August 26, 2025 • 43 mins
Heading back to school can feel stressful for families managing food allergies. Last year, new recommendations for food allergy management in schools were released, offering schools a roadmap for keeping students safe and included. In this episode, I’m joined by Christine Creter to break down what they mean, how they can be applied, and how parents can utilize them to support their child’s safety and success at school. We hope that as your school year is getting started, this episode will give you practical takeaways to help you breathe a little easier this school year.
FAMS Recommendations: FAMS_ExpertRecs_English_9.18_Final.pdf
Effective Employee Engagement Programs With Creter Group
Special thanks to Kyle Dine for permission to use his song The Doghouse for the podcast theme!
www.kyledine.com
Find Dr. Whitehouse:
-thefoodallergypsychologist.com
-Instagram: @thefoodallergypsychologist
-Facebook: Dr. Amanda Whitehouse, Food Allergy Anxiety Psychologist
-welcome@dramandawhitehouse.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker (00:01):
Welcome to the Don't Feed the Fear podcast, where we
dive into the complex world offood allergy anxiety.
I'm your host, Dr.
Amanda Whitehouse, food allergyanxiety psychologist and food
allergy mom.
Whether you're dealing withallergies yourself or supporting
someone who is, join us for anempathetic and informative
journey toward food allergy calmand confidence..
(00:22):
Back to school season is uponus.
Some of you are already back andsome of us here where I live are
getting ready to head back afterLabor Day.
Whatever your connection to foodallergies is, you know how much
planning this involves.
So I sat down with ChristineCreter, who is one of many
amazing contributors behindsomething that was released last
year, the Food AllergyManagement in Schools, expert
(00:44):
recommendations for GradesKindergarten through 12.
Christine is the founder of thegroup of business combining
creative design and contentdevelopment for live and digital
learning programs.
And Christine is connected tothe food allergy world because
she and her son managelife-threatening food allergies.
She was involved in managing andcoordinating this project, which
(01:04):
pulled together an advisorycouncil of some of our top
experts and leadingorganizations in food allergy
management to consider andupdate our recommendations about
how to keep our children as safeas possible in schools.
Christine, or Chris, as she goesby, is here to talk about how
these were developed.
Unpack what they mean and tohelp us understand how schools
(01:25):
can put them into practice andwhat parents can do to
collaborate with the schools tomake sure that their child is
set up for a safe and successfulschool year.
So as you're thinking about yourchild and what that will mean
for the year ahead, I hope thatthis conversation will give you
some helpful information and itcertainly will lead you to a
really great resource to helpyou do that.
Amanda Whitehouse, PhD (01:45):
Thank you so much for joining me,
Chris.
I'm excited to have you here onthe show to talk about the food
allergy management in schoolsguidelines that you were a big
part of.
Chris Creter (01:52):
Thanks.
Happy to be here.
amanda-whitehouse--phd_2_ (01:54):
Let's get started by introducing you a
little bit.
What's your involvement withfood allergy personally and
professionally?
chris-creter--she-her-_1_ (02:00):
Sure, I'll start personally.
So, almost 15 years ago I had mylittle boy, my one and only, and
the first time I nursed him, hislittle face swelled up and we
didn't really know why at first.
And so we.
They took him into the nurseryand they checked his face and
brought him back, and then I ateand fed him again and it
happened again.
And so, by day four or five, hewas covered in eczema and
(02:21):
reacting and.
By five months old, we diagnosedhim with 10 life-threatening
food allergies, and we havesince found another seven.
So he has 17 life-threateningfood allergies plus eosinophilic
esophagitis.
In that kind of same period oftime, I developed five adult
onset allergies of my own, whichI had eaten all of those foods
and I love those foods and nolonger can eat.
(02:42):
Five, which is sesame peanut,tree nut, coconut, and,
scallops.
Which is a strange one.
And then I also for a careerhave worked in the healthcare
industry doing training.
So a lot of times,pharmaceutical training, biotech
training, healthcare trainingwith hospitals.
And so I started working withnonprofit organizations to do
(03:04):
some training initiatives, somestrategy work.
And most recently had theprivilege of spending over a
year working on the food allergymanagement in schools expert
recommendations, which was a.
Project from the CDC and theAAP.
amanda-whitehouse--phd_2_08 (03:17):
And that was a group project with a
lot of amazing organizationsinvolved.
So I know very little.
Other than the end result, willyou tell us about that process
and your involvement?
chris-creter--she-her-_1_ (03:28):
Yeah, it was, uh, it was like being on
the Food allergy Dream team thefirst step was to.
Figure out how are we gonna dothis?
We had one year with the grantthat we were given from the CDC
and the a EP.
So we came up with a plan and astrategy for how we were going
to approach this.
And we wanted to assemble a teamof experts that really
understood schools.
So the first step was toassemble the, the dream team, so
(03:50):
to speak.
Dr.
Pistiner, who many people know,Dr.
Michael Pistiner, he agreed tobe our chairperson.
And then we started grabbingpeople who agreed to sign on
from all different realms ofschools.
So for example, we had first,the a EP had a couple of
representatives with BrookeBashan and Dr.
Wang, Julie Wang.
We then had the,, AmericanSchool Health Association
(04:13):
involved, which was AndreaBoudreau.
We had representation from theInstitute of Child Nutrition
with Liz Dixon.
We had the School NutritionAssociation, Susan Matthew.
We then wanted to make sure weencompass school nurses, so the
National Association of SchoolNurses, had Linda Newman join
us.
We then wanted to also make sureadministrators were involved.
(04:34):
So we had, Kayla Jackson fromthe School Superintendent's
Association, and then a bunch ofnonprofits.
'cause they didn't want this.
Even though Fair kind of wastaking the charge, we had fact,
FARE.
Jenna from AAFA, um, and ThomasSilvera from the Elijah-Alavi
Foundation.
And then I certainly cannotforget the attorneys.
(04:56):
So it was Mary Vargas and AmeliaSmith, that both.
out the kind of civil rightsand, and legal standpoint.
It was the dream team, like thethe Food allergy Dream team in
one, one room for two days.
But we worked together over thecourse of the year to come up
with what the recommendationswould be.
amanda-whitehouse--phd_2_0 (05:14):
Were you literally in one room
together?
All of those people met inperson, which is unheard of
these days.
chris-creter--she-her-_1_08- (05:20):
my gosh.
Yeah.
Well, we worked virtually atfirst to kind
amanda-whitehouse--phd_ (05:23):
Mm-hmm.
chris-creter--she-her-_1_08 (05:23):
our thoughts and kind of get us into
categories of topics that wewanted to make sure we
addressed.
'cause this is meant to be anextension of.
The the 2013 CDC guidelines, butthey're not updated.
They're not current based onevidence that we have.
So the idea was we kind of knewsome topics, we drilled it down,
and then eventually, once we gotto the point where we really had
(05:43):
to hash through things, we fleweverybody into DC and we were in
a room for a couple days, andhad some really incredible
dialogue
Amanda Whitehouse, PhD (05:52):
I would've loved to have been a
fly on the wall.
It sounds so interesting.
It's hard to even know where tostart, but I wanna let people
know this is a document that'savailable.
There's a summary at thebeginning, that goes over the
main topic, areas that werecovered, almost like checklist
style.
Where do you wanna start interms of letting people know
what's in here or what thechanges or the most important
updates were?
Chris Creter (06:11):
Yeah.
Well first just, and how to findthis document, it's if you
Google Food Allergy Managementin schools or fams.org, it does
live on the food allergyResearch and education or fair
website.
but you can pull up the wholedocument and you're absolutely
right.
There is a two page summary,that starts around page eight,
and it looks like a checklist,just like you said, and it
(06:32):
organizes the four topic areasand what questions schools might
have.
To answer.
So to just briefly kind of gohigh level, the four topics were
personnel training andeducation.
and the two questions we answerunder that were what information
should schools even include infood allergy training?
(06:53):
And so we addressed that.
The second question was, howshould schools implement food
allergy training?
'cause that's a question thatcame up a lot in our
conversation.
So that was the first topic.
And there are.
I think seven or eightrecommendations under there.
I do wanna point out, this is a25 page document.
It is not the 113 pages of theCDC guidelines.
(07:13):
Our goal was to make thisshorter and consumable and
actionable and it worked.
But anyway, that was the firstpersonnel training and
education.
The second is preventingallergen exposure, which that's
probably the hottest topic todiscuss because there's a little
bit of controversy in how to doprevention'cause it's different
in different realms, differentage groups, et cetera.
(07:35):
And then the third bucket waspreparing for emergencies.
So that's really responding, andwhat protocols and procedures to
put in place.
And then the fourth is aboutcommunication and collaboration
within the school environment.
Amanda Whitehouse, PhD (07:47):
number one is important with the
training and education, but asfar as my audience, most of us
don't have a say in that part ofit, right?
That's up to schooladministrators and.
Personnel.
So maybe we could start withpart number two, which is
preventing exposure, which isalways a hot button topic.
The thing that jumped right outat me is what was the
conversation like around, shouldwe have allergen free classrooms
(08:09):
in schools?
I think that's one of the mostheated topics in our community,
Chris Creter (08:13):
It is.
And So what you probably saw isthat there was not a
recommendation on
Amanda Whitehouse, PhD (08:18):
right.
Chris Creter (08:18):
I was a fly on the wall.
I was not considered on theexpert team.
I was the organizer of theexpert team, so I had to listen
and try not to be biased, whichwas challenging at times.
But it was fascinating becausethe insights that the various
audiences brought.
helped us bring light to why wemight need a recommendation.
So should we have an allergenfree room or an allergen free
(08:42):
school, was a big topic ofconversation and the evidence
that people brought up was,well, from a anaphylaxis
standpoint, there is not reallymuch evidence that having an
allergen free school and by theallergen, what allergen are you
even talking about, right?
Because.
That's a problem, but it's anallergen-free school doesn't
(09:05):
necessarily reduce the rate ofanaphylaxis in schools, there's
considerable evidence to showthat.
Now there's a lot of otherfactors that do need to be
considered, which is emotionalsocial components.
Are there schools that perhapshave people with developmental,
challenges where it's just toochallenging to try to monitor
(09:25):
all the foods and it's justeasier to eliminate it?
these would be isolated inindividualized cases.
And as our fabulous attorneyspointed out, you know, this is
where section five oh fours comein, and this is where there
might be individualized needs tohave allergen-free rooms
airborne, for example.
There might be the case forthat, but we can't make a
(09:45):
overall recommendation.
to have, you know, food freeschools or food free rooms or
no, because really it might notbe what's in the best interest
of our food allergy students todo that.
