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Allergies to peanut butter and nuts, for example are particularly frightening because even the tiniest amount can cause death within minutes in an allergic child. Other foods, including shellfish, fish, eggs, and milk can also cause severe reactions.

Anaphylaxis is the most severe type of allergic reaction. It is sudden, violent and life-threatening. An anaphylactic reaction can begin with itching or swelling of the eyes, face, lips, tongue or throat. The face or body may become flushed and tightness in the throat, mouth and chest may occur. Other symptoms may develop, such as difficulty breathing and swallowing, dizziness, stomach upset and vomiting.

In Canada, about one person in 100 is estimated to be at risk.

If the reaction is not stopped at this point, the symptoms may become more severe, leading to a drop in blood pressure, loss of consciousness and even death. Children with severe allergies need quick access to an Epi-Pen (an emergency treatment that people with severe allergies carry with them) and medical attention to treat an anaphylactic reaction.

The frequency of fatal and near-fatal anaphylactic reactions has increased in the past several years and is likely to continue to rise. This is especially true of food-induced reactions. In Canada, about one person in 100 is estimated to be at risk and there may be as many as 50 deaths a year.

If you have school children, you may have already been asked to refrain from sending certain foods such as peanut butter or nut products to school because a child is allergic.

That child's food allergy is not a trivial matter. Parents who have a severely allergic child, myself included, have done their best to provide the safest possible atmosphere for their child at home. Most have declared their homes a nut-free zone despite the fact that other family members may enjoy peanut butter and nut products.

When an allergic child goes to school, co-operation from the entire school community is needed to help reduce an anaphylactic child's exposure to foods that can be harmful to him or her.

Peanuts and peanut butter are the most likely foods to trigger a full-blown anaphylactic reaction. Some children are so sensitive that even the smell of peanut butter or nuts can cause problems.

Peanut butter is also sticky and greasy. It's very difficult to clean peanut butter from surfaces such as tables and desks. Peanut butter on a friend's hand could be transferred to a crayon, pencil, soccer ball or skipping rope handle.

For these reasons,nut-containing foods should not be eaten in a classroom used by a child who has been diagnosed with peanut or nut allergies. Children who eat in an allergic child's class should be encouraged to bring nut-free lunches or eat in another classroom.

Anyone who does eat peanut butter or nut-containing products at a school where there is an anaphylactic child should be encouraged to wash his or her face and hands immediately after eating.

There are many hidden sources of nuts and nut oils in foods that also pose a threat to peanut/nut allergic kids. Some examples include cookies, muffins, cakes, pastries, doughnuts, sweet rolls, granola bars, some cereal bars, trail mix, candies, chocolate bars, cheese spreads, ice cream, Nutella, Chinese food, snack crackers and chips.

Older children with peanut/nut allergies may already know which foods they cannot eat and adept at reading food labels. Younger children, however, may still be keen to accept treats or sip on a friends drink. To reduce their exposure to offending foods, children with food allergies should only eat foods they have brought from home. All children need to be cautioned about not sharing snacks.

If you are concerned that your child will not be getting enough protein at lunch without peanut butter, you'll be happy to know that he or she is probably getting more than enough protein each day already. The following foods have approximately the same amount of protein as two tablespoons of peanut butter: one ounce of meat or cheese, one cup of yogurt, one cup of milk, one cup of raisin bran cereal, and one bagel.

The key to a balanced lunch is to have at least one food from each of the four food groups of Canada's Food Guide to Healthy Eating. Here are some lunch box ideas that can be balanced out with whole grain bread, bagels or pita bread, raw vegetables, fruit and a serving of milk, yogurt or pudding.

Try a hard boiled egg, leftover chicken legs, cold cuts, chili, cream cheese, cheese slices, meat or vegetable stew, macaroni and cheese, leftover spaghetti or pasta, baked beans, soup, tuna or egg salad, or leftover pizza.