From Victoria Groce,
Your Guide to Food Allergies.
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Having a child start preschool can be nerve-wracking for any parent. When you've got food allergies to consider, however, it can be downright terrifying. Not every childcare facility is willing to cope with severe food allergies, and you and your child will both need more preparation than others before starting school. Read on to learn how to find a welcoming preschool and how to prepare for a safe, easy beginning to school for your allergic child.

Before the Transition: Getting Your Child Ready For Preschool

Children who were diagnosed with food allergies as infants or toddlers -- especially severe allergies -- have usually learned that they can't eat certain dangerous foods. If they haven't, though, they should be aware of their restricted diets before entering preschool. They may have been taught to tell anyone who wants to give them food to ask their parents if it's safe, or never to accept food given to them from anyone except their parents or a designated caregiver.

In most preschool settings, your child will be eating a snack (or perhaps even a lunch) without a parent present. That's why it's critical that your child knows what to expect. Leslea Harmon, mother of a 6-year-old son with a peanut allergy and founder of Allergyware Allergy Alert apparel, told her son before he started attending full-day preschool that his father would check the school's menu every day. "He was only to eat what Dad said was OK," says Harmon.

This underscores the importance of setting expectations both with your child and with the school. Mimsie Leyton, director of the Berkman Family Center Preschool in Pittsburgh, recommends similar steps to prepare your child: "Ahead of time you'll want to have established with the preschool when children will be eating or working with food. And then you'll want to talk with your child and say, 'After you play or after you come in from the playground, or whatever the case may be, everybody will wash their hands and sit down at the table and then some kids will eat this and you will eat that.'" Whether you've agreed with your school that you or the school will be providing separate snacks or whether the preschool will be providing snacks that are safe for all the kids in the class, your child needs to know.

Also, your child needs to know that if he starts to have any symptoms of an allergic reaction he needs to let his teachers know immediately. He should be aware of whatever symptoms he's had previously as well as other common symptoms of asthma or food allergies.

Finding the Right Fit

Getting your child ready for preschool, of course, is only one aspect of making this transition. Once you're sure your child is ready for preschool, you'll have to find a facility that can meet your needs. For Harmon, this was difficult. She started looking at home daycares but quickly found that the ones she spoke to in her area were unwilling to make the necessary accommodations to keep Sam safe, especially given that during off-hours these facilities are the owners' homes. So she began looking at larger preschools. "If there had been somebody around who said, 'We have kids here with food allergies, and we are used to this,' they would have been at the top of my list. But there was nobody in our area like that."

As About.com's Childcare Guide, Robin McClure, mentions in her tips for helping childcare programs manage food allergies, finding a facility with expertise in food allergies is ideal. But it's not always possible. Leyton suggests that you look for inclusive, welcoming language on the preschool's literature as a sign that meeting unique needs like food allergies is a priority for the preschool's administration. She also points out that, "With the Americans with Disabilities Act, we should all be receptive to doing whatever we can to make the right accommodations."

The right fit is individual, and what feels comfortable will vary from parent to parent. "If someone treats your child's food allergy like it's an inconvenience," says Harmon, "that's the wrong preschool or daycare for you." There are some questions you can ask that will help you make a decision:

• Have you dealt with food allergies before? If so, what kinds of precautions did you take in the classroom?
• How much turnover has there been on staff? What kind of arrangements do you make when a teacher needs to be out? (Having consistent caregivers makes it less likely that your child will accidently be given an unsafe food and more likely that, in the event of a problem, a teacher will recognize that something is seriously wrong. You also want to be sure that any occasional substitute teachers will be aware of your child's allergies.)
• Do you have an open-door policy? Can parents drop in at any time to observe the class?
• How do you handle medical emergencies?
• How would you keep a child with a severe food allergy safe without making him feel excluded?

Finally, if children with food allergies are already in the school, Harmon strongly recommends that before you enroll, you ask school personnel to pass your contact information along to those families and ask them to call you. (Getting contact information from parents of existing students with allergies is more problematic due to HIPAA (the Health Insurance Portability and Accountability Act) and other medical privacy laws, but you can certainly ask administrators to give other parents your contact information.) Says Harmon, "It will do a ton to help put you at ease."