As students returned to the classroom last week, the top post on the Loudoun County school system’s website informed parents how to find lower-cost EpiPen emergency allergy shots.
That’s an indication that, more and more, allergies are on families’ minds.
Grappling with allergies has become a big challenge in Loudoun’s school district and much of the country, and administrators continually tweak policies, cafeteria menus and employee training to ensure the growing number of students with severe allergies are safe at school.
One in every 13 children in the U.S. are afflicted with potentially deadly allergies. That’s roughly two in every classroom.
“We are constantly talking and thinking about this. It’s a great concern here in Loudoun County,” said Becky Domokos-Bays, supervisor of the county’s School Nutrition Services.
New this year to Loudoun schools’ cafeterias are signs that clearly indicate whether a menu item contains any of the nine most common allergens—from tree nuts to fish—or whether it is vegetarian. Local schools also recently launched a gluten-free menu at the request of parents and students.
Domokos-Bays, who also serves as president of the national organization School Nutrition Association, said allergies have become one of the most discussed issues among school leaders across the country.
“We’re not talking about just a sensitivity. An allergy is a life-threatening thing. It can kill you,” she said. “So it’s a lot of pressure on teachers and families to make sure they cooperate and communicate what the real needs are.”
Prepared for the Worst
“It happens frequently.”
Jeannie Kloman, the county’s supervisor of Student Health Services, said of the use of EpiPens on Loudoun students. It is a device that has become a vital piece of equipment in the county’s 89 public schools.
Every middle and high school has a full-time nurse on staff, and most elementary schools have a health clinic specialist, who is trained in first aid, CPR, prescription administration, seizure care and how to respond to allergic reactions.
But it’s not just the nurses’ offices anymore that are equipped to respond to anaphylaxis, but also principals, teachers, teaching assistants, bus drivers and cafeteria monitors. “We do unbelievable amounts of training,” Kloman said. “We want everybody to recognize symptoms and how to administer epinephrine.”
Every Virginia school is required to keep epinephrine on hand, a directive adopted in 2012 when a bill championed by Ashburn Del. Thomas A. “Tag” Greason (R-32) became state law. Kloman said, with 78,665 students in Loudoun, epinephrine is administered frequently. When it is, the school calls 9-1-1 and the student is transported to the hospital for further treatment.
Having to be ready to respond quickly to a potentially deadly situation can be a scary thought for some teachers, but Kloman feels that public schools are equipped to respond.
“We want people to know there is a plan in place and you just need to activate the plan,” she said.
School cooks and cafeteria managers undergo their own stringent training. When making dishes with some of the more common allergens, they use separate pans, utensils and gloves. “We have to really be careful about cross contamination—that’s huge,” Domokos-Bays said. “If you’re celiac, for example, the smallest amount of wheat protein can really wreak havoc on your intestinal system.”
Exposure to other allergens, like peanuts, can be deadly.
When Domokos-Bays started working in school nutrition, students with allergies were few and far between. It was in the mid-’90s, when she worked in Fairfax County schools. Then she started seeing more students effected by the condition. A national study by Food Allergy Research and Education found allergies among children increased by more than 50 percent from 1997 to 2011; researchers say it is unclear what is causing the growth.
Domokos-Bays has found that keeping up with students’ allergies required constant work, and she considers it a team effort between the school system and families.
“When some of this first started, I asked parents what advice do you have for us?” she said. “I think we’ve become very good partners with our families.”
Loudoun schools’ Nutrition Services Department website encourages parents to meet with cafeteria staff members to talk about their child’s allergies and even share their favorite recipes with them.
Even students have been asked to weigh in. Last year, a survey of middle and high school students showed that many kids who have allergies were afraid to eat school lunches because of fears they would eat something that would be a danger to them. That prompted the easy-to-read signage this school year.
Domokos-Bays counts families who do not have children with allergies part of that team effort. Instead of bringing homemade cupcakes or cookies to celebrate a birthday, parents are encouraged to bring a fruit or veggie tray or non-food treats like pencils or coloring books.
She said her department’s responsiveness to parents’ and students’ concerns has received kudos from effected families. “Several parents have contacted us and thanked us for allowing their kids to have a normal lunch time. That’s great to hear.”
Work in Progress
The public schools have made significant headway in protecting students with allergies since Cheryl Hill first enrolled her son into Mountain View Elementary in Purcellville 10 years ago.
Henry, now 16, is allergic to eggs, peanuts, tree nuts, shellfish, fish and cherries. When he was in elementary school, there was no school nurse, and administrators at first told her they would keep Henry’s EpiPen locked in the office. Hill had to kindly ask the teachers to wear a waist pack with the device so the medicine could be near her son at all times. She also remembers the mother of one of Henry’s classmates being upset because she couldn’t bring cupcakes for the class.
“I didn’t blame her; I felt really bad, but it’s not worth the risk,” Hill said.
She admits that before she had Henry, her third child, she thought parents who talked about kids with severe allergies were just being overly sensitive.
“I kept thinking this was some sort of health food thing, until I had a kid of my own with food allergies,” she said. “A lot of our journey has been about education; we became educated and we educated teachers and administrators and other parents—that has been the hardest thing. A lot of people don’t get how serious it is.”
Hill has been impressed by the changes, from administrative policies down and employee training to families who don’t have children with allergies. Over the years, Henry’s classmates have asked their parents to pack peanut-free lunches so they can sit with him in the cafeteria.
“I appreciate every person who came along and made changes so that he could go to public school,” she said. “Over the last 16 years, I’ve seen a lot more procedures put in place to protect children, and a lot more acceptance.”
To her 16-year-old son, Hill said much of the world is “a danger zone.” She packs a meal for him for almost every occasion, including the pre-game Loudoun Valley High School football dinners. “We’ve learned how to navigate the mine field,” she said, “and others can, too.”
Her advice for parents is to meet with the school nurse or health specialist, the teacher and cafeteria managers ahead of the start of school,
Domokos-Bays said she and her team see the parents as the experts of their child’s condition and want to hear from them. And, she added, there’s no telling what the future might hold for school cafeterias. She knows of students who are allergic to products that were once considered “allergy free,” like sunflower butter.
“When I first started in school nutrition, I don’t remember anybody having food allergies, but it’s a different world now,” she said. “So at this point in my life I’ve learned to say any food can be a potential allergy to somebody.”