So it was just fascinating'causeI went in with a very firm
opinion of what I thought wasimportant.
And I have to admit, I really, Ilearned a lot in this process.
Amanda Whitehouse, PhD (10:06):
Well, and it's so tricky.
Depends on, I feel, which hatyou're wearing, because as a
food allergy mom, I'm like, noone should ever have peanuts on
the playground.
But of course then there's a kidsitting next to me with dairy
allergy and I, I, I've got mycoffee in my hand.
You know, so, so we, we havethat perspective.
But then as a psychologist, Ithink how avoid.
Begets more avoidance and fear,and it's good for kids if
(10:29):
there's not a true medical riskto be in proximity and to be
comfortable being near theirallergens and knowing how to
keep themselves safe, which isdifferent for a preschooler than
it is for a senior in highschool.
Chris Creter (10:38):
Exactly.
And that's where, um, I shouldpoint out, these are specific to
K 12.
There was another group workingon preschool, recommendations.
I know Thomas and the ElijahAlavi Foundation is very
instrumental in all of that.
And the
amanda-whitehouse--phd_2_0 (10:52):
Yes.
Chris Creter (10:52):
work going on.
As we saw at some of theconferences we've been to, um,
but this is very specific topublic schools, K through 12,
with the hope that maybe privateschools would use it as well for
the same age groups, but evenwithin K 12 there are some
pretty, significant differencesin expectations at the older
child age groups versus theyounger child age groups.
(11:14):
So we wanted to take that intoaccount as well as we went
through all of theserecommendations.
Amanda Whitehouse, PhD (11:19):
What other parts of that area of the,
guidelines do you think areimportant for us to talk about
the, the preventing exposure.
Chris Creter (11:28):
So there's a few questions that we're trying to
answer.
How should schools identify anddocument food allergies is a big
to topic that came up and whatwe hear is, in some cases,
parents just, they don't wannahave their kids stand out and we
don't wanna.
tell anybody it's just oneallergy and they can manage
this.
This happens a lot in the olderschools, so making sure there's
(11:48):
protocols and open door kind ofwelcoming processes in places in
schools to make sure parentsfeel welcome and it was
important that we don't tellschools exactly what to do as
long as you're following theguidelines.
So for example, how do weidentify and document food
allergies?
'cause there was a lot ofconversation between the nurses
and the school nutrition staff,for example.
(12:10):
The nutrition staff saying,well, I need to know.
So that we can put it in thecomputer system and make sure we
don't accidentally give the kidsome food.
And the nurses are saying, well,I might get this information in,
but what's the system andprocess in place to get that
allergen information to thecafeteria?
Or a kid comes up in line ofcafeteria and says, oh, I can't
have that.
I'm allergic.
(12:30):
And they don't have it in thesystem, and the nurse doesn't
know.
So it's making sure that theycan identify and document and
create a path between.
What are like not usual andtypical lines of communication
within a school system.
'cause the nutrition servicesoften didn't have a reason until
food allergy to really overlap.
So that was just one of theexamples that we say established
(12:52):
standardized procedures foridentifying known food allergies
in students.
what, no matter where you'rehearing that from, have a
procedure in the school.
So again, we don't say how it's,how is up to the school, the
financial impact that this couldhave on some schools.
We were very conscious of Titleone schools that may not have
the resources to put in computersystems and, you know, all of
(13:14):
this.
So we were really, reallycareful not to make,
recommendations that would beimpossible to implement.
Another one was standardizingdocumentation and communication.
Of the known food allergies.
That's different thanestablishing the procedure for
identifying known foodallergies.
So it's funny'cause we wouldstart talking and realize we
were almost arguing about twoseparate things and it would
(13:35):
split the recommendation intotwo.
We also had a lot ofconversation around 504's and
the utility and the need for504's.
And what we kind of came to,well first 5 0 4 is the only
legally.
document that anybody has tosupport the accommodations
(13:58):
required for their disability,food allergy being a disability.
And what I found interesting wasthe, the fear of the 5 0 4 from
a staffing standpoint at theschools, or they don't really
need it, or, you know, the, theconversation was just absolutely
fascinating about 504's ingeneral.
And what we kind of came to waswe need to make sure people are
(14:20):
aware of.
The 504 process and what theneeds are of students, if you
have solid procedures andpolicies in place, then many
students might not even need the5 0 4 because theoretically, the
school will have theaccommodations baked into their
policies and procedures Now.
Most schools we know don't havethat level of policy and
(14:42):
procedure or the investment intime in the policies and
procedures to allow for that,which then results in the need
for a 504 to protect thestudent.
So there is a whole section ondefining.
The difference between an AAEP,you know, our allergy and
anaphylaxis emergency plan,which comes from our healthcare
provider, which theoreticallygoes to a nurse.
(15:03):
If the school has a nurse, thatbecomes an IHP, which is
individualized healthcare plan.
And then if we need furtheraccommodations, there may be a
request for a 504 plan, which isthat.
You know, the legally allowableright of anybody with a
disability to establish whataccommodations are necessary in
(15:23):
order to keep that student safeand able to learn in the school
environment.
So this is very carefully laidout and detailed.
'cause what we have found is alot of people were misusing or
misunderstanding that processand that cascade,
Amanda Whitehouse, PhD (15:36):
Parents get overwhelmed and confused.
There's also then an IEP, whichwould be used for a child who
also then is identified with alearning need or a learning
disability, and then the.
Accommodations can be loopedinto that as well,
Chris Creter (15:47):
Yes.
Amanda Whitehouse, PhD (15:48):
it's overwhelming for parents to
understand the difference.
Chris Creter (15:50):
overwhelming.
All these things.
Absolutely, and you're right,the IEP is listed there too, but
typically the disability doesn'tnecessitate the IEP, but an IEP
may incorporate.
The food allergy disability and5 0 4 accommodations.
So yes, again, another areawhere I learned a lot, a lot,
um, especially from Amelia andMary Vargas on the, you know,
(16:10):
their perspectives on all ofthis.
It was really found fascinating.
Amanda Whitehouse, PhD (16:15):
For the audience, there's a really nice
chart inside of the documentthat explains these, and I think
for any parent sending a kid offto school, it's very helpful to
know the differences betweenthese so that when you're having
a conversation with the school,you, they are used to using this
language all the time, andhopefully they're explaining it.
But
Chris Creter (16:31):
Yeah.
Amanda Whitehouse, PhD (16:31):
they're, you know, throwing out all of
these acronyms and you don'tknow what they mean, it's a
really great chart to have infront of you to help you
distinguish between thedifferences of what they're
talking about.
Chris Creter (16:40):
absolutely.
I, I, truthfully, just to myhumble, you know, lack of
knowledge when I was on this, Ididn't even know what an IHP
was.
didn't know that step evenhappened in a school.
And I've been doing this for 14years with my son.
So it was just that knowledge.
That's why I keep tellingeverybody just read this
document'cause it's so conciselysummarizes what we need.
(17:01):
Uh, the next chapter after thisin the document is all about
school nutrition.
about another area where Ilearned so much.
I just, just got back fromspeaking about FAMs at, the
School Nutrition AssociationConference in San Antonio.
And it was great'cause peopleare so eager to learn about this
and what we do about it, I thinkwe don't appreciate how much
(17:24):
goes into the school nutritionand the nuances and following
USDA code and.
school code, let alonedisability requirements.
And so this is where I think alot of these recommendations
were really helpful.
And then at the school nutritionconference, people just flooded
the room.
They wanted to stay late, theywanted to ask more questions.
(17:45):
So they, they are eager, like alot of the school lunch programs
and, you know, services thatare, are conglomerates that are
around the country are eagerlyand really actively trying to
incorporate food allergyinformation in there.
Point of sale digital servicesand ingredient listing
opportunities.
So what FAM says is to make surethat we kind of structure our
(18:08):
school nutrition services insome way, knowing that this can
be a huge undertaking,especially for really large
districts, to make sure wecreate these child nutrition
programs and allow students, nomatter, if they're on a free
lunch program or if they're in arural area where it's hard to
access some allergy safe foods.
We still are required by law todo that in most cases.
Amanda Whitehouse, PhD (18:31):
My audience is, is parents, a lot
of parents and families.
So from their perspective, whatshould they know about that
part?
Chris Creter (18:36):
I think what's really important for families to
know from a school nutritionstandpoint is that there's a lot
more in play than just the foodallergy itself.
Making sure that you work withthe nurse, but you have to point
blank, say to the nurse, I needto have this communicated.
With the school nutrition staff,who can I meet with Don't assume
the nurse can translateeverything to school nutrition
(18:58):
services because like I said,there's USDA and guidelines that
school nutrition has to abide bycertain foods, and food types
have to be on a plate that goesto any student, and they have to
find that balance of differenttypes of nutrition.
For every single student,regardless of the the allergy
needs.
So maintaining what they callmedical statements, um, from a
(19:21):
state licensed healthcareprofessional, and that state li
medical statement is to requirethe alternative food and often
to give suggestions onalternative foods.
Now what happens is you go toyour allergist, you say, I need
a medical statement.
The allergist doesn't know everybrand of food that's out there
and for a long time.
A state licensed healthcareprofessional was only like a
(19:43):
prescribing physician or anurse, but now they've actually
just recently the USDA changedtheir guidelines where they can
actually have a state licensednutritionist, uh, be that person
to write the food modificationstatements requirements.
The reason the nutrition peopleneed this medical statement is
for reimbursement purposes, theywill not get reimbursed by the
(20:06):
state.
if they don't have the correctdocumentation.
So this is where for families,they're not just trying to be a
pain in your neck and make yougo through the rigmarole, it's
because they have to make surethat they follow the rules, they
get audited, they have to makesure they get refunded,
especially for the excessivecosts for a lot of the foods for
that some of our food allergykids need.
(20:28):
So this was an area that I havesuch respect for school
nutrition professionals and whatthey're doing.
And then just the level of carethat goes into the detail you're
trying to feed In some of theseschools I learned about, I mean
you're talking thousands of kidsare coming through in minutes,
you know, across some states,and to be able to pause and
(20:50):
safely make sure you provide.
School meals for this nuancedcommunity is exceptionally hard.
And you think about people whosign up to be a lunch person,
didn't necessarily sign up tosave people's lives every day or
to prevent children from, youknow, a severe allergic
reaction.
So it's making sure we do theproper training and allow the
(21:14):
funding for the time for thosestaff to be trained.
