Preparing the Staff For Your Child
Once you've found a facility you like, you'll need to come up with an action plan that works for you, your child, and the classroom staff. Major issues to discuss with your child's teachers are recognizing and handling reactions, dealing with food on a day-to-day basis, planning for special occasions involving food, and potential sources of hidden allergens or cross-contamination.
Consider keeping an allergy emergency kit in your child's classroom. Your child's school may have guidelines for labeling nonprescription medication (like Benadryl) or a set emergency contact form for you to keep updated. You'll want to establish a protocol for when teachers are authorized to give your child epinephrine or other medications.
You should also provide phone numbers for emergency contacts, the hospital you prefer, and your child's allergist. Be sure, also, to update staff as soon as possible if your child's medical situation changes -- if he's diagnosed with asthma, for example. Teachers should know how your child has reacted to his allergens in the past plus other common food allergy symptoms.
Most preschools have a set snack time. Some also serve lunch. You may come to any number of agreements as to how to handle daily eating times in the classroom. You may pack food; the school may provide safe snacks for everyone; or the preschool may keep a stockpile of agreed-upon safe snacks for days when the snack is unsafe. The key is that everyone is clear on what's expected. If both safe and unsafe foods are to be present in the classroom, make sure that the staff is clear on the principle of cross-contamination and come up with some way to ensure that safe snacks stay that way.
Policies against kids sharing food can go a long way towards making allergic kids safe, especially if students bring lunches from home. They're also smart for other reasons, as Mimsie Leyton points out: "We don't know what's particularly cultural or who can't eat certain foods [for non-medical reasons]. If a child is interested in someone else's lunch, we'll save the wrapper or tell the parent, but we're fastidious about children not sharing others' lunches." This sort of policy allows children to express curiosity about new foods without compromising safety.
In many classrooms, students bring in food for birthdays or other special occasions. This can, of course, be a major issue. But there are compromises that might work. First, is there a readily available kid-friendly food that might be acceptable for birthdays? Second, is there a non-food option -- a special game, birthday music, small toys -- that might work equally well for celebrations? Teachers and other parents in the class may be able to come up with creative ideas that will keep everyone happy.
Be aware of hidden allergens in art supplies. Play dough is often made from wheat and can be a problem for those with wheat allergies or celiacs. Tempera paint is made from eggs. Peanut butter is sometimes used in art activities. And cooking may be part of preschool curricula. Discuss these situations in advance and come up with alternatives before your child enters the classroom or, at the very least, before special projects are planned.
Keeping in Touch and Troubleshooting
Once you've picked a school and are sure everyone is on the same page with respect to your child's medical needs, you'll need to check in regularly. Fortunately, daily dropoffs and pickups are an ideal time to chat with your child's teacher. Preschool-age kids change quickly. They acquire language rapidly, go through behavioral stages in a matter of months, and may behave differently at home and school. Leyton points out, "Preschool teachers deliberately set up that we want to see parents in the morning and at pickup time because we want a chance to exchange information. In the life of a young child, even the smallest of events can seem disruptive or uncomfortable."
Leslea Harmon's family discussed allergy issues daily with Sam's preschool. You may choose to discuss health concerns less often, depending on how pervasive your child's allergies are, but you should certainly be made aware of any unusual symptoms immediately.
Sometimes, despite your best efforts in choosing a preschool and educating caregivers about food allergies, problems happen. For example, despite her agreement with preschool staff that Sam was only to be fed food approved by her husband, Harmon had recurrent problems with Sam being fed snacks that weren't on his safe food list.
"He would come home and say, 'Mommy, I had a Hershey bar today.' To our credit, I think, we never overreacted when he told us this stuff. We reiterated that he needed to only eat foods that Mom and Dad said are safe." Substitute teachers not being aware of Sam's allergies and young staff members who may not have fully understood the severity of his allergies compounded the problem. "They just didn't take good enough care of the situation because they assumed that his dad took care of everything."
In a situation like this, Leyton recommends that you call at the first sign of trouble: "Please don't let it fester. At the first sign of something making you uncomfortable, call right away. Speak to the teacher first, because they're the one in direct contact with the children on a day-to-day basis. If you don't get anywhere with that, then go to the next step. Everybody has a supervisor. And most of the time, teachers will want to make it right. Some of the time they may feel that they're caught between agency policy and parental request, and they may say they'll have to speak to the director. Most will be open to making their students and families comfortable. But don't let it get to the point where everybody's angry and nobody's willing to sit down and talk to each other, and that's gotten in the way of the issue at hand."
If you can't resolve the problem after communicating with your child's teachers and supervisor, remember: Your child's health is paramount. As frustrating as the search for a preschool that is willing to work with you can be, it's better to restart the hunt than to stick with a school you're not comfortable with.