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How Can Students Manage Allergies At School?

Tribune photo by JASON BEHNKEN

Allergies can interfere with a child's performance at school, but parents can be proactive.

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By RICHARD F. LOCKEY, M.D.

Tribune correspondent

Published: September 19, 2008

School is back, and managing students' allergies in the classroom is a concern for many parents, teachers and school nurses.

More than 20 percent of children have some allergic disease, most commonly asthma or allergic rhinitis (hay fever). A recent landmark "Pediatric Allergies in America" survey found that 40 percent of parents of children with allergic rhinitis reported that the condition - marked by a runny nose, congestion and sneezing - interferes with their children's school performance. Side effects from some nasal allergy medications, particularly over-the-counter varieties, may also affect a child's alertness and ability to concentrate.

Parents can be proactive by making sure their children's teachers and other school professionals are aware of the child's specific condition, the environmental and lifestyle triggers, what medications he or she uses and possible side effects. If your child has asthma or severe allergies, ask the doctor to provide a written action plan for the school like the one found on the Patients & Consumers Resources page of the American Academy of Allergy, Asthma and Immunology Web site, www.aaaai.org.

Asthma and allergies usually can be successfully managed by taking medications before and after school; however, sometimes mediations are prescribed "as needed" for symptom relief. For instance, the main treatment for worsening asthma is a short-acting bronchodilator (quick-relief inhaler) that opens the airways of the lungs within five to 10 minutes. After they learn how to properly use the device and can monitor their own symptoms, school-age children should carry an inhaler with them at all times This includes bringing it to physical education classes, the gymnasium or after-school sports activities, since some children are prone to exercise-induced asthma attacks.

Allergies to peanuts, tree nuts, eggs and milk can be life-threatening, so it is particularly important for parents to ask detailed questions about the school's food allergy policy. Inform teachers and school cafeteria personnel what foods your food-allergic child must avoid. Parents of younger children with food allergies should pack their lunches, teach them not to share food with friends and provide safe snacks for classroom parties whenever possible.

Children allergic to stings from insects (ants and wasps are the most likely to cause problems in Florida) ideally should be treated with venom immunotherapy (allergy shots). This treatment virtually eliminates the problem at school and elsewhere.

Children allergic to either food or insect stings should always carry an epinephrine auto-syringe for use in an emergency. It is used to reverse an allergic reaction, typically characterized by hives, red skin and itching, which can quickly progress to respiratory distress, decreased blood pressure and unconsciousness. I encourage responsible young students to carry their own epinephrine syringe, so they can immediately self-administer medication at the earliest signs of a reaction. Make sure that the epinephrine injector is not outdated.

Animals in the classroom, even hamsters or gerbils, can be a problem for students allergic to animal dander. If you notice that your child is experiencing more difficulty with hay fever or asthma during the school day, seek appropriate medical care to rule out the possibility that a classroom pet is the trigger.

While teachers, coaches, school administrators, parents and health care professionals can work together to help prevent uncomfortable or dangerous allergic reactions, children are ultimately responsible for managing their allergies at school. Encourage your children to become active participants in their own care, educating them how to recognize their allergy symptoms and immediately report them to an adult in charge.

Dr. Lockey is professor of medicine, pediatrics and public health at USF Health, where he directs the Division of Allergy and Immunology and holds the Joy McCann Culverhouse Chair in Allergy and Immunology.

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