This document just says,basically ensure that students
with food allergies asdetermined by that state
licensed healthcareprofessional, have full and
equal access to foods offered bythe school nutrition program.
And so the training goes intothat and a lot of other things.
Um, the other thing for allfamilies that.
(21:35):
Is a lot harder than I everrealized, which is the
publication of meal plans andcalendars.
Um, so one of the, therecommendation 2.5 to be exact,
uh, is to publish weekly ormonthly school menus.
And that way parents can look atthe menu in advance and decide,
is this safe for my kid?
(21:55):
Do I need to call and find outif there's an alternative or
make arrangements or send my ownfood in?
Um, and they can have enoughnotice to do that.
Some of the challenges that comein are school supply issues.
The delivery of the chickennuggets didn't come in and now
we have to bob and weave andfind a new meal.
(22:15):
And uh, now I have to call thisparent and I, so with that comes
a lot.
And what do you put on the menu?
Is it all ingredient lists?
Are we talking aboutprecautionary labeling?
So just putting, well, all wesaid is just publish a weekly or
monthly menu.
Like just start with that andthen come up with policies and
procedures for when thoseadjustments occur and what you
(22:37):
have to do.
And that may vary from districtto district, depending on who
they've subcontracted the, um,the food services too, if they
have.
And then what they, weabsolutely were firm about was
maintaining a current food labellibrary.
no matter what, it's 25% of allin-school.
Anaphylactic reactions are firsttime reactions, so what we said
(23:00):
is if that is a first timereaction, we have to be able to
go back 24 to 48 hours and seeeverything that that child ate
to try to dissect and learn.
What could have been the culpritfor that anaphylactic reaction.
So that's that recommendation tome.
We all, that was a no brainer.
Everybody was like, yes, thatneeds to be in for sure.
Um, but you know, it's not easyto do for, from a school
(23:25):
nutrition standpoint.
So, know, I, I encourageeverybody, if you're involved in
school nutrition or if you canread this document, there's so
much fine print between theserecommendations that kind of
give you some.
Understanding of how this isn'tjust so easy to publish a menu.
Um, I, I hope that people cankind of have that new respect
and create that communicationand collaboration with, these
(23:48):
folks in the, in the cafeteriaand the school nurse and
everybody else.
Amanda Whitehouse, PhD (23:52):
Yes.
I know how hard it is to run ahousehold and feed three boys
three times a day.
I cannot imagine.
Organizationally, all of thechallenges that you're
presenting, how much goes intoit, how much coordination, so
there's so much appreciation,that can come from understanding
that why isn't it just so easyto just gimme a menu?
Yeah.
Chris Creter (24:12):
So I, I worked with my school district to
change, just to take a quickside story my son and I both sat
on the wellness committee many,many years ago.
So he was young.
I mean, he was probably eightyears old and we're on this
board of education wellnesscommittee.
'cause we wanted to try to putsome rules in place about like
class parties.
And there were so many timeswhere my son had to leave the
(24:32):
room.
He never could participate.
We always had his.
Stash of treats, you know, forwhatever.
But inevitably somebody showedup with some, you know, oh, it's
a rainy Wednesday.
So I brought in cupcakes.
I mean, it was a free for all.
They'd eat Doritos in thecomputer room.
Um, and so we started to say,can we just put some policy
around this and limit the amountof food that is involved in
(24:53):
school in a regular basis?
So my little son sat in thewellness committee and we talked
about policy and we were reallyworking on it.
Then he went into anaphylaxisschool and we're pretty sure
it's from the computer roomwhere they would let the
afterschool kids eat, freely,and of course at that point we
went into overdrive and we wereable to change the
recommendations, but we had no.
(25:15):
Framework.
We had no guidepost or expertrecommendations like this to put
these rules in place.
So we went to other schools, wewent to more conservative school
policies, and we went to lessconservative school policies,
and we crafted our own.
This document will help the nextsection, which is called How Can
Schools Prevent Food AllergyExposure?
This, to me, is the biggestthing for parents that they can
(25:38):
take this document and literallygo through this like a checklist
and say, this is what the expertrecommendations from the CDC and
the A A P say is the best thingto keep students from having
exposure to allergens at school.
And the first one is, whenpossible discourage eating in
classrooms.
Now we also know that in a lotof schools there are no
(25:58):
cafeterias, so that is, it'simpossible to say we can't
always eat in classrooms, so wefinished that recommendation
with if eating in classrooms isnecessary, designate an area for
eating that is separate from thelearning spaces, especially
younger children to prevent thatcross contact.
So that was the first big, bigone.
(26:19):
And we put in some bestpractices for how to do that
within the document.
So you can read that.
The second recommendation thatcame right on its heels, and
this was one of those that wewere kind of battling and then
it separated out was wash handsbefore and after preparing,
serving, or eating meals orsnacks so that we can avoid
food.
Allergen cross contact.
And this includes surfaces.
(26:40):
So two 2.10 is about hands.
2.11 is about surfaces.
So those three together arediscouraging in classrooms.
But if you have to wash handsand wash surfaces what those
three recommendations togethersay, and we did make a big call
out that hand sanitizer andsanitizing sprays on tables is
not effective.
(27:01):
It is ineffective at removingfood proteins and to make sure
that no one does that with acitation.
So, so you can use that withyour schools when they're
saying, oh, we can do.
Parties and snacks andeverything else.
Amanda Whitehouse, PhD (27:15):
Yeah.
And I, as a psychologist, Ijust, this is one of the things
that I find the most often, um,that surprises the adults in
kids' lives in terms of how muchtime kids spend the same way we
do as allergy moms, you and I,when they're supposed to be
learning a really hard new mathconcept or learning how to read,
and all their thinking is, likeyou said, they had Doritos.
It's on their, their hands.
(27:36):
I can smell it.
You would be shocked at theamount of time that kids explain
to me that, that that's allthat's in their head when
they're at school.
And then we expect them to belearning.
It's not just, it is obviouslyfirst and foremost about their
safety, but it's, they're atschool to learn
chris-creter--she-her-_1_0 (27:50):
Yes.
amanda-whitehouse--phd_2_ (27:51):
can't learn when that's their mindset
and, and when they're in thatpanic or fear or hypervigilant
state.
chris-creter--she-h (27:58):
Absolutely.
Absolutely.
We have since put policy inplace and we're currently
updating it for these, these newrecommendations in my town.
But I sat at a parent night, itwas at the end of the last
school year, and I went into anelementary school classroom
where they had this meeting, andthis was for like a specific
learning environment thing thatmy son's in and.
(28:19):
All parents from all differentage groups are in there, and
one, it, it's food free.
Now our, our building classroomsare now all food free at the
elementary level.
We're working on it at the otherones, but they, one mom pulls
out a bottle of water, a bag ofnuts, literally a bag of
almonds.
I'm allergic almonds, and all Icould do is sit there and stare
(28:40):
at her.
I have no idea what this meetingwas about because then all I'm
sitting there, I'm thinking.
Oh my gosh.
I, I, I can't shake her hand.
Oh.
And I better make sure I stayafter and I have wipes in my
purse and I can give them to theteacher to make sure we wipe the
desk off so a kid doesn't comein tomorrow and eat it.
I spent my whole time thinking,and exactly what you just said,
I was thinking.
Wow.
Like these kids do this.
(29:01):
You know, these little tiny kidswhose brains can't even really
get around much else other thanI know this is unsafe for me.
They just need to be learning.
Every single kid just needs tobe learning.
That's it.
amanda-whitehouse--phd_2_0 (29:12):
Yes.
chris-creter--she-her-_1_ (29:13):
that, and.
amanda-whitehouse--phd_2_08- (29:14):
Oh my gosh.
Yeah.
Yeah.
And they, they're so little.
They don't even know what it isin there.
They just know that they feelafraid.
It's, you know, it could take anhour long therapy session for a
kid to actually have the help toput that into words, what you
and I, as adults can articulateso easily.
My heart, goes out to thoselittle kiddos that are carrying
this through school
Chris Creter (29:32):
I
Amanda Whitehouse, PhD (29:33):
all and everywhere they go.
Chris Creter (29:34):
then not isolate them either.
So like some of these nextrecommendations were things like
discourage sharing of food itemsamong students, not
Amanda Whitehouse, PhD (29:42):
Right.
Chris Creter (29:42):
the allergy kid.
They'll be like, okay, you guyscan all share Lollipop, but this
kid can't, like, don't give itto this kid.
Just recently we had an incidentwhere.
The, there was a team eating, Iguess they eat lunch together in
the high school and a person inthe school, like a teacher
walked into the room and said,oh, you guys can't do this next
(30:03):
year.
'cause the, the, we have thisallergy kid coming up and it's
that moment of like, the allergykid shouldn't create this wave
of change if we have the rightpolicies and procedures in
place.
Across all of our schools, thenwe're not isolating any one kid
because of their specific needs.
But I think discouraging sharingof food items, that's one.
(30:24):
This one was huge.
Encouraging the use of non-foodstudent incentives and rewards
in classroom celebration.
So this was, you don't hand outlollipops because everybody got
above the 90 on the test.
You don't, uh, I had a teacherthat would take the juices that
the kids didn't want from theirlunches, and then she froze them
with Popsicle sticks in them andthen handed them out to the kids
(30:45):
thinking, well, it's a schoollunch.
Like I can give school lunchitems out.
And eventually had tocommunicate that.
First of all, you're setting aprecedent.
Second of all, it could bepotentially dangerous.
You don't know if one of thosekids is or is not allergic to
that type of.
or juice or whatever it is.
And so this is where theeducation, again, is gonna fuel
(31:05):
that.
But stop with the food rewards.
Give them exciting experiences.
I'm sure you've heard of plentyof fun things to do at school
that does not involve a cupcake.
Amanda Whitehouse, (31:15):
Absolutely.
Before we started recording, youwere talking about the episode
that I had done with SarahHoring.
She's a friend of mine and anadministrator in the schools and
the district that I live in.
And this was a huge, thing thatshe, was trying to get across in
the schools There's so many funways to celebrate and honor and
connect and enjoy things withkids as humans.
I think we need to learn todisconnect that.
With from food.
(31:36):
Food can be joy and pleasureand, and all of those things,
but it shouldn't be the onlysource of it for a lot of
reasons that just do reality.
Chris Creter (31:44):
that that episode was fantastic.
She was
Amanda Whitehouse, PhD (31:46):
She's great.
Chris Creter (31:47):
and I completely agree.
I've seen it done where peoplemake a creative thing.
So since our policy took place,they asked whatever non-food
type celebration could think of,and someone's grandmother came
in who was in the military andused Morse code.
And so she came in and taughtMorse code to all these kids.
They talked about this for thewhole year.
(32:08):
Just because it was a uniquedifferent experience for her
granddaughter's birthday, youknow, and extra recess is very
popular for the birthday andthings like that, mystery
readers.
And you don't need the cupcake.
You just
Amanda Whitehouse, PhD (32:22):
agreed.
Agreed.
Anything that fostersconnection.
That's the point of it, right?
Chris Creter (32:26):
yeah,
Amanda Whitehouse, PhD (32:27):
I think that's, that's so much more
important.
Chris Creter (32:29):
What's scarier though is when it doesn't happen
in, when it, when that sameissue with exclusion happens in
the academic setting.
And so 2.15 says, ensurestudents with food allergies can
fully participate by evaluatingschool materials, activities.
Projects for potential foodallergens and make those
adjustments accordingly.
(32:49):
So we give examples of, youknow, you can't have Play-Doh if
you have a kid with a weeallergy or unless you have Safe
Play-Doh.
And is it safe Play-Doh foreveryone or is it just the food
allergy student?
Um, you know, you talk, thinkabout the egg drop and the, milk
cartons and the bird seed
Amanda Whitehouse, PhD (33:06):
Oh, and the Halloween.
Squish our hands into mysteryfoods and pretend they're scary
Chris Creter (33:11):
Sensory tables.
Yeah, it's a relativelyabbreviated document compared to
what had been there before.
And there's hyperlinks.
To ideas.
KFA kids with food allergies,which is through AAFA, they have
a link in there to like greatideas.
I know FAACT has some and fairhas some as well.
To get ideas for what you can doin your classrooms, even in the
(33:31):
curriculum.
And this even happens in highschool.
The medium in science classes,the, if you were dissecting, if
you have a child with Alpha Gsyndrome, they can't do the pig,
you know, they can't dissect thepig.
So we really have to thinkabout.
How much influence this can havein different settings.
Amanda Whitehouse, P (33:49):
Definitely there.
There's so much here but let'stouch on the third section,
preparing for emergencies.
Chris Creter (33:54):
Sure.
I'll have to say the preparingfor emergency section was
probably one of the easiest
Amanda Whitehouse, PhD (33:58):
Mm-hmm.
Chris Creter (33:59):
really aligned on, easiest to agree on, I should
say.
Amanda Whitehouse, PhD (34:02):
Sure.
Great.
Because we need, everyone needstheir epinephrine, right?
Bottom line.
Chris Creter (34:06):
Exactly, and so really it, you know, the, the
first bit was just aboutprotocols and procedures and
having an a a P in place and whoknows about the A A P, the
allergy and asthma emergencyplan.
Is it good enough if it's in thenurse's office?
Probably not, because theteachers need to know.
So all the right people thatneed to know and making sure
(34:28):
that you don't.
HIPAA at the same time.
So we did have a lot of dialogueabout that.
Um, but really it's up to just,it's about maintaining those
aeps year over year and makingsure that your IHP, which is the
internal document at the schoolthat's educating the school
nutrition and the gym teacherand everybody else on what to do
(34:49):
is updated.
And the 504 plan accommodationsare also communicated.
So that is really thatintersection that needs to
happen at a school.
It's not just about having it onfile, it's about making sure the
accommodations are made and thatthe child isn't ostracized for
having those accommodations,really the best practices around
epinephrine was some of themost.
(35:10):
Engaging, dialogue, and that'sreally around unassigned
epinephrine or we know as stockepinephrine, maintaining a
constant supply.
And that's hard because we knowthat there's been gaps in the
available resources.
For ordering it, but what we sawwas a bigger problem was
actually who's responsible forit.
So making sure that you have aperson assigned, that you have
(35:33):
it on the calendar when you haveto update it, that you know when
the expiration dates are of thatepinephrine.
your state allowed to use alldifferent types of epinephrine?
Because now that we have nasalepinephrine and we're soon to
have sublingual epinephrine,does your state even allow you
to have that as unassignedepinephrine?
So I know for me in my state ofcourse,'cause I am who I am, I
(35:55):
went to my representative and.
worked and just finally thismonth now have, different forms
of stock epinephrine availablefor our schools.
But that is not the case in thewhole country right now.
So it's not so easy.
There are some links embedded,that you can access to get free
stock epinephrine or unassignedepinephrine in schools, but
making sure you have thoseprocedures in place so that
(36:17):
it's.
don't have expired epinephrineon the wall is so, so important.
and then allowing students whoare deemed ready by their
caregivers and healthcareproviders to self-care or self
administer.
We've heard so many storieswhere they were told they can't
or they're not allowed to.
So this is where ourrecommendation, and this may
mean we have to make some statedistrict policy changes in order
(36:39):
to allow this.
And I think that's the biggestthing to know is your state may
just not allow some of theserecommendations to happen yet.
So.
Sometimes we might have to go tothe state level or the, you
know, state Board of educationto, to fix some of this.
But our recommendation is thatif a student is deemed
acceptable to self-care by theirhealthcare professional, then
they should be able to self-careor self administer.
(37:00):
And that's just for accessreasons.
'cause we found too manydistricts where it's still a, a
rule to lock.
The epinephrine up.
And so that was number 3.5 isthe next one that said store
unassigned and assignedepinephrine in secure areas that
are unlocked and easilyaccessible by staff.
(37:21):
that was because we've justheard so many stories, so, so
many stories of people thatcan't access their own
epinephrine'cause of the rulesof the school.
So hopefully this can helpchange some of that state policy
or the district policy that doesstill require the lockup of the
epinephrine, which I still justdon't understand
Amanda Whitehouse, PhD (37:43):
Right,
Chris Creter (37:43):
that.
Amanda Whitehouse, PhD (37:43):
right.
And for right, because we hear,the stories that I hear are that
it was locked in the nurse'sroom.
It took someone 10 minutes orthe nurse wasn't in the building
and that's.
That's terrifying if that's whatyour school is telling you, it,
it's, we have so much moreconfidence going to the district
with a document like this in ourhands, explaining, sharing
references, you know, it can, itcan help us to communicate what
we know to have this behind us.
Chris Creter (38:05):
Yeah, and The big thing for me now with this tool,
the tool's, great.
Right?
This, this document, this iscomprehensive.
It's, I mean, it has links tofree training programs.
There's nothing in here that youcannot not implement, right?
All the training, just click thelink, give it to your school.
They can do it for free.
It's all in here.
The problem is coordinating allthe resources,
Amanda Whitehouse, PhD (38:28):
Mm-hmm.
Chris Creter (38:29):
the nurse, the administrators, the time it
takes to do policy.
Obviously, food allergy is notthe top of mind for a school
administrator.
Everybody's under budgetconstraints now.
Funding is, you know, going awayfrom.
Different sources.
So people get worried.
They're not focused on this.
So really what it takes is usparents to bring this to the
(38:49):
attention of a school board or aa school and to say, can we put
procedures in place?
And if we don't have a policy,you can still put procedures in
place to make some of this stuffhappen.
And starting with your ownprincipal and your own school
nurse, and create a littlecollaborative team and try to
say, oh, here, we can make this.
Together.
And I think that's the impetusand the effort that this is
(39:11):
gonna require is grassrootspeople taking this and actually
doing something with it nowbecause it is not a requirement
that people follow theserecommendations.
I wish it was, but right nowit's gonna take us getting this
out there and helping schoolsmake the necessary changes to
keep these almost 6 million kidswith food allergies across the
(39:32):
United States safe.
Amanda Whitehouse, PhD (39:33):
It's a great point that you make and so
we all can be inspired to use itand to, advocate and collaborate
and connect with the peoplethat, we need to in order to
enact what we know is based onall of the evidence and research
and best practices and the mindsof all, all of the people in the
allergy world who are ourleading experts.
So I wanna thank you for thetime you put into this, all of
(39:56):
those amazing people andorganizations, because we do
feel overwhelmed as parents andfamilies in something like this.
Brings so much clarity and somuch confidence in, in what to
how to approach certain thingsthat we don't know what to do
about.
Chris Creter (40:10):
Well, thank you for allowing me to help get it
out there and if anybody wantsto reach out and.
Ask me for more answers if Ihave them, or ways I can point
you.
I'm more than happy to help out.
But I think the more schools,the more districts that can
start to embrace this we'll justkeep our kids safer until we
have a cure for this, this thingthat we're all dealing with.
Amanda Whitehouse, PhD (40:30):
Yes.
Yes.
amanda-whitehouse--phd_2_ (40:31):
Thank you.
I appreciate you taking the timeto chat and explain this to us
in such a great way that helpsmake it, something that we feel
like we can grasp.
Because the concept is big, butthe document and the way you're
explaining it are verydigestible.
Of
Chris Creter (40:42):
you.
Thanks for having me.
Amanda Whitehouse, PhD (40:44):
course.
I hope that today's conversationgave you some clarity and some
confidence about the steps thatschools can and should be taking
to protect children with foodallergies.
How to consider what might bethe most helpful for your child
and maybe some ideas forcommunicating and collaborating
with your school if you feellike there's some work to be
done in that area.
These recommendations are agreat tool to help you think
(41:07):
through what a safe andinclusive learning environment
looks like for your child.
So here's some action steps tohelp you follow through on what
we chatted about today.
Number one, find therecommendations.
They're easy to find if you justdo a search for food allergy
management in schools.
They're housed on the FAREwebsite, food allergy.org, and
I'll put the link in the shownotes Number two.
(41:29):
Sit down and carefully consideryour child's accommodations.
Get out their paperwork.
Look at the plan.
Some of you may have just satdown with the team and
reevaluated this, renewed yourpaperwork.
Some of you, it may have beenquite a while since you had a
meeting to discuss this, so I'dencourage you to get it out,
look through it, think about.
What parts of your child's dayseem to be going well, where
(41:52):
there might have been somedifficulties in the past, and if
there are areas where you oryour child don't feel so sure
about how things are managed,number three, if you've missed
it, this would be a great timeto go back and catch episode 11
of the show.
It's called From Home to theHallways with Sarah Horning.
She is a wonderful friend ofmine and an amazing school
administrator, and herdiscussion about how she
influenced change in the schooldistrict that we live in is also
(42:14):
a very positive and encouragingchat about similar topics that
we discussed today.
By working together with ourschools and communities, we can
help to protect kids with foodallergies and make them feel
supported and free to focus ontheir learning.
Thanks for tuning in.
If you enjoyed the show, I wouldvery much appreciate a rating or
a review.
