Grow and Go experts discuss: Allergies and intolerances

Do you know how to spot the signs of a food allergy and what to do if an allergic reaction occurs? Some early educators may not feel confident when it comes to managing allergies and intolerances in ECEC settings.

 

We spoke to dietitian Dr Clare Dix from The University of Queensland’s School of Human Movement and Nutrition Sciences and The Grow&Go Toolbox to bring you the latest research and practical tips to support your families.

 

The Grow&Go Toolbox team recently released a new podcast that offers expert information on early childhood nutrition. Each episode focuses on a different nutrition topic and provides practical tips and advice. The dietitians were joined by Dr Merryn Netting from the National Allergy Council to discuss what food allergies and intolerances are, how they are diagnosed and managed, and how ECEC settings can manage allergies and intolerances. 

 

In addition to the podcasts, the Grow&Go Toolbox team has co-created a range of resources with families and health and education professionals, including digital and paper-based resources that educators can use to assist with common queries and issues encountered during mealtimes in ECEC. 

 

Allergies and intolerances: what are they and are they getting worse?

 

Food allergies are common, affecting around 5-10 per cent of children in Australia. The most common are egg, cow’s milk, peanut, tree nuts, sesame, soy, wheat, fish, and shellfish. 

 

Unfortunately, there is no cure for food allergies, and strict avoidance of the allergen is the only way to prevent a reaction. Educators need to be aware and prepared to respond to any allergic reactions, as anaphylaxis can be life-threatening if not treated promptly.

 

What’s the difference between an intolerance and an allergy?

 

Food intolerances and allergies are different. A food intolerance is a reaction to a carbohydrate or other food chemical, leading to issues like stomach upsets. In contrast, a food allergy involves the immune system reacting to a harmless protein. Allergic reactions can range from mild to severe, with anaphylaxis being the most severe that needs immediate treatment with adrenaline.

 

Allergy aware approach

 

Research shows that banning foods or using terms like ‘nut-free’ is not an effective strategy. For preventing or managing anaphylaxis in ECEC services, we need an allergy-aware approach. 

 

This involves:

 

• Identifying children at risk of anaphylaxis.
• Implementing appropriate risk minimization strategies.
• Completing a comprehensive risk management plan.
• Ensuring staff are trained in anaphylaxis and food preparation.

 

What does an allergic reaction look like?

 

The signs and symptoms of a food allergic reaction may occur almost immediately after eating or, most often, within 20 minutes to 2 hours after eating. Rapid onset and development of potentially life-threatening symptoms are characteristic markers of anaphylaxis. Allergic symptoms may initially appear mild or moderate but can progress very quickly. The most dangerous allergic reactions (anaphylaxis) involve the respiratory (breathing) system and/or cardiovascular (heart and blood pressure) system.

 

Mild to moderate allergic reaction

 

• Hives, welts or body redness
• Swelling of the face, lips, eyes 
• Vomiting abdominal pain (these are signs of a severe allergic reaction/anaphylaxis in someone with severe insect allergy)
• Tingling of the mouth

 

Severe allergic reaction – (also known as ANAPHYLAXIS)

 

• Complex and/or noisy breathing
• Swelling of the tongue
• Swelling or tightness in the throat
• Difficulty talking and/or hoarse voice
• Wheeze or persistent cough
• Persistent dizziness or collapse in its place
• Pale and floppy (in young children)

 

What should you do if an allergic reaction occurs?

 

In case of mild to moderate allergic reactions, take the following actions:

 

• Stay with the person and call for help
• Locate the adrenaline injector
• Phone family or emergency contact

 

For anaphylaxis, follow these actions:

 

1. Lay the person flat and do not allow them to stand or walk. If unconscious or pregnant, place them in the recovery position (on the left side if pregnant). If breathing is difficult, allow them to sit with legs outstretched. Hold young children flat, not upright.
2. Administer the adrenaline injector.
3. Call an ambulance at 000
4. Phone family or emergency contact.
5. Further adrenaline may be given if there is no response after 5 minutes.
6. Transfer the person to the hospital for at least 4 hours of observation.

 

If in doubt, administer the adrenaline injector. Commence CPR at any time if the person is unresponsive and not breathing normally.

 

The adrenaline injector doses are:

 

• 150 mcg for children weighing 7.5-20kg
• 300 mcg for children over 20kg and adults
• 300 mcg or 500 mcg for children and adults over 50kg

 

Instructions are available on the device labels.

 

Supporting children and families with allergies and intolerances

 

Developing and maintaining an anaphylaxis management policy is crucial and should be reviewed and updated in the case of an allergic reaction. Updated medical information should be collected from any child with an allergy, and an individualised anaphylaxis care plan should be created, including a copy of the child’s ASCIA Action Plan. If an allergic reaction occurs while the child is in the care of the CEC service, reporting is crucial to ensure a safe and well-managed environment.

 

Educating and training staff on preventing, recognising, and treating allergic reactions, including anaphylaxis, is vital. Staff involved in meal preparation, serving, or supervision should also receive education and training on food allergen management which can be found at:  https://allergyaware.org.au 

 

Every centre should have one general-use adrenaline injector available to staff in case of previously unknown allergic reactions.

 

Educating children and your wider community

 

Educating your families and community and parents about managing anaphylaxis risk is important. Sharing information can help minimise risk. This could be in your newsletter, posters in your centre and so on. Strategies to reduce the risk of accidental exposure should be explored, and practical and effective approaches should be implemented. 

 

Age-appropriate allergy education

 

We can read books and talk to children about they can help keep their friends safe. Some centres may include allergy information as part of a doctor/hospital area or kitchens.

 

These tips, and many more, are shared in the Grow&Go Toolbox Podcast episode titled Allergies and Intolerances. Access it on YouTube here, or via Spotify here.

 

Resources that support this episode include:

 

• Grow & Go allergy resources
• Prevent allergies
• Allergy Aware

 

For more advice or support visit the Grow&Go Toolbox at www.growandgotoolbox.com or follow us on social media.