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asap advice on daycare anaphylaxis policy please!

post #1 of 16
Thread Starter 
My 23 mnth old is about to start a toddler centre. He is anaphylactic to beef, and very allergic to cow's milk and egg too. The centre prepares snacks but children bring their own lunch. I'll be preparing all of his food, obviously!

Should I request that the daycare ban beef? I ask because they do ban peanuts as a rule, which I understand, but they want to give my son a food tray as his "safe space". That doesn't seem enough to me. I'm frightened of children sharing food with him that contains beef, of beef residue on toys and clothing, of staff inadvertently sharing contaminated utensils...

Moral support and suggestions needed. My meeting with the daycare staff is tomorrow!!
post #2 of 16
I would be terrified to send a toddler to a place serving his anaphylactic item. I would certainly ask them not to do beef. I can't imagine they want to risk him going into anaphylaxis on them there. You can't always bring a child out even with an epi pen.
post #3 of 16
If you're here in the States, this may be helpful or give you some ideas re something comparable under your (CDN?) gov't oversight:

http://www.foodallergy.org/page/504-plan
post #4 of 16
It looks like alot of potential problems. You are right to be concerned about the sharing of food. What is the teacher to child ratio? Do adults sit with kids during meal? I have vivid memories of my non-allergic DS eating food right out of his seatmates hands. My allergic DD (dairy, egg, peanut, treenut and shellfish) reacts airborne and to contact. She can't be around other kids eating something like goldfish crackers since the residue gets all over the place. What do the kids drink? If it is milk, you are looking at the potential for spills. Banning beef may be possible, but you still have the dairy and egg (which may get worse).

Hope that you can create a safe environment for him. Is keeping him in another location during lunch (like an office where an adult is working) and until clean-up is complete an option?
post #5 of 16
Thread Starter 
The children eat in their groups with a caregiver, all around the same table. The ratio is something like 5:1. I'm not so worried about the dairy, although they will still have to be very careful. My worries are mainly beef, as it's a common food here where I am (western Canada) and he has had a terrible anaphylactic reaction to it in the past. DS was in the infant centre for a while and ate in a completely separate area with one-on-one help all the time (we got a disability grant for this, though it may not be renewed). I've heard that the toddler centre can't accommodate a separate eating area, that avoidance is not possible (as it creates a false sense of security -- but that people can be trained not to be falsely secure, surely!), and that my child needs to learn safe eating habits etc (he's only 23 months!). Children are such messy eaters. I'm scared!

I also don't understand why, if peanuts are (rightly) banned throughout the centre, why beef can't be banned while my DS is there too?

My meeting is in 3 hours...I'm so nervous!
post #6 of 16
Hope that you meeting went well. I agree with you that 23 months is too young to expect him to keep himself safe.
post #7 of 16
How did it go OP.
post #8 of 16
I, too, am interested in how it went.

If you do decide to send DC to the center, I would request (demand?) that your DS sit at a separate table with a teacher for meals and snacks.

Ask what their training for allergies and responses is. Ask how substitute caregivers are trained. That's where our slip-up occurred - a substitute teacher gave DS some meatballs. And I was sitting right there in the room!! (how dumb/responsible did I feel afterward?) But I did get the center to change how they did their sub training after that incident.
post #9 of 16
Thread Starter 
The meeting went well and they agreed to ban beef. Such a relief. They have a lower staff:child ratio than I thought (1:3) so mealtimes aren't quite the danger zone I thought. DS sits at the end of a breakfast bar, with 2 other friends on one side of him and a caregiver standing over. He has a placemat that serves as his 'safe space' and the children are learning not to share food with him. I'm still worried about him accidentally getting milk and eggs, but he's only eating food from home (or supposed to be -- thanks for tip about subs). He's having a very slow transition and I'm with him most of the time this week. They have a very clear anaphylaxis action plan which is reassuring.

Ah, but there's still the worry that he'll drink from someone else's sippy cup...

Such a leap of faith, leaving him anywhere.

Thanks very much for all your ideas and support!
post #10 of 16
Yay that they banned beef.


In addition to whatever sub training they do, you want your child identified IMMEDIATELY when he enters the room the first time the sub is there. (Or if he is already in the room when the sub arrives, your DS gets introduced immediately.) Identified by name, and "He has food allergies. Do not feed him ANYthing. If he cannot breath, his EpiPen is in the lockbox on the shelf right here." (point to EpiPen location). Even if if is not mealtime. Even if subs cannot administer EpiPens (ours can't). They should be aware of his potential condition.

The sub should be immediately introduced to you, and you can reinforce this, "We brought his lunch from home, and this is all he is allowed to eat. If he cannot breath and needs to use his EpiPen, Miss RegularTeacher/Director will administer it. You need to call 911 if this happens."

Make sure some sort of (immediate) identifying and instruction are given the FIRST (and possibly other) time your DS and sub meet. This is in addition to whatever training/introduction they get to the classroom.
post #11 of 16
Are you sure that they know what it means to ban beef? Do they understand that it's not just steak and hamburgers? That they have to read the ingredients? At our daycare, they have to keep the food costs down, so there isn't much stuff with beef ingredients.

The only thing that worries me is hot dogs. Don't some hot dogs have beef? Or maybe they just have the all pork kind? But still, something as minor as a brand change could have consequences for you child, and you probably want to educate the director and cook about that.

Just saying. Because EVERY SINGLE retail baker I've asked about whether their cakes contain dairy will either give me a blank look (because they have no idea what is in the cake) or (even the bakers that personally bake from scratch) will say, "Yes, it has dairy because there are EGGS in the cake!"