And if you would share this withanyone else who might enjoy
(42:35):
listening, Here's to a safe andconfident start to the school
year.
the content of this podcast isfor informational and
educational purposes only, andis not a substitute for
professional medical or mentalhealth advice, diagnosis, or
treatment.
If you have any questions aboutyour own medical experience or
mental health needs, pleaseconsult a professional.
I'm Dr.
Amanda Whitehouse.
(42:55):
Thanks for joining me.
And until we chat again,remember don't feed the fear.
Welcome to the Don't Feed the Fear podcast, where we
dive into the complex world offood allergy anxiety.
I'm your host, Dr.
Amanda Whitehouse, food allergyanxiety psychologist and food
allergy mom.
Whether you're dealing withallergies yourself or supporting
someone who is, join us for anempathetic and informative
journey toward food allergy calmand confidence..
(00:22):
Back to school season is uponus.
Some of you are already back andsome of us here where I live are
getting ready to head back afterLabor Day.
Whatever your connection to foodallergies is, you know how much
planning this involves.
So I sat down with ChristineCreter, who is one of many
amazing contributors behindsomething that was released last
year, the Food AllergyManagement in Schools, expert
(00:44):
recommendations for GradesKindergarten through 12.
Christine is the founder of thegroup of business combining
creative design and contentdevelopment for live and digital
learning programs.
And Christine is connected tothe food allergy world because
she and her son managelife-threatening food allergies.
She was involved in managing andcoordinating this project, which
(01:04):
pulled together an advisorycouncil of some of our top
experts and leadingorganizations in food allergy
management to consider andupdate our recommendations about
how to keep our children as safeas possible in schools.
Christine, or Chris, as she goesby, is here to talk about how
these were developed.
Unpack what they mean and tohelp us understand how schools
(01:25):
can put them into practice andwhat parents can do to
collaborate with the schools tomake sure that their child is
set up for a safe and successfulschool year.
So as you're thinking about yourchild and what that will mean
for the year ahead, I hope thatthis conversation will give you
some helpful information and itcertainly will lead you to a
really great resource to helpyou do that.
Amanda Whitehouse, PhD (01:45):
Thank you so much for joining me,
Chris.
I'm excited to have you here onthe show to talk about the food
allergy management in schoolsguidelines that you were a big
part of.
Chris Creter (01:52):
Thanks.
Happy to be here.
amanda-whitehouse--phd_2_ (01:54):
Let's get started by introducing you a
little bit.
What's your involvement withfood allergy personally and
professionally?
chris-creter--she-her-_1_ (02:00):
Sure, I'll start personally.
So, almost 15 years ago I had mylittle boy, my one and only, and
the first time I nursed him, hislittle face swelled up and we
didn't really know why at first.
And so we.
They took him into the nurseryand they checked his face and
brought him back, and then I ateand fed him again and it
happened again.
And so, by day four or five, hewas covered in eczema and
(02:21):
reacting and.
By five months old, we diagnosedhim with 10 life-threatening
food allergies, and we havesince found another seven.
So he has 17 life-threateningfood allergies plus eosinophilic
esophagitis.
In that kind of same period oftime, I developed five adult
onset allergies of my own, whichI had eaten all of those foods
and I love those foods and nolonger can eat.
(02:42):
Five, which is sesame peanut,tree nut, coconut, and,
scallops.
Which is a strange one.
And then I also for a careerhave worked in the healthcare
industry doing training.
So a lot of times,pharmaceutical training, biotech
training, healthcare trainingwith hospitals.
And so I started working withnonprofit organizations to do
(03:04):
some training initiatives, somestrategy work.
And most recently had theprivilege of spending over a
year working on the food allergymanagement in schools expert
recommendations, which was a.
Project from the CDC and theAAP.
amanda-whitehouse--phd_2_08 (03:17):
And that was a group project with a
lot of amazing organizationsinvolved.
So I know very little.
Other than the end result, willyou tell us about that process
and your involvement?
chris-creter--she-her-_1_ (03:28):
Yeah, it was, uh, it was like being on
the Food allergy Dream team thefirst step was to.
Figure out how are we gonna dothis?
We had one year with the grantthat we were given from the CDC
and the a EP.
So we came up with a plan and astrategy for how we were going
to approach this.
And we wanted to assemble a teamof experts that really
understood schools.
So the first step was toassemble the, the dream team, so
(03:50):
to speak.
Dr.
Pistiner, who many people know,Dr.
Michael Pistiner, he agreed tobe our chairperson.
And then we started grabbingpeople who agreed to sign on
from all different realms ofschools.
So for example, we had first,the a EP had a couple of
representatives with BrookeBashan and Dr.
Wang, Julie Wang.
We then had the,, AmericanSchool Health Association
(04:13):
involved, which was AndreaBoudreau.
We had representation from theInstitute of Child Nutrition
with Liz Dixon.
We had the School NutritionAssociation, Susan Matthew.
We then wanted to make sure weencompass school nurses, so the
National Association of SchoolNurses, had Linda Newman join
us.
We then wanted to also make sureadministrators were involved.
(04:34):
So we had, Kayla Jackson fromthe School Superintendent's
Association, and then a bunch ofnonprofits.
'cause they didn't want this.
Even though Fair kind of wastaking the charge, we had fact,
FARE.
Jenna from AAFA, um, and ThomasSilvera from the Elijah-Alavi
Foundation.
And then I certainly cannotforget the attorneys.
(04:56):
So it was Mary Vargas and AmeliaSmith, that both.
out the kind of civil rightsand, and legal standpoint.
It was the dream team, like thethe Food allergy Dream team in
one, one room for two days.
But we worked together over thecourse of the year to come up
with what the recommendationswould be.
amanda-whitehouse--phd_2_0 (05:14):
Were you literally in one room
together?
All of those people met inperson, which is unheard of
these days.
chris-creter--she-her-_1_08- (05:20):
my gosh.
Yeah.
Well, we worked virtually atfirst to kind
amanda-whitehouse--phd_ (05:23):
Mm-hmm.
chris-creter--she-her-_1_08 (05:23):
our thoughts and kind of get us into
categories of topics that wewanted to make sure we
addressed.
'cause this is meant to be anextension of.
The the 2013 CDC guidelines, butthey're not updated.
They're not current based onevidence that we have.
So the idea was we kind of knewsome topics, we drilled it down,
and then eventually, once we gotto the point where we really had
(05:43):
to hash through things, we fleweverybody into DC and we were in
a room for a couple days, andhad some really incredible
dialogue
Amanda Whitehouse, PhD (05:52):
I would've loved to have been a
fly on the wall.
It sounds so interesting.
It's hard to even know where tostart, but I wanna let people
know this is a document that'savailable.
There's a summary at thebeginning, that goes over the
main topic, areas that werecovered, almost like checklist
style.
Where do you wanna start interms of letting people know
what's in here or what thechanges or the most important
updates were?
Chris Creter (06:11):
Yeah.
Well first just, and how to findthis document, it's if you
Google Food Allergy Managementin schools or fams.org, it does
live on the food allergyResearch and education or fair
website.
but you can pull up the wholedocument and you're absolutely
right.
There is a two page summary,that starts around page eight,
and it looks like a checklist,just like you said, and it
(06:32):
organizes the four topic areasand what questions schools might
have.
To answer.
So to just briefly kind of gohigh level, the four topics were
personnel training andeducation.
and the two questions we answerunder that were what information
should schools even include infood allergy training?
(06:53):
And so we addressed that.
The second question was, howshould schools implement food
allergy training?
'cause that's a question thatcame up a lot in our
conversation.
So that was the first topic.
And there are.
I think seven or eightrecommendations under there.
I do wanna point out, this is a25 page document.
It is not the 113 pages of theCDC guidelines.
(07:13):
Our goal was to make thisshorter and consumable and
actionable and it worked.
But anyway, that was the firstpersonnel training and
education.
The second is preventingallergen exposure, which that's
probably the hottest topic todiscuss because there's a little
bit of controversy in how to doprevention'cause it's different
in different realms, differentage groups, et cetera.
(07:35):
And then the third bucket waspreparing for emergencies.
So that's really responding, andwhat protocols and procedures to
put in place.
And then the fourth is aboutcommunication and collaboration
within the school environment.
Amanda Whitehouse, PhD (07:47):
number one is important with the
training and education, but asfar as my audience, most of us
don't have a say in that part ofit, right?
That's up to schooladministrators and.
Personnel.
So maybe we could start withpart number two, which is
preventing exposure, which isalways a hot button topic.
The thing that jumped right outat me is what was the
conversation like around, shouldwe have allergen free classrooms
(08:09):
in schools?
I think that's one of the mostheated topics in our community,
Chris Creter (08:13):
It is.
And So what you probably saw isthat there was not a
recommendation on
Amanda Whitehouse, PhD (08:18):
right.
Chris Creter (08:18):
I was a fly on the wall.
I was not considered on theexpert team.
I was the organizer of theexpert team, so I had to listen
and try not to be biased, whichwas challenging at times.
But it was fascinating becausethe insights that the various
audiences brought.
helped us bring light to why wemight need a recommendation.
So should we have an allergenfree room or an allergen free
(08:42):
school, was a big topic ofconversation and the evidence
that people brought up was,well, from a anaphylaxis
standpoint, there is not reallymuch evidence that having an
allergen free school and by theallergen, what allergen are you
even talking about, right?
Because.
That's a problem, but it's anallergen-free school doesn't
(09:05):
necessarily reduce the rate ofanaphylaxis in schools, there's
considerable evidence to showthat.
Now there's a lot of otherfactors that do need to be
considered, which is emotionalsocial components.
Are there schools that perhapshave people with developmental,
challenges where it's just toochallenging to try to monitor
(09:25):
all the foods and it's justeasier to eliminate it?
these would be isolated inindividualized cases.
And as our fabulous attorneyspointed out, you know, this is
where section five oh fours comein, and this is where there
might be individualized needs tohave allergen-free rooms
airborne, for example.
There might be the case forthat, but we can't make a
(09:45):
overall recommendation.
to have, you know, food freeschools or food free rooms or
no, because really it might notbe what's in the best interest
of our food allergy students todo that.
So it was just fascinating'causeI went in with a very firm
opinion of what I thought wasimportant.
And I have to admit, I really, Ilearned a lot in this process.
Amanda Whitehouse, PhD (10:06):
Well, and it's so tricky.
Depends on, I feel, which hatyou're wearing, because as a
food allergy mom, I'm like, noone should ever have peanuts on
the playground.
