FREDERICK, MD. – Everyone who enters the Cunningham household in Frederick needs to wash their hands. The students in 6-year-old Caroline Cunningham’s classroom at Ballenger Creek Elementary School are required to do the same.
That’s because Caroline is severely allergic to eggs, peanuts, tree nuts and garlic.
No food is allowed in her classroom unless it comes from her house and no lotion either, because it could contain nut oils.
She even has a school aide with her at all times to make sure she stays away from anything that could cause her to have a life-threatening reaction.
Caroline has her own desk for lunch that sits next to her class lunch table. The desk is specially cleaned, covered in plastic and stored after each day to make sure nothing comes in contact with it.
Caroline is one of 3 million children in America who have food allergies. Eleven states including Maryland provide schools with guidelines for how to manage food allergies and anaphylaxis.
Now, a bill in the Senate would direct Secretary of Health and Human Services Kathleen Sebelius and Secretary of Education Arne Duncan to develop voluntary guidelines for the nation’s schools and early childhood programs.
Under the guidelines, parents would have an obligation to provide schools and early childhood centers with specific documentation on what their child is allergic to and what medicines can be given if there’s a risk of anaphylaxis.
The guidelines would also suggest creating individual plans for food allergy management tailored to students’ needs. Each plan would include directions about how to manage the risk when the student goes on a field trip or is involved in before- or after-school programs.
Under the plan, Sebelius would be able to award grants to help pay for assistance — like Caroline’s aide — alternative meals for students with food allergies and allergen-free wipes to clean the classroom.
The bill, packaged with the FDA Food Modernization act and reported out of the Health, Education, Labor and Pensions Committee in November, is expected to come to the Senate floor soon. It is already garnering support from advocacy groups such as the Food Allergy and Anaphylaxis Network in Fairfax, Va.
Providing guidelines at a national level would help schools be consistent in how to manage the risk, said Christopher Weiss, vice president of advocacy and government relations for the Food Allergy and Anaphylaxis Network.
“If you look at the country right now, there’s very little consistency from state to state and even within the state, say from town to town, city to city or even school to school within a town,” Weiss said.
It’s a problem for parents who don’t know what to expect from their schools, he said.
“Parents have to do a lot of homework beforehand,” Weiss said. “They have to meet with people before school starts to get a sense of how schools actually manage food allergies.”
Maryland’s guidelines were most recently updated in 2009. Donna Mazyck, the state school nurse consultant at the Maryland State Department of Education, said the guidelines are put together with advice for experts in the field and reflect current laws and science on the subject.
They include a checklist for the school nurse, a definition of the symptoms of food allergies and even step-by-step instructions on how to give someone a shot of epