One of the many things we found frustrating about daycare in general when we tried to enroll our daughter was the lack of any solid policy or even guideline with regards to food allergies and anaphylaxis. The daycare act briefly touched on the subject constituting that no child shall be discriminated against based on disability (though children with food allergies are not even considered disabled under the official definition of disability for many government organizations). The daycare act points out that food allergies exist and so daycares may have to accommodate children with food allergies, most likely in reference to peanut & tree nut allergies. In any case, I think daycares in this province are practically ignorant when it comes to other life threatening food allergies. That being said, there are a small number of them who acknowledge the severity of food allergies and refuse to take in children with severe allergies simply because they do not have the means to keep the child safe. I talked about all that in previous posts. So if you are still muddling through the daycare swamp, please feel free to take a look at my family's experience. I warn you though; it's not pretty and some of the comments are just down right nasty. But you may find some of it helpful.

Moving on to school... perhaps one of the main differences between public school and daycare is the fact that public education is available to everyone. Every child has the right to an education in public school and every child has the right to be safe in school. Unlike daycare, public schools do not have paying customers. They may have strong PTAs and uncooperative parents (that could very easily make your life a living hell if they wish to) but public schools cannot deny your child the right to an education. Daycare on the other hand, is allowed to tell you that staff "cannot handle your child" or that your child's presence "requires too much work and is inconveniencing everyone". Daycare can also tell you that they have no spot (even when you know the spot is still available because you just talked to a mom who said she got the call two days ago for the same spot, the very same one you got the call about three days ago to tell you it was gone) and they can simply choose to accept a child based on his/her disability. They accept a child that comes with funding. It sounds like discrimination but unfortunately under the daycare act, it is not. They can choose a child with autism for example, because that child would most likely be getting funding from the province, whereas a child with food allergies is not. But I'm not going to ramble on about daycare. I've ranted about this subject till I turned blue in the face. Today I want to talk about schools, because I have good news.

Last year, something very important (and massive, and huge, and I have no idea why this was not publicized or hyped up) happened in the public school arena. You probably already knew that the Halifax Regional School Board had long established an anaphylaxis policy, which was not as extensive as school boards in other provinces but at least it was a step in the right direction (or left, or backwards if you actually read the policy). The HRSB (aka Halifax Regional School Board. I'm so getting tired of typing the whole name so I'm just gonna use acronyms, k?) adopted a life threatening allergies policy that was basically divided into two small sections (and I mean small, as in short, vague, unfocused, non committal and shorter than the word 'short').

It included a policy section, which was one paragraph long and a procedure section that had several sub sections. Each of those sub sections outlined responsibilities of the school principal, classroom teacher, parents/guardians of the allergic child, and the allergic child. The part involving the staff was particularly lacking in identifying the responsibilities of the teacher given that the classroom teacher is possibly the one staff member who will be directly involved with your child and has the most contact with him/her throughout the day. Perhaps someone at the time thought they were doing us a favor by even considering to adopt a life threatening allergies policy. In my opinion, the old policy, in no way shape or form, addressed even the most minor of concerns to parents of food allergic children.

In March 2011, things changed dramatically, and to the better in my opinion. The old policy was revised and an updated version was created. There's always room for improvement but still, the efforts put forth by the parties involved are commendable and appreciated. The changes to the policy are substantial and include a much more detailed description of the responsibilities of all the different parties involved as well as a clear reference to the policy framework. The entire document is comprised of two sections, policy and procedures, each outlined in further detail with additional sub sections discussing various aspects of the policy. Let me summarize them for you (because I'm that kind of person, giving and sharing in every way, in sickness and in health as they say).

This Policy section is just an intro but it does three very important things. It outlines the main principles of the policy, the framework it's based on, and last but not least, authorizes the development and implementation of procedures that may support the policy. The policy acknowledges that HRSB (and by extension all schools under their jurisdiction) will maximize the safety of children with life threatening food allergies (i.e. you will no longer be given lame excuses such as "we can't handle your child"). That acknowledgement by default recognizes that anaphylaxis is a serious condition that poses safety concerns if certain procedures are not put it place to protect the child. 

The policy also highlights the holy trinity of allergies and anaphylaxis: information & awareness, avoidance, and emergency response. That means no more contemplating whether to call 911 or "just wait for it to pass" and also means that it is not unreasonable to request a one on one meeting with staff who will be dealing with your child to talk to them about your child's allergies and safety. It also means that the classroom teacher cannot force your child to participate in any activity involving food that may pose a risk to your child's safety. More importantly, it clearly identifies that managing anaphylaxis is a group effort that involves not only parents and caregivers of an allergic child but also school staff, other parents and the entire school community. This is something that was totally absent in the old policy, adopted in 1997. (After 13 years, someone decided that it was time... better late than never!)

The Procedures section is broken out into six different parts. Each outlines in detail the responsibilities of the respective parties and guidelines on what to do in the event of an allergic reaction. One of the key points in this section is the determination to review the entire policy every three years. That is a huge step forward. It indicates that there is an understanding that things change and what may have worked in the past may no longer work in the present. It gives the policy some flexibility to adjust to any number of changing conditions, something that was also missed in the old policy.