But of course then there's a kidsitting next to me with dairy
allergy and I, I, I've got mycoffee in my hand.
You know, so, so we, we havethat perspective.
But then as a psychologist, Ithink how avoid.
Begets more avoidance and fear,and it's good for kids if
(10:29):
there's not a true medical riskto be in proximity and to be
comfortable being near theirallergens and knowing how to
keep themselves safe, which isdifferent for a preschooler than
it is for a senior in highschool.
Chris Creter (10:38):
Exactly.
And that's where, um, I shouldpoint out, these are specific to
K 12.
There was another group workingon preschool, recommendations.
I know Thomas and the ElijahAlavi Foundation is very
instrumental in all of that.
And the
amanda-whitehouse--phd_2_0 (10:52):
Yes.
Chris Creter (10:52):
work going on.
As we saw at some of theconferences we've been to, um,
but this is very specific topublic schools, K through 12,
with the hope that maybe privateschools would use it as well for
the same age groups, but evenwithin K 12 there are some
pretty, significant differencesin expectations at the older
child age groups versus theyounger child age groups.
(11:14):
So we wanted to take that intoaccount as well as we went
through all of theserecommendations.
Amanda Whitehouse, PhD (11:19):
What other parts of that area of the,
guidelines do you think areimportant for us to talk about
the, the preventing exposure.
Chris Creter (11:28):
So there's a few questions that we're trying to
answer.
How should schools identify anddocument food allergies is a big
to topic that came up and whatwe hear is, in some cases,
parents just, they don't wannahave their kids stand out and we
don't wanna.
tell anybody it's just oneallergy and they can manage
this.
This happens a lot in the olderschools, so making sure there's
(11:48):
protocols and open door kind ofwelcoming processes in places in
schools to make sure parentsfeel welcome and it was
important that we don't tellschools exactly what to do as
long as you're following theguidelines.
So for example, how do weidentify and document food
allergies?
'cause there was a lot ofconversation between the nurses
and the school nutrition staff,for example.
(12:10):
The nutrition staff saying,well, I need to know.
So that we can put it in thecomputer system and make sure we
don't accidentally give the kidsome food.
And the nurses are saying, well,I might get this information in,
but what's the system andprocess in place to get that
allergen information to thecafeteria?
Or a kid comes up in line ofcafeteria and says, oh, I can't
have that.
I'm allergic.
(12:30):
And they don't have it in thesystem, and the nurse doesn't
know.
So it's making sure that theycan identify and document and
create a path between.
What are like not usual andtypical lines of communication
within a school system.
'cause the nutrition servicesoften didn't have a reason until
food allergy to really overlap.
So that was just one of theexamples that we say established
(12:52):
standardized procedures foridentifying known food allergies
in students.
what, no matter where you'rehearing that from, have a
procedure in the school.
So again, we don't say how it's,how is up to the school, the
financial impact that this couldhave on some schools.
We were very conscious of Titleone schools that may not have
the resources to put in computersystems and, you know, all of
(13:14):
this.
So we were really, reallycareful not to make,
recommendations that would beimpossible to implement.
Another one was standardizingdocumentation and communication.
Of the known food allergies.
That's different thanestablishing the procedure for
identifying known foodallergies.
So it's funny'cause we wouldstart talking and realize we
were almost arguing about twoseparate things and it would
(13:35):
split the recommendation intotwo.
We also had a lot ofconversation around 504's and
the utility and the need for504's.
And what we kind of came to,well first 5 0 4 is the only
legally.
document that anybody has tosupport the accommodations
(13:58):
required for their disability,food allergy being a disability.
And what I found interesting wasthe, the fear of the 5 0 4 from
a staffing standpoint at theschools, or they don't really
need it, or, you know, the, theconversation was just absolutely
fascinating about 504's ingeneral.
And what we kind of came to waswe need to make sure people are
(14:20):
aware of.
The 504 process and what theneeds are of students, if you
have solid procedures andpolicies in place, then many
students might not even need the5 0 4 because theoretically, the
school will have theaccommodations baked into their
policies and procedures Now.
Most schools we know don't havethat level of policy and
(14:42):
procedure or the investment intime in the policies and
procedures to allow for that,which then results in the need
for a 504 to protect thestudent.
So there is a whole section ondefining.
The difference between an AAEP,you know, our allergy and
anaphylaxis emergency plan,which comes from our healthcare
provider, which theoreticallygoes to a nurse.
(15:03):
If the school has a nurse, thatbecomes an IHP, which is
individualized healthcare plan.
And then if we need furtheraccommodations, there may be a
request for a 504 plan, which isthat.
You know, the legally allowableright of anybody with a
disability to establish whataccommodations are necessary in
(15:23):
order to keep that student safeand able to learn in the school
environment.
So this is very carefully laidout and detailed.
'cause what we have found is alot of people were misusing or
misunderstanding that processand that cascade,
Amanda Whitehouse, PhD (15:36):
Parents get overwhelmed and confused.
There's also then an IEP, whichwould be used for a child who
also then is identified with alearning need or a learning
disability, and then the.
Accommodations can be loopedinto that as well,
Chris Creter (15:47):
Yes.
Amanda Whitehouse, PhD (15:48):
it's overwhelming for parents to
understand the difference.
Chris Creter (15:50):
overwhelming.
All these things.
Absolutely, and you're right,the IEP is listed there too, but
typically the disability doesn'tnecessitate the IEP, but an IEP
may incorporate.
The food allergy disability and5 0 4 accommodations.
So yes, again, another areawhere I learned a lot, a lot,
um, especially from Amelia andMary Vargas on the, you know,
(16:10):
their perspectives on all ofthis.
It was really found fascinating.
Amanda Whitehouse, PhD (16:15):
For the audience, there's a really nice
chart inside of the documentthat explains these, and I think
for any parent sending a kid offto school, it's very helpful to
know the differences betweenthese so that when you're having
a conversation with the school,you, they are used to using this
language all the time, andhopefully they're explaining it.
But
Chris Creter (16:31):
Yeah.
Amanda Whitehouse, PhD (16:31):
they're, you know, throwing out all of
these acronyms and you don'tknow what they mean, it's a
really great chart to have infront of you to help you
distinguish between thedifferences of what they're
talking about.
Chris Creter (16:40):
absolutely.
I, I, truthfully, just to myhumble, you know, lack of
knowledge when I was on this, Ididn't even know what an IHP
was.
didn't know that step evenhappened in a school.
And I've been doing this for 14years with my son.
So it was just that knowledge.
That's why I keep tellingeverybody just read this
document'cause it's so conciselysummarizes what we need.
(17:01):
Uh, the next chapter after thisin the document is all about
school nutrition.
about another area where Ilearned so much.
I just, just got back fromspeaking about FAMs at, the
School Nutrition AssociationConference in San Antonio.
And it was great'cause peopleare so eager to learn about this
and what we do about it, I thinkwe don't appreciate how much
(17:24):
goes into the school nutritionand the nuances and following
USDA code and.
school code, let alonedisability requirements.
And so this is where I think alot of these recommendations
were really helpful.
And then at the school nutritionconference, people just flooded
the room.
They wanted to stay late, theywanted to ask more questions.
(17:45):
So they, they are eager, like alot of the school lunch programs
and, you know, services thatare, are conglomerates that are
around the country are eagerlyand really actively trying to
incorporate food allergyinformation in there.
Point of sale digital servicesand ingredient listing
opportunities.
So what FAM says is to make surethat we kind of structure our
(18:08):
school nutrition services insome way, knowing that this can
be a huge undertaking,especially for really large
districts, to make sure wecreate these child nutrition
programs and allow students, nomatter, if they're on a free
lunch program or if they're in arural area where it's hard to
access some allergy safe foods.
We still are required by law todo that in most cases.
Amanda Whitehouse, PhD (18:31):
My audience is, is parents, a lot
of parents and families.
So from their perspective, whatshould they know about that
part?
Chris Creter (18:36):
I think what's really important for families to
know from a school nutritionstandpoint is that there's a lot
more in play than just the foodallergy itself.
Making sure that you work withthe nurse, but you have to point
blank, say to the nurse, I needto have this communicated.
With the school nutrition staff,who can I meet with Don't assume
the nurse can translateeverything to school nutrition
(18:58):
services because like I said,there's USDA and guidelines that
school nutrition has to abide bycertain foods, and food types
have to be on a plate that goesto any student, and they have to
find that balance of differenttypes of nutrition.
For every single student,regardless of the the allergy
needs.
So maintaining what they callmedical statements, um, from a
(19:21):
state licensed healthcareprofessional, and that state li
medical statement is to requirethe alternative food and often
to give suggestions onalternative foods.
Now what happens is you go toyour allergist, you say, I need
a medical statement.
The allergist doesn't know everybrand of food that's out there
and for a long time.
A state licensed healthcareprofessional was only like a
(19:43):
prescribing physician or anurse, but now they've actually
just recently the USDA changedtheir guidelines where they can
actually have a state licensednutritionist, uh, be that person
to write the food modificationstatements requirements.
The reason the nutrition peopleneed this medical statement is
for reimbursement purposes, theywill not get reimbursed by the
(20:06):
state.
if they don't have the correctdocumentation.
So this is where for families,they're not just trying to be a
pain in your neck and make yougo through the rigmarole, it's
because they have to make surethat they follow the rules, they
get audited, they have to makesure they get refunded,
especially for the excessivecosts for a lot of the foods for
that some of our food allergykids need.
(20:28):
So this was an area that I havesuch respect for school
nutrition professionals and whatthey're doing.
And then just the level of carethat goes into the detail you're
trying to feed In some of theseschools I learned about, I mean
you're talking thousands of kidsare coming through in minutes,
you know, across some states,and to be able to pause and
(20:50):
safely make sure you provide.
School meals for this nuancedcommunity is exceptionally hard.
And you think about people whosign up to be a lunch person,
didn't necessarily sign up tosave people's lives every day or
to prevent children from, youknow, a severe allergic
reaction.
So it's making sure we do theproper training and allow the
(21:14):
funding for the time for thosestaff to be trained.
This document just says,basically ensure that students
with food allergies asdetermined by that state
licensed healthcareprofessional, have full and
equal access to foods offered bythe school nutrition program.
And so the training goes intothat and a lot of other things.
Um, the other thing for allfamilies that.
(21:35):
Is a lot harder than I everrealized, which is the
publication of meal plans andcalendars.
Um, so one of the, therecommendation 2.5 to be exact,
uh, is to publish weekly ormonthly school menus.
And that way parents can look atthe menu in advance and decide,
is this safe for my kid?
