As Whitehorse students pluck water bottles and food containers from their lunch bags, something unfamiliar to most Canadian schools emerges: a small tin of mixed nuts.
This month, École Émilie Tremblay unveiled a new policy to allow peanuts and tree nuts, which came after consultations with both staff and families — including those with food allergies, noted principal Marie-Héléne Gagné. While nuts remain a no-go in kindergarten, as well as in Grade 1 and Grade 2 if there are students with allergies in those classrooms, no restrictions remain for Grade 3 and up.
For years, peanuts and tree nuts have been considered off-limits or strongly discouraged in school snacks and lunches as a precaution protecting those with life-threatening allergies. It’s a practice that many families with food-allergic kids consider crucial.
However, amid recent research that questioned the effectiveness of blanket, site-wide food restrictions, some experts think the tide could be turning away from specific food bans if a host of other safeguards are employed.
Education over restriction
Before the new policy began on Jan. 8, Gagné said school staffers took an online training course about food allergies and reviewed procedures on what to do when there’s an allergic reaction and how to use epinephrine auto-injectors. They also went over with students the importance of washing hands, not sharing food and cleaning desks and tables once lunch is done.
“Children that have allergies are already educated [about] that: they know how to behave to protect themselves. So now we’re trying to educate the rest of the population…. Education rather than prohibition,” Gagné said.
“Fish or seafood or pineapple or kiwi — these could be as deadly as nuts and peanuts. So really, education … is a path that will help us make change easier and grow.”
There are a number of best practices for schools to consider, says allergist and clinical immunologist Dr. Susan Waserman, including:
- Rigorous education about managing anaphylaxis (and regular refresher sessions).
- Renewed emphasis on hand-washing and cleaning.
- Schools stocking unassigned epinephrine auto-injectors.
In 2021, the McMaster University professor led an international panel that published a series of recommendations about managing food allergies in schools and child care settings after five years of analyzing evidence-based research on the topic.
With a caveat about the need for more and better quality research on the topic, the panel said the evidence reviewed doesn’t support blanket food restrictions.
“Food restriction has been institutionalized now for many years and these are not easy practices to change. But do I see it coming? Yes, in all likelihood it will,” said Waserman, based in Hamilton, Ont.
“Do I anticipate resistance? Of course there’ll be…. The anxiety among both the parents and the teachers is probably pretty fierce. So we’re expecting that there will be barriers, there will be challenges.”
Waserman believes extensive and repeated education efforts plus communication involving everyone — school staff and administrators, food-allergic students and their families, as well as the wider school community — are key to creating safe policies going forward.
“We all have the same aim in mind. We want to keep food-allergic children safe,” she said. “It’s the start of a discussion: What do schools do in the future regarding food-allergic children?”
Bans are a tool in toolbox of safety measures
Of the approximately three million Canadians affected by food allergies, there are about 600,000 school-aged children and teens under 19, says Jennifer Gerdts, executive director of Food Allergy Canada. The non-profit group educates and advocates for the community and creates learning resources for students, teachers and school staffers.
Some provinces and territories compel educational authorities to establish and maintain policies to support students with life-threatening allergies — Ontario and Alberta have specific legislation about it, she noted. Others issue guidelines for school boards, districts or divisions to follow. From that point, it often trickles down to individual schools to maintain a policy reflecting local circumstances.
Edmonton Public Schools, for instance, “operates under a site-based decision making model … where principals make decisions for school and/or classroom allergy policies based on the needs of students and staff,” a spokesperson told CBC News.
The Toronto District School Board has an operational procedure document instructing school staff on managing students at risk of anaphylaxis. A similar approach exists at the Vancouver School Board. Meanwhile, at P.E.I.’s Public Schools Branch, the anaphylaxis information handbook that guides its schools includes a host of specific recommendations, including that principals “request parents not send peanuts, peanut butter or any products containing peanuts or peanut oil” to elementary schools that have food-allergic students.
So, while there’s no law specifically stating “‘these foods must be banned,'” Gerdts explained, restrictions are usually something “that [individual] schools have deemed to be appropriate for their setting.”
But protecting kids with food allergies at school doesn’t rest with restrictions alone, Gerdts said.
For example, families of food-allergic students are typically updating forms and/or meeting with staff yearly to review their child’s details and what to do in case of anaphylaxis, she said. Some school policies include staff regularly reviewing anaphylaxis training. Another common requirement is for families to supply spare epinephrine auto-injectors to keep on hand in the office or classrooms.
At home, families with food-allergic children are also teaching them to be safe and aware from an early age, Gerdts said, including diligent hand-washing before and after eating, always carrying epinephrine, checking ingredient labels and declining foods from others, or checking with an adult before partaking.
Restricting or prohibiting foods like peanuts and tree nuts is just one instrument in a larger toolbox of risk-mitigating measures school officials can use — one that Gerdts acknowledges that principals may be reluctant to let go of in the case of the youngest students or because their school lacks resources to implement other measures.
For instance, adult supervision by a staffer trained in recognizing and reacting to anaphylaxis is one highly recommended practice. However, due to staffing shortages at many elementary schools, it’s older students who are monitoring younger ones at lunchtime.
Families of food-allergic kids always aware of risks, says parent
The idea of schools lifting nut restrictions is likely alarming for many food-allergic kids and their parents, especially those indignant at the notion food bans create a false sense of security.
When Morgan Klachefsky gave a cashew to her son Simon at 18 months old as part of introducing new foods to her toddler, it set off an immediate anaphylactic reaction that sent them racing to the hospital. Another severe reaction at age three is also burned into the Winnipeg mom’s memory.
She’s since advocated for her son in child care and school settings and trained friends and family to read food labels, ask about ingredients and on how to use Simon’s EpiPen.
Klachefsky has started to ease her “all-consuming” fear for her now nine-year-old son’s safety amid his severe allergy to cashews and pistachios, after realizing Simon himself, some of his friends and others in their circle have gradually become his advocates as well. Still, she’s aghast at the idea of schools lifting restrictions on peanuts and tree nuts, which are the most common food allergens (followed by dairy, egg, finned fish and shellfish).
“I’ve heard all the complaining about what an inconvenience [it is] that children have all these allergies, like ‘What can we even send in their lunch anymore?'” Klachefsky said.
“As a mother of a child with life-threatening allergies who could die from eating the wrong thing … I would hope that a school would do everything they could to protect kids,” she added.
“Everyone in a school should be trained to deal with this and we should not be allowing in the foods that are risking children’s lives, period.”