The meat of the policy though, is in the outlined responsibilities of all the parties involved. Those include the principal, school staff, parents of the allergic child, and the allergic child him/herself. The principal has the most autonomy and a broad range of authorization to do whatever he/she deems necessary to keep the allergic child safe within the school environment. That means that you no longer have to fight with the teacher to make the classroom food free. Decisions such as having all children eat in the cafeteria as opposed to the classroom for example, are things within the purview of the principal. What's new in the policy is the requirement to post names and pictures of students with an Anaphylaxis Emergency Plan attached to their file. The old policy required that the principal post "allergy alert forms" which is a very general and non specific term. That could be anything - a form with the student's name and allergy on it or just a piece of paper that says peanut allergy in classroom A. The new policy identifies that it is a plan specific to each child who has an allergy and that it must be readily available at the office and staff room in case of emergency. The principal also is required to notify the parents immediately if it is discovered that their child does not have his/her auto-injector.

The staff section was also expanded to include important matters such as ensuring that there are steps in place to protect an allergic child during classroom celebrations and events. Staff also are required to notify parents of the allergic child when classroom activities involve food. The policy also states that staff need to take into account food allergies when purchasing or using supplies and materials for class activities. That means that for a child who is severely allergic to milk, the classroom teacher is going to have to use something other than the famous goldfish crackers (doused in cheese) to teach students how to count. Even if the child will not be eating the crackers, he/she will still not be able to touch them without risking an allergic reaction or touch any other students who handled the crackers (otherwise known as cross contamination in our fun filled world of allergies).

The section about parent and child responsibilities has also been expanded. Of note is the fact that the old policy stated that the allergic child must know how to use an auto-injector, without stipulating that children under 7 cannot be expected to use the injector properly even if, in theory, they know how. The new policy clearly points out that children under 7 are not expected to inject themselves and so the responsibility falls onto the staff.

In addition, the new policy includes an appendix that lists the definitions of several key words related to allergies and anaphylaxis, such as allergen, epinephrine and auto injector. This is a brilliant idea and it makes total sense. Given the sheer number of people who assume my daughter is simply "lactose intolerant" when I mention that she is allergic to dairy, why on earth would we expect them to know the meaning of the medical terms we commonly use in reference to allergies, especially when we've had to learn all those terms ourselves, out of necessity? Last but not least, the new policy also includes a copy of what the Emergency Anaphylaxis Plan looks like. 

In short, the updated policy is more clear and precise about the functions and responsibilities of the parents, child and school. It may not seem like much because it's all on paper but for us, this is huge progress, one that we welcome with open arms.

Click here to see the 1997 Life Threatening Allergies Policy (the old policy)

Click here for the 2011 Life Threatening Allergies Policy (updated version)

You may also be interested in the Severe Medical Conditions Policy, which forms part of the framework of the Updated Life Threatening Allergies Policy.

We are still embarking on this school journey/adventure/nightmare and in doing so we will be learning new things which I will make sure to pass along to you. In theory, the policy sounds very good. In practice, the functionality remains to be seen. I'm crossing my fingers and toes! 

There is a very good reason why you need to read the label of every product you buy every time, even if you trust the company's labeling practices. The reason is because manufacturers can change the manufacturing process, packaging or facilities without alerting the consumer. Some manufacturers add an allergy warning if they know the product might be cross contaminated with an allergen.  This is the case with Kraft Canada Foods, which is why I love to purchase their products, because I feel more comfortable with their labeling practices. It is because I trust their labeling that I read the label every time. 

Checking the label is the best way to find out what is in the product or what it may have come in contact with. Reading every label every time is an essential part of living with food allergies. I admit, sometimes I slack off and don't read the label, especially when I'm short on time. I tend to just grab the box off the shelf and throw it in the cart. I know that my husband is going to double check after me but still - it's no excuse.

Today while I was grocery shopping I put two small cans of Fry's Cocoa Powder in the cart without looking twice. I knew that the big cans of Fry's Cocoa have an allergy warning on the label with regards to milk, eggs and nuts. However, the small cans are manufactured in a different facility. I had confirmed it by calling the company and was told that it is manufactured in a different facility that does not process dairy, eggs or nuts. But (and you know there's a but) that was last year. This year it looks like Fry's may have changed facilities. I called the manufacturer today. Currently, some of their small cans, just like the big cans, have an allergy warning on them. I saw it at the grocery store today. It clearly states on the label: MAY CONTAIN MILK. Some of the small containers are manufactured in a facility that does not process milk, eggs or nuts. But some are manufactured in a facility that processes those allergens. Therefore, it is essential to read the label of every can you pick up while grocery shopping as there is no way to know which batch/facility that particular can came from. Despite my disappointment, I have to give the manufacturer credit for labeling. They have done their part; it is my responsibility to read the label every time.

Needless to say, I returned the Fry's Cocoa Powder containers back to the shelf and picked up a different brand - one that is not potentially cross contaminated with dairy, eggs or nuts.

Lesson learned: READ EVERY LABEL EVERY TIME.