respond to an allergic reaction with the appropriate emergency medicine and procedures to protect that child.    

As I am passionate about food allergy education for the entire school community, I have been involved in the creation of two resources created for this purpose. 

The first, a free allergy education website,, offers education that addresses many different allergic disorders. We have created a specific section to help educate the entire school community about food allergies.

The second resource is Everyday Cool with Food Allergies, a children’s book designed to help parents and caregivers teach basic food allergy management skills to preschool and early school age children. This can be used not only to teach young kids with food allergies but also to teach their non allergic friends.

Additional information can be found at AllergyHome.orgFood Allergy InitiativeFAAN, and the Kids with Food Allergies Foundation

(And special thanks to Karen Rance, DNP, RN, CPNP, AE-C and Ready Set Grow, the publication of the National Association of Pediatric Nurse Practitioners, for collaborating on a similar piece about food allergy awareness due for publication in the Fall of 2011.)

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About Dr. Michael Pistiner

Michael Pistiner, MD, MMSc joined Harvard Vanguard Medical Associates in 2011 as a pediatric allergist and is an instructor in pediatrics at Children’s Hospital Boston, Harvard Medical School. He is a fellow in the American Academy of Pediatrics where he is a member of the Council of School Health, Section of Allergy & Immunology, and a member of the American Academy of Allergy Asthma & Immunology where he is a member of the Adverse Reaction to Food Committee. He is a food allergy educator and advocate and serves as a voluntary consultant for the Massachusetts Department of Public Health, School Health Services. He also serves on a team assembled to implement a law designed to increase food allergy awareness in Massachusetts eating establishments and is a medical advisor for Kids with Food Allergies Foundation. Dr. Pistiner has received awards from the Food Allergy & Anaphylaxis Network in 2009 and 2010, as well as the American Medical Association Young Physician Section Community Service Award (2010) for his work on the Food Allergy Awareness in Restaurants Act. He is co-creator of, an allergy education website, and has recently authored "Everyday Cool With Food Allergies," a children’s book designed to teach basic food allergy management skills to preschool and early school age children.


  1. The link for the 4.5 minute powerpoint presentation isn’t working. Has that page moved? Is there an updated link? I’d like to share this article with my son’s teacher and the school’s administration. Thanks!

    Comment by Lynne Farmer on September 28, 2011 at 9:36 am
  2. Thanks for catching that broken link! They’re fixing now, so please check back.

    Comment by Harvard Vanguard on September 30, 2011 at 3:15 pm
  3. Great article Dr Pistiner. I think you’ve hit the nail on the head about food allergy needing to be a community issue and not just an issue for families and schools etc.
    As they say, we’re all in this together.

    Comment by Robbie on October 2, 2011 at 5:53 am
  4. I think it is great to communicate that food allergy is a community issue, but wonder if you would also be willing to help educate the community about fragrance allergies? Many children have respiratory allergies or asthma, as do many adults. Fragrances can cause breathing difficulties, headaches and other serious or unpleasant reactions that can interfere with a child’s ability to interact in the classroom. Most people are familiar with the idea that food allergies can be serious, but there seems to be very little education about fragrances allergies. Advertisements bombard us with the idea that every natural smell needs to be covered by spraying an air-freshener, lighting a scented candle or spraying furniture to “freshen” the environment . Even some healthcare providers wear fragrance.

    It is common practice in organizations such as choral groups, and exercise/yoga classes to have a policy asking that participants refrain from wearing perfume, cologne or using strongly scented toiletries. This is especially important in situations that require participants to be in an enclosed space in close proximity to one another while needing to be able to breathe freely and comfortably.

    I have a friend who works at a school and needs to take strong antihistamines at school because, although asked many times, the school will not implement a fragrance-free policy and the other adults ignore the problem. This is an adult who can speak up for herself and still has not been given any consideration – what about children who deserve equal opportunity to learn and to be comfortable in school?

    Comment by Mary on November 9, 2011 at 8:19 pm
  5. There is additional information on allergies, including food allergies, at the Asthma and Allergy Foundation of America’s website:
    This organization offers educational information, support groups, etc., and was very helpful to me as an allergic patient.

    Comment by Pat Mischler on November 10, 2011 at 6:52 pm

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