Blog written by Erin Kirwan for Advanced Allergy, Asthma, and Immunology
One look at Cadence and you can’t help but notice her bright smiling eyes and the large bow that tops her head of blonde curls like a crown on a princess.
Hi, I’m Cadence and I have food allergies, the 4-year-old will probably recite upon meeting you. Then, she’ll likely show you her colorful new bracelet bought special for her first day of school.
As sweet as Cadence’s greeting and bracelet are, the pair could one day save her life. Cadence wears the bracelet and has practiced over and over knowing her allergens – to alert others to her multiple food allergies.
Cadence is allergic to dairy, soy, tree nuts, peanut, sesame, sunflower, oats, carrots, and bananas. Once, when she was little, simply walking into a steak restaurant that offered peanuts caused Cadence’s face to swell and a bright red ring to develop around her lips. Cadence has been hospitalized multiple times for food-related allergic reactions. She can’t go out to eat to many places, her home has been emptied of food, beauty, and cleaning products that could contain her allergens, and, a very strict guideline is in place on what food is allowed to be brought into the home by others. In addition, during holidays, each part of a meal is made to be allergy-friendly, including homemade breads and special order turkeys. Then, there’s the never-ending-making-of-food Cadence’s mom and dad prepare and pack for almost everywhere they go, including birthday parties.
It’s been a good, necessary routine. One that’s getting quite the shake up as Cadence prepares for a right of passage that’s pretty major in the life of a 4-year-old: The start of school.
This month, Cadence started Pre-K. And for a child with multiple food allergies, it was like opening up a whole new can of worms.
“I was anxious, fearful, worried, but, I was also excited,” said Cadence’s mother, Courtney.
While some parents home-school a child with multiple food allergies, Courtney said home-schooling just didn’t seem to be the right fit for Cadence. So Courtney and her husband began researching schools for one that would somehow limit the impact Cadence’s allergies may play in her education. And that’s not always easy. “Unfortunately, many schools opt to exclude students like Cadence from participating in activities that might trigger a reaction,” continued Courtney. She and her husband talked at great length with administrators at various schools about the policies, procedures, and precautions in place for children with food allergies, They also focused their research on how the school handles exclusion versus integration in the classroom setting. Finally, after a lot of reading, discussion, soul-searching, and visits, Courtney and her husband decided they had found a school where they believed Cadence would have a shot at a safe and inclusive learning opportunity.
So Cadence got ready for Concordia Lutheran School, and, Concordia Lutheran School got ready for her.
With a school now secured, it was time for Courtney to formulate a plan. She turned to Dr. Patricia Gomez Dinger, Cadence’s Allergist, for help in creating a Food Allergy Action Anaphylaxis Plan. It is something Dr. Dinger says every child with a food or insect allergy should have in place. “A Food Allergy Anaphylaxis Plan should clearly identify each food allergen and outline specific instructions on symptoms and treatment, namely, when to give life-saving Epinephrine, in the case of a reaction,” says Dr. Dinger. Dr. Dinger added that a child’s Food Allergy and Anaphylaxis Plan should be signed by both the child’s physician and given to the school nurse. Dr. Dinger suggests, however, that a parent of a child with a food allergy also talk with the child’s teachers, an administrator, coaches, club advisors – basically, anyone in charge of supervising a child with a food allergy should be well familiar with the child’s allergens, symptoms, and preferred treatment. ( For more information on a Food Allergy and Anaphylaxis Plan, or to download one designed by FARE, Food Allergy Research and Education, click here. ) Also, interesting to note, said Dr. Dinger, most schools now recognize food allergy under the 504 plan for disability. With her Allergy Plan in place Dr. Dinger also made sure Cadence’s prescription for Epinephrine, the recommended two-pack, was filled and ready to go.
Once the more administrative guidelines and precautions were secured, the other accommodations simply seemed to fall in place. Rather easily, much to Courtney’s relief. Cadence’s teacher incorporated a hand washing program where students wash hands in the morning before starting their work and immediately after lunch. When it comes to snack time, which is allowed in the classroom, Cadence’s teacher implemented a no nut policy. Additional classroom snacks for a child who may have forgotten his at home are all allergy-friendly.
Also, as Cadence proudly makes her way around the classroom, through the hallways, and in the cafeteria, she does so flashing a food allergy tag on her lunch box and a food allergy button on her backpack. In addition, for added precaution, Courtney labels all of Cadence’s food as either ‘safe food’ or ‘safe snack’.
One more thing – Courtney says establishing open and clear communication with Cadence’s teacher has been crucial, and thankfully easy, especially when it comes to inclusion, one of Courtney’s greatest fears. In the school lunchroom, for example, Courtney said food services monitors all labels to ensure no nuts are in the products they are serving. Also, while Cadence packs her lunch each day, if she were to try to buy something in the cafeteria, an alert would appear reflecting her allergies and her tray would be checked. Then, you know that so-called ‘allergy table’ some schools provide in the lunchroom, isolating students with food allergies? Courtney wasn’t a fan. “At Cadence’s school, we have a plan to be able to separate her from potential life threatening allergens by sitting her with her classmates but separated by those who are buying lunch trays, which have already been cleared of her life threatening allergens,” Courtney shared.
When her class engaged in a gingerbread project where kids would at one point get to eat their gingerbread, Cadence’s teacher worked closely with mom to provide an alternative allergy- friendly gingerbread special for Cadence.
Yes, in just the first week, 4-year-old Cadence spread her wings and flew like a beautiful, blonde-haired, big bow’ed butterfly – happily, and most importantly, healthily.
That doesn’t mean Courtney can, or really, ever will let her guard down. She still worries. She still reflects. She still studies and researches. Courtney still hopes, daily, that parents of non-food allergy children will come to understand that the touching of a Lego or the holding of a hand that was previously exposed to a life-threatening allergen can be enough to cause a reaction in some children.
“The beginning of a new school year is the perfect time for all parents to have a discussion with their own children about the one in 13 children who, today, have a food allergy,” says Dr. Dinger. “Discussing briefly how your child can be a good friend to those who have to go through school a little more cautiously than others could be not only helpful but maybe even life-changing for someone like Cadence.”
A former journalist, Erin Kirwan, Owner of Savvy Media, works with Dr. Dinger and Advanced Allergy to help share important news, information, and patient stories.