Food-allergic reactions in schools and preschools

A. Nowak-Wegrzyn, M. K. Conover-Walker, R. A. Wood

Research output: Contribution to journalArticlepeer-review

143 Scopus citations


Background: Food allergies may affect up to 6% of school-aged children. Objectives: To conduct a telephone survey to characterize food-allergic reactions in children (defined as those aged 3-19 years in this study) with known food allergies in schools and preschools and to determine mechanisms that are in place to prevent and treat those reactions. Design: The parents of food-allergic children were contacted by telephone and asked about their child's history of food-allergic reactions in school. The schools the children attended were contacted, and the person responsible for the treatment of allergic reactions completed a telephone survey. Results: Of 132 children in the study, 58% reported food-allergic reactions in the past 2 years. Eighteen percent experienced i or more reactions in school. The offending food was identified in 34 of 41 reactions, milk being the causative food in 11 (32%); peanut in 10 (29%); egg in 6 (18%); tree nuts in 2 (6%); and soy, wheat, celery, mango, or garlic in 1 (3%) each. In 24 reactions (59%), symptoms were limited to the skin; wheezing occurred in 13 (32%), vomiting and/or diarrhea in 4 (10%), and hypotension in 1 (2%). Also, 15 (36%) of the 41 reactions involved 2 or more organ systems, and 6 (15%) were treated with epinephrine, Fourteen percent of the children did not have a physician's orders for treatment, and 16% did not have any medications available. Of the 80 participating schools, 31 (39%) reported at least 1 food-allergic reaction within the past 2 years and 54 (67%) made at least I accommodation for children with a food allergy, such as peanut-free tables, a peanut ban from the classroom, or alternative meals. Conclusions: It is common for food-allergic children to experience allergic reactions in schools and preschools, with 18% of children having had at least 1 school reaction within the past 2 years. Thirty-six percent of the reactions involved 2 or more organ systems, and 32% involved wheezing. Every effort should be made to prevent, recognize, and appropriately treat food-allergic reactions in schools.

Original languageEnglish (US)
Pages (from-to)790-795
Number of pages6
JournalArchives of Pediatrics and Adolescent Medicine
Issue number7
StatePublished - 2001
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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