Why can't your child bring peanut butter to school any more? The mother of a peanut-allergic daughter spreads the word
By Victoria Curran
CanadianLiving.Com (Health & Family)

"Going into Grade 1, they (children with peanut allergies) are supposed to go into a washroom where kids who have eaten peanut butter have left peanut residue all over the faucet and door handles. And she's in the playground with everyone," says Hubert, who lives with her husband and three children in Courtice, Ont.

Chantal was 18 months old when she first came in contact with peanuts. Within half an hour of eating a peanut butter sandwich, the toddler had diarrhea and was sick to her stomach. Her babysitter assumed she had a virus, cleaned her up and lay the exhausted child down for a nap. A couple of hours later Hubert arrived to find Chantal covered in a rash. "I didn't know anything about allergies, but I recognized something very serious was happening," she remembers. At such a young age, Chantal wasn't able to express what she was feeling. "I tried to give her a drink of water, and she wasn't drinking," says Hubert. "I started thinking there was something wrong with her throat and rushed her to the doctor right away."

Immediately making the connection between an allergic reaction and the peanut butter sandwich, the doctor diagnosed Chantal with anaphylaxis, a severe reaction that can be life threatening. The doctor proceeded to explain that there were no tests to gauge how strong a person's allergic reaction will be. Chantal's next exposure to peanuts or the one after that or the one 10 years down the line might set off an anaphylactic response, or it might never happen. For the rest of her life, Chantal, now six, will likely have to avoid contact with peanuts and carry an auto-injector of epinephrine, the hormone adrenaline. If Chantal does have another reaction, an auto-injection from an EpiPen or Ana-Kit would stop the reaction rapidly. The effects of epinephrine can be temporary, so Chantal must go to the hospital immediately after the injection. This means that Chantal must always be close to medical care.

It was a lot for Hubert to absorb in one afternoon. Most frightening to her was the discovery that eating peanuts isn't the only way to incur an anaphylactic reaction. Simply putting something in your mouth that's contaminated with a particle of peanut residue, even breathing in the strong smell of peanuts can prove potentially fatal. As soon as she returned home with her daughter, Hubert started reading the labels on everything in her kitchen and ridding the house of peanut products.

"It was very difficult at first," says Hubert, an associate scientist with Ontario Hydro. "It has taken many years just to get family to understand. It was hard to get her grandparents to read labels before they offered her things. It still is."

Until she was six, Chantal didn't play by herself in the front yard in case neighbourhood kids unwittingly brought her in contact with peanut products. Today she doesn't go to a friend's house without a preliminary phone call from Hubert to explain Chantal's condition. She doesn't share cake at birthday parties because of the risk that baked goods bought from a store or made by someone not familiar with peanut-safe practices may be contaminated. Once Chantal had a minor reaction at a restaurant after using a crayon that must have carried peanut traces.

When Chantal entered junior kindergarten in 1995, the school had no guidelines in place to cope with anaphylactic children. Hubert wrote a letter explaining the peanut allergy to the parents of her daughter's classmates. The following year when Chantal was in senior kindergarten, the principal took it upon herself to write the letter.

When Chantal entered Grade 1 last year she left behind the more controlled environment of kindergarten. Chantal's school is attended by more than 700 children, a number that staggers Hubert. "In kindergarten they're in their own little world. They have their lunch in their classroom, they go out in the playground on their own, they're not with the bigger kids, they have a washroom in the classroom."

The principal asked the teachers to create a peanut-free classrooms and post peanut-free signs on doors to increase awareness. Hubert joined a committee of parents, teachers, principals and board trustees to develop a consistent policy for the entire school board to minimize risk, increase awareness and handle accidental exposure. They will have the policy in place before school starts this fall.

Peanut-safe is the preferred goal over peanut-free. That means designing where peanuts are eaten, posting signs outside allergen-free classrooms, discouraging food swaps, encouraging thorough cleanup and good hygene and educating staff, children and their families about anaphylaxis.

Hubert knows banning peanuts is unrealistic and would create a false sense of security, leading to dangerous complacency for people with anaphylaxis. She admits that she made the mistake of eliminating peanuts so completely from Chantal's world that her child didn't even know what they looked like. When Chantal was four years old, a boy threatened her with an acorn and she thought she was going to die.

And because she can't remember her only serious reaction, Chantal's already getting tired of the dietary restrictions. Hubert must constantly stay on guard to prevent her daughter from growing complacent and to make sure she remembers to carry her EpiPen inside her fanny pack.

"My biggest fear is that a parent or somebody out there doesn't quite believe the seriousness of peanuts and anaphylaxis, and a child overhears this at home...and thinks, it can't be that serious because my parents think I should be taking peanut butter to school."

Hubert hopes that through educating Chantal's classmates, teaching them about auto-injectors and the symptoms of allergic reactions, they will grow up with a clear understanding of what it means to live with anaphylaxis.

HOW YOU CAN HELP

You may be one of thousands of parents who are asked to stop sending peanuts and peanut products in your child's lunch. Because of the minimal amount of peanut protein that can set off a severe reaction and the sticky consistency of peanut butter that makes it troublesome to clean, schools need everyone's cooperation to help contain the presence of peanuts around people who are anaphylactic.

WHEN SENDING FOOD TO SCHOOL

• Discourage children from trading or sharing foods, utensils or containers. Have them wash their hands after eating.
  
• Removing peanuts from an item does not make it safe to eat and once a peanut has touched another food, that food is contaminated by peanut residue.
  
• If you will be making treats for the class for your daughter's birthday, be sure that the pans are well-cleaned and free from peanut products, or better still, use disposable pans.
  

WHEN PREPARING FOOD

• Avoid cross-contamination. Don't dip a peanut butter knife into the jam jar.
  
• Check labels to ensure the product doesn't contain nut extracts, oils or pieces.
  
• Use clean utensils for each type of food you prepare and serve.
  
• While shopping, be cautious of bulk-food bins and their scoops and be aware that the automatic bread, cheese and meat slicers may contain traces of allergens.
  
• Serve meals containing peanut butter at home and send your child to school with an alternative for lunch.
  
• If a person with a nut allergy is visiting your home, wash utensils, tables, toys and crayons clean of contaminated foods.
  

PEANUT-FREE SCHOOL LUNCH ALTERNATIVES

• Broaden the types of food that your child can brown-bag by purchasing a widemouth thermos for hot items such as soups, stews and spaghetti. Make sure your child is old enough to handle the responsibility of bringing the containers back home.
  
• Alternative peanut-safe and cost-efficient menus have been developed by several public-health departments. Ask your school or public-health department for more information.
  
• Some peanut-free options; pitas stuffed with tuna salad or cold cuts; cereal, bagels, crackers or muffins with cheese; pizza; pasta or potato salad. Some fun extras: celery layered with soft cheese; carrot sticks; cucumbers and red and green pepper rings with dip; sliced melon; hard cooked eggs; yogurt. Pack all pershables in insulated containers with ice packs.
  
• Make extra servings at dinner to send the next day.