(21:55):
Do I need to call and find outif there's an alternative or
make arrangements or send my ownfood in?
Um, and they can have enoughnotice to do that.
Some of the challenges that comein are school supply issues.
The delivery of the chickennuggets didn't come in and now
we have to bob and weave andfind a new meal.
(22:15):
And uh, now I have to call thisparent and I, so with that comes
a lot.
And what do you put on the menu?
Is it all ingredient lists?
Are we talking aboutprecautionary labeling?
So just putting, well, all wesaid is just publish a weekly or
monthly menu.
Like just start with that andthen come up with policies and
procedures for when thoseadjustments occur and what you
(22:37):
have to do.
And that may vary from districtto district, depending on who
they've subcontracted the, um,the food services too, if they
have.
And then what they, weabsolutely were firm about was
maintaining a current food labellibrary.
no matter what, it's 25% of allin-school.
Anaphylactic reactions are firsttime reactions, so what we said
(23:00):
is if that is a first timereaction, we have to be able to
go back 24 to 48 hours and seeeverything that that child ate
to try to dissect and learn.
What could have been the culpritfor that anaphylactic reaction.
So that's that recommendation tome.
We all, that was a no brainer.
Everybody was like, yes, thatneeds to be in for sure.
Um, but you know, it's not easyto do for, from a school
(23:25):
nutrition standpoint.
So, know, I, I encourageeverybody, if you're involved in
school nutrition or if you canread this document, there's so
much fine print between theserecommendations that kind of
give you some.
Understanding of how this isn'tjust so easy to publish a menu.
Um, I, I hope that people cankind of have that new respect
and create that communicationand collaboration with, these
(23:48):
folks in the, in the cafeteriaand the school nurse and
everybody else.
Amanda Whitehouse, PhD (23:52):
Yes.
I know how hard it is to run ahousehold and feed three boys
three times a day.
I cannot imagine.
Organizationally, all of thechallenges that you're
presenting, how much goes intoit, how much coordination, so
there's so much appreciation,that can come from understanding
that why isn't it just so easyto just gimme a menu?
Yeah.
Chris Creter (24:12):
So I, I worked with my school district to
change, just to take a quickside story my son and I both sat
on the wellness committee many,many years ago.
So he was young.
I mean, he was probably eightyears old and we're on this
board of education wellnesscommittee.
'cause we wanted to try to putsome rules in place about like
class parties.
And there were so many timeswhere my son had to leave the
(24:32):
room.
He never could participate.
We always had his.
Stash of treats, you know, forwhatever.
But inevitably somebody showedup with some, you know, oh, it's
a rainy Wednesday.
So I brought in cupcakes.
I mean, it was a free for all.
They'd eat Doritos in thecomputer room.
Um, and so we started to say,can we just put some policy
around this and limit the amountof food that is involved in
(24:53):
school in a regular basis?
So my little son sat in thewellness committee and we talked
about policy and we were reallyworking on it.
Then he went into anaphylaxisschool and we're pretty sure
it's from the computer roomwhere they would let the
afterschool kids eat, freely,and of course at that point we
went into overdrive and we wereable to change the
recommendations, but we had no.
(25:15):
Framework.
We had no guidepost or expertrecommendations like this to put
these rules in place.
So we went to other schools, wewent to more conservative school
policies, and we went to lessconservative school policies,
and we crafted our own.
This document will help the nextsection, which is called How Can
Schools Prevent Food AllergyExposure?
This, to me, is the biggestthing for parents that they can
(25:38):
take this document and literallygo through this like a checklist
and say, this is what the expertrecommendations from the CDC and
the A A P say is the best thingto keep students from having
exposure to allergens at school.
And the first one is, whenpossible discourage eating in
classrooms.
Now we also know that in a lotof schools there are no
(25:58):
cafeterias, so that is, it'simpossible to say we can't
always eat in classrooms, so wefinished that recommendation
with if eating in classrooms isnecessary, designate an area for
eating that is separate from thelearning spaces, especially
younger children to prevent thatcross contact.
So that was the first big, bigone.
(26:19):
And we put in some bestpractices for how to do that
within the document.
So you can read that.
The second recommendation thatcame right on its heels, and
this was one of those that wewere kind of battling and then
it separated out was wash handsbefore and after preparing,
serving, or eating meals orsnacks so that we can avoid
food.
Allergen cross contact.
And this includes surfaces.
(26:40):
So two 2.10 is about hands.
2.11 is about surfaces.
So those three together arediscouraging in classrooms.
But if you have to wash handsand wash surfaces what those
three recommendations togethersay, and we did make a big call
out that hand sanitizer andsanitizing sprays on tables is
not effective.
(27:01):
It is ineffective at removingfood proteins and to make sure
that no one does that with acitation.
So, so you can use that withyour schools when they're
saying, oh, we can do.
Parties and snacks andeverything else.
Amanda Whitehouse, PhD (27:15):
Yeah.
And I, as a psychologist, Ijust, this is one of the things
that I find the most often, um,that surprises the adults in
kids' lives in terms of how muchtime kids spend the same way we
do as allergy moms, you and I,when they're supposed to be
learning a really hard new mathconcept or learning how to read,
and all their thinking is, likeyou said, they had Doritos.
It's on their, their hands.
(27:36):
I can smell it.
You would be shocked at theamount of time that kids explain
to me that, that that's allthat's in their head when
they're at school.
And then we expect them to belearning.
It's not just, it is obviouslyfirst and foremost about their
safety, but it's, they're atschool to learn
chris-creter--she-her-_1_0 (27:50):
Yes.
amanda-whitehouse--phd_2_ (27:51):
can't learn when that's their mindset
and, and when they're in thatpanic or fear or hypervigilant
state.
chris-creter--she-h (27:58):
Absolutely.
Absolutely.
We have since put policy inplace and we're currently
updating it for these, these newrecommendations in my town.
But I sat at a parent night, itwas at the end of the last
school year, and I went into anelementary school classroom
where they had this meeting, andthis was for like a specific
learning environment thing thatmy son's in and.
(28:19):
All parents from all differentage groups are in there, and
one, it, it's food free.
Now our, our building classroomsare now all food free at the
elementary level.
We're working on it at the otherones, but they, one mom pulls
out a bottle of water, a bag ofnuts, literally a bag of
almonds.
I'm allergic almonds, and all Icould do is sit there and stare
(28:40):
at her.
I have no idea what this meetingwas about because then all I'm
sitting there, I'm thinking.
Oh my gosh.
I, I, I can't shake her hand.
Oh.
And I better make sure I stayafter and I have wipes in my
purse and I can give them to theteacher to make sure we wipe the
desk off so a kid doesn't comein tomorrow and eat it.
I spent my whole time thinking,and exactly what you just said,
I was thinking.
Wow.
Like these kids do this.
(29:01):
You know, these little tiny kidswhose brains can't even really
get around much else other thanI know this is unsafe for me.
They just need to be learning.
Every single kid just needs tobe learning.
That's it.
amanda-whitehouse--phd_2_0 (29:12):
Yes.
chris-creter--she-her-_1_ (29:13):
that, and.
amanda-whitehouse--phd_2_08- (29:14):
Oh my gosh.
Yeah.
Yeah.
And they, they're so little.
They don't even know what it isin there.
They just know that they feelafraid.
It's, you know, it could take anhour long therapy session for a
kid to actually have the help toput that into words, what you
and I, as adults can articulateso easily.
My heart, goes out to thoselittle kiddos that are carrying
this through school
Chris Creter (29:32):
I
Amanda Whitehouse, PhD (29:33):
all and everywhere they go.
Chris Creter (29:34):
then not isolate them either.
So like some of these nextrecommendations were things like
discourage sharing of food itemsamong students, not
Amanda Whitehouse, PhD (29:42):
Right.
Chris Creter (29:42):
the allergy kid.
They'll be like, okay, you guyscan all share Lollipop, but this
kid can't, like, don't give itto this kid.
Just recently we had an incidentwhere.
The, there was a team eating, Iguess they eat lunch together in
the high school and a person inthe school, like a teacher
walked into the room and said,oh, you guys can't do this next
(30:03):
year.
'cause the, the, we have thisallergy kid coming up and it's
that moment of like, the allergykid shouldn't create this wave
of change if we have the rightpolicies and procedures in
place.
Across all of our schools, thenwe're not isolating any one kid
because of their specific needs.
But I think discouraging sharingof food items, that's one.
(30:24):
This one was huge.
Encouraging the use of non-foodstudent incentives and rewards
in classroom celebration.
So this was, you don't hand outlollipops because everybody got
above the 90 on the test.
You don't, uh, I had a teacherthat would take the juices that
the kids didn't want from theirlunches, and then she froze them
with Popsicle sticks in them andthen handed them out to the kids
(30:45):
thinking, well, it's a schoollunch.
Like I can give school lunchitems out.
And eventually had tocommunicate that.
First of all, you're setting aprecedent.
Second of all, it could bepotentially dangerous.
You don't know if one of thosekids is or is not allergic to
that type of.
or juice or whatever it is.
And so this is where theeducation, again, is gonna fuel
(31:05):
that.
But stop with the food rewards.
Give them exciting experiences.
I'm sure you've heard of plentyof fun things to do at school
that does not involve a cupcake.
Amanda Whitehouse, (31:15):
Absolutely.
Before we started recording, youwere talking about the episode
that I had done with SarahHoring.
She's a friend of mine and anadministrator in the schools and
the district that I live in.
And this was a huge, thing thatshe, was trying to get across in
the schools There's so many funways to celebrate and honor and
connect and enjoy things withkids as humans.
I think we need to learn todisconnect that.
With from food.
(31:36):
Food can be joy and pleasureand, and all of those things,
but it shouldn't be the onlysource of it for a lot of
reasons that just do reality.
Chris Creter (31:44):
that that episode was fantastic.
She was
Amanda Whitehouse, PhD (31:46):
She's great.
Chris Creter (31:47):
and I completely agree.
I've seen it done where peoplemake a creative thing.
So since our policy took place,they asked whatever non-food
type celebration could think of,and someone's grandmother came
in who was in the military andused Morse code.
And so she came in and taughtMorse code to all these kids.
They talked about this for thewhole year.
(32:08):
Just because it was a uniquedifferent experience for her
granddaughter's birthday, youknow, and extra recess is very
popular for the birthday andthings like that, mystery
readers.
And you don't need the cupcake.
You just
Amanda Whitehouse, PhD (32:22):
agreed.
Agreed.
Anything that fostersconnection.
That's the point of it, right?