(OT: I can understand why many people don't think of margarine as dairy, but where in the world does every single baker get the idea that an egg is dairy?)
post #12 of 16
I'm SO glad the daycare agreed to ban beef. Honestly, I was worried that they would just decide that you were too high maintenance to work with.

It will get easier soon. It got a lot easier when my dd became 3 years old. She was able to understand that she was allowed only to eat food from her lunch box and no one elses. Plus, her little 3 year old friends helped her police the food for her. Her little friends would tell substitute teachers that "Dd doesn't eat our food, she eats her own food" in a very loud voice at snacktime. So at about 3 years old, probably no one will have to watch your child like a hawk to make sure that he doesn't eat what he's not supposed to.

So when your child is about 3 years old, the only real problem you will have to worry about is cross-contamination. (Still a big worry, yes, but manageable.)

The 3:1 ratio is fantastic and will help a lot. My dd was in the middle of a much higher ratio.

Things are looking up for you!
post #13 of 16
Is it feasible for the centre to switch to goat milk instead of cow? Would that lower the risk?
post #14 of 16
Thread Starter 
You're right to underline the point about subs. That's a great tactic.

Unfortunately DS can't have goat's milk either.

The parents have all been sent a letter by the daycare manager banning beef and beef products. There's also a big red notice on the door with DS's allergies. So I *hope* parents pay attention to labels.

I got alarmed when a teacher walked round the room with a snack, tempting kids to come to the snack table. What if it was cubes of cheese, and one fell on the floor? Or a bowl of yoghurt and it spilled on DS? Ahhh. Luckily they are open to changes. It's a good job I'm there all week with him because I've learned to be so hyper-vigilant and can spot a problem a mile off.
post #15 of 16
just a little reassurance -

a 23 month old can most definitely understand not to take or touch another child's food or drink. We stressed it to my daughter and she was ok. Even younger than 23 months, she was great with this. I think it depends on what you have told your child and how long they have had to have the allergy issues ingrained in them.

At that age, we were finishing at a daycare center and transitioning to Montessori toddler program.

At the daycare center, they provided all the food. They had 1 mistake where they gave her veggies with a cheese sauce, and noticed immediately and took it away. Unfortunately she did not say anything to her teachers, but maybe she would have if they didn't take it so quickly. I don't know. They ate family style around a table. There was ALWAYS the concern (for me anyways) that a child would knock over a cup of milk, or dump their yogurt, etc. I also am always worried that there may be dairy residue on a chair that is not cleaned that she may use later and that kind of thing. But in actuality, she never had any allergic reactions at daycare.

In the Montessori classroom, they provide the snacks (technically parents provide them for the school on a rotating basis). She stays for wraparound care, so I provide a lunch and they provide afternoon snack. This is how it is normally done, and how we did it until we found out she was also allergic to soy (supposedly). They also did cooking projects in her classroom. For the cooking projects, they pretty much restricted her to fruits and veges. For snack, they just made sure her stuff was safe. Again I was always (and always will be) concerned about another child spilling their food or drink. For lunch, all the kids eat at a big table. They put my dd at a different table and she is the only one who eats at that table. She started Montessori at 24 months. and she KNEW what she could and couldn't have and knew not to share any food. In fact she is not even allowed to share with her sister, even if the food itself is safe due to the risk the dd1 may have contaminated it. Now with the extra soy allergy, we provide all snacks and her lunch.

I still worry about cross contamination issues mostly. I know she would never take food or drink or use someone else's cup. She KNOWS this. But it is other people's actions I worry about. Do they make sure not to touch her snacks after touching the other snacks? Sometimes there are spills - another child shakes and spills milk from their sippy cup. I have seen them just wipe it with paper towels, but that doesn't remove the allergen. I have seen another child take my dd's water cup and drink from it. That means my dd can't use it again until it is washed. The teachers know this. But what if no ones sees the other kid do it?

Now my dd is not ana to dairy or soy. She is for peanuts and probably for tree nuts. The day care centers and Montessori school are nut free.
I am terrified to send her to public elementary school. My dd1 goes there, I have visited and after the visit, I am terrified. I wasn't until I visited. Their may be some nut free classrooms, but the cafeteria is not. PB&J offered everyday. Kids not required to wash hands before playing,coloring, etc for the rest of the lunch session, walking back to classrooms touching the walls, etc. Even if they wash hands back in their classroom (and only the younger grade I would expect to have a sink in the room), they have already contaminated EVERYTHING. There are makers, crayons, paper, other activities in the cafeteria for the kids to use when they are done eating. My dd will not be able to touch those. She may have to spend the entire lunch time isolated from all the other kids to try to keep her safe and there are still no guarantees especially once she leaves the lunch room. That doesn't seem fair to me.


but anyways, just trying to reassure that a 23 month old most definitely can be taught what he/she needs to do to be safe.

I am very glad they are banning beef for you. I wouldn't feel comfortable sending a young child somewhere that had stuff they are ana to because even if your own child is 100% good about their allergies, the other little kids won't be.
post #16 of 16
Thread Starter 
Today another parent forgot about the beef ban and sent in some beef with lunch. The teachers only found out at home time. Luckily none got near DS, but it just shows how easy it is for a slip to happen.

Thanks for your story. I must underline to DS that he can't eat or drink anyone else's food. And no one else's fingers in his mouth either. I think he is getting the message from home, as we have a 3 year old who eats dairy and eggs and whose food we always keep very separate.

Can't a school ban peanuts on request from a parent? It seems where I am (western Canada) that most schools are nut free now. It seems to me amazing how much we have to advocate for our allergic children!
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