Chris Creter (32:26):
yeah,
Amanda Whitehouse, PhD (32:27):
I think that's, that's so much more
important.
Chris Creter (32:29):
What's scarier though is when it doesn't happen
in, when it, when that sameissue with exclusion happens in
the academic setting.
And so 2.15 says, ensurestudents with food allergies can
fully participate by evaluatingschool materials, activities.
Projects for potential foodallergens and make those
adjustments accordingly.
(32:49):
So we give examples of, youknow, you can't have Play-Doh if
you have a kid with a weeallergy or unless you have Safe
Play-Doh.
And is it safe Play-Doh foreveryone or is it just the food
allergy student?
Um, you know, you talk, thinkabout the egg drop and the, milk
cartons and the bird seed
Amanda Whitehouse, PhD (33:06):
Oh, and the Halloween.
Squish our hands into mysteryfoods and pretend they're scary
Chris Creter (33:11):
Sensory tables.
Yeah, it's a relativelyabbreviated document compared to
what had been there before.
And there's hyperlinks.
To ideas.
KFA kids with food allergies,which is through AAFA, they have
a link in there to like greatideas.
I know FAACT has some and fairhas some as well.
To get ideas for what you can doin your classrooms, even in the
(33:31):
curriculum.
And this even happens in highschool.
The medium in science classes,the, if you were dissecting, if
you have a child with Alpha Gsyndrome, they can't do the pig,
you know, they can't dissect thepig.
So we really have to thinkabout.
How much influence this can havein different settings.
Amanda Whitehouse, P (33:49):
Definitely there.
There's so much here but let'stouch on the third section,
preparing for emergencies.
Chris Creter (33:54):
Sure.
I'll have to say the preparingfor emergency section was
probably one of the easiest
Amanda Whitehouse, PhD (33:58):
Mm-hmm.
Chris Creter (33:59):
really aligned on, easiest to agree on, I should
say.
Amanda Whitehouse, PhD (34:02):
Sure.
Great.
Because we need, everyone needstheir epinephrine, right?
Bottom line.
Chris Creter (34:06):
Exactly, and so really it, you know, the, the
first bit was just aboutprotocols and procedures and
having an a a P in place and whoknows about the A A P, the
allergy and asthma emergencyplan.
Is it good enough if it's in thenurse's office?
Probably not, because theteachers need to know.
So all the right people thatneed to know and making sure
(34:28):
that you don't.
HIPAA at the same time.
So we did have a lot of dialogueabout that.
Um, but really it's up to just,it's about maintaining those
aeps year over year and makingsure that your IHP, which is the
internal document at the schoolthat's educating the school
nutrition and the gym teacherand everybody else on what to do
(34:49):
is updated.
And the 504 plan accommodationsare also communicated.
So that is really thatintersection that needs to
happen at a school.
It's not just about having it onfile, it's about making sure the
accommodations are made and thatthe child isn't ostracized for
having those accommodations,really the best practices around
epinephrine was some of themost.
(35:10):
Engaging, dialogue, and that'sreally around unassigned
epinephrine or we know as stockepinephrine, maintaining a
constant supply.
And that's hard because we knowthat there's been gaps in the
available resources.
For ordering it, but what we sawwas a bigger problem was
actually who's responsible forit.
So making sure that you have aperson assigned, that you have
(35:33):
it on the calendar when you haveto update it, that you know when
the expiration dates are of thatepinephrine.
your state allowed to use alldifferent types of epinephrine?
Because now that we have nasalepinephrine and we're soon to
have sublingual epinephrine,does your state even allow you
to have that as unassignedepinephrine?
So I know for me in my state ofcourse,'cause I am who I am, I
(35:55):
went to my representative and.
worked and just finally thismonth now have, different forms
of stock epinephrine availablefor our schools.
But that is not the case in thewhole country right now.
So it's not so easy.
There are some links embedded,that you can access to get free
stock epinephrine or unassignedepinephrine in schools, but
making sure you have thoseprocedures in place so that
(36:17):
it's.
don't have expired epinephrineon the wall is so, so important.
and then allowing students whoare deemed ready by their
caregivers and healthcareproviders to self-care or self
administer.
We've heard so many storieswhere they were told they can't
or they're not allowed to.
So this is where ourrecommendation, and this may
mean we have to make some statedistrict policy changes in order
(36:39):
to allow this.
And I think that's the biggestthing to know is your state may
just not allow some of theserecommendations to happen yet.
So.
Sometimes we might have to go tothe state level or the, you
know, state Board of educationto, to fix some of this.
But our recommendation is thatif a student is deemed
acceptable to self-care by theirhealthcare professional, then
they should be able to self-careor self administer.
(37:00):
And that's just for accessreasons.
'cause we found too manydistricts where it's still a, a
rule to lock.
The epinephrine up.
And so that was number 3.5 isthe next one that said store
unassigned and assignedepinephrine in secure areas that
are unlocked and easilyaccessible by staff.
(37:21):
that was because we've justheard so many stories, so, so
many stories of people thatcan't access their own
epinephrine'cause of the rulesof the school.
So hopefully this can helpchange some of that state policy
or the district policy that doesstill require the lockup of the
epinephrine, which I still justdon't understand
Amanda Whitehouse, PhD (37:43):
Right,
Chris Creter (37:43):
that.
Amanda Whitehouse, PhD (37:43):
right.
And for right, because we hear,the stories that I hear are that
it was locked in the nurse'sroom.
It took someone 10 minutes orthe nurse wasn't in the building
and that's.
That's terrifying if that's whatyour school is telling you, it,
it's, we have so much moreconfidence going to the district
with a document like this in ourhands, explaining, sharing
references, you know, it can, itcan help us to communicate what
we know to have this behind us.
Chris Creter (38:05):
Yeah, and The big thing for me now with this tool,
the tool's, great.
Right?
This, this document, this iscomprehensive.
It's, I mean, it has links tofree training programs.
There's nothing in here that youcannot not implement, right?
All the training, just click thelink, give it to your school.
They can do it for free.
It's all in here.
The problem is coordinating allthe resources,
Amanda Whitehouse, PhD (38:28):
Mm-hmm.
Chris Creter (38:29):
the nurse, the administrators, the time it
takes to do policy.
Obviously, food allergy is notthe top of mind for a school
administrator.
Everybody's under budgetconstraints now.
Funding is, you know, going awayfrom.
Different sources.
So people get worried.
They're not focused on this.
So really what it takes is usparents to bring this to the
(38:49):
attention of a school board or aa school and to say, can we put
procedures in place?
And if we don't have a policy,you can still put procedures in
place to make some of this stuffhappen.
And starting with your ownprincipal and your own school
nurse, and create a littlecollaborative team and try to
say, oh, here, we can make this.
Together.
And I think that's the impetusand the effort that this is
(39:11):
gonna require is grassrootspeople taking this and actually
doing something with it nowbecause it is not a requirement
that people follow theserecommendations.
I wish it was, but right nowit's gonna take us getting this
out there and helping schoolsmake the necessary changes to
keep these almost 6 million kidswith food allergies across the
(39:32):
United States safe.
Amanda Whitehouse, PhD (39:33):
It's a great point that you make and so
we all can be inspired to use itand to, advocate and collaborate
and connect with the peoplethat, we need to in order to
enact what we know is based onall of the evidence and research
and best practices and the mindsof all, all of the people in the
allergy world who are ourleading experts.
So I wanna thank you for thetime you put into this, all of
(39:56):
those amazing people andorganizations, because we do
feel overwhelmed as parents andfamilies in something like this.
Brings so much clarity and somuch confidence in, in what to
how to approach certain thingsthat we don't know what to do
about.
Chris Creter (40:10):
Well, thank you for allowing me to help get it
out there and if anybody wantsto reach out and.
Ask me for more answers if Ihave them, or ways I can point
you.
I'm more than happy to help out.
But I think the more schools,the more districts that can
start to embrace this we'll justkeep our kids safer until we
have a cure for this, this thingthat we're all dealing with.
Amanda Whitehouse, PhD (40:30):
Yes.
Yes.
amanda-whitehouse--phd_2_ (40:31):
Thank you.
I appreciate you taking the timeto chat and explain this to us
in such a great way that helpsmake it, something that we feel
like we can grasp.
Because the concept is big, butthe document and the way you're
explaining it are verydigestible.
Of
Chris Creter (40:42):
you.
Thanks for having me.
Amanda Whitehouse, PhD (40:44):
course.
I hope that today's conversationgave you some clarity and some
confidence about the steps thatschools can and should be taking
to protect children with foodallergies.
How to consider what might bethe most helpful for your child
and maybe some ideas forcommunicating and collaborating
with your school if you feellike there's some work to be
done in that area.
These recommendations are agreat tool to help you think
(41:07):
through what a safe andinclusive learning environment
looks like for your child.
So here's some action steps tohelp you follow through on what
we chatted about today.
Number one, find therecommendations.
They're easy to find if you justdo a search for food allergy
management in schools.
They're housed on the FAREwebsite, food allergy.org, and
I'll put the link in the shownotes Number two.
(41:29):
Sit down and carefully consideryour child's accommodations.
Get out their paperwork.
Look at the plan.
Some of you may have just satdown with the team and
reevaluated this, renewed yourpaperwork.
Some of you, it may have beenquite a while since you had a
meeting to discuss this, so I'dencourage you to get it out,
look through it, think about.
What parts of your child's dayseem to be going well, where
(41:52):
there might have been somedifficulties in the past, and if
there are areas where you oryour child don't feel so sure
about how things are managed,number three, if you've missed
it, this would be a great timeto go back and catch episode 11
of the show.
It's called From Home to theHallways with Sarah Horning.
She is a wonderful friend ofmine and an amazing school
administrator, and herdiscussion about how she
influenced change in the schooldistrict that we live in is also
(42:14):
a very positive and encouragingchat about similar topics that
we discussed today.
By working together with ourschools and communities, we can
help to protect kids with foodallergies and make them feel
supported and free to focus ontheir learning.
Thanks for tuning in.
If you enjoyed the show, I wouldvery much appreciate a rating or
a review.
And if you would share this withanyone else who might enjoy
(42:35):
listening, Here's to a safe andconfident start to the school
year.
the content of this podcast isfor informational and
educational purposes only, andis not a substitute for
professional medical or mentalhealth advice, diagnosis, or
treatment.
If you have any questions aboutyour own medical experience or
mental health needs, pleaseconsult a professional.
I'm Dr.
Amanda Whitehouse.
(42:55):
Thanks for joining me.
And until we chat again,remember don't feed the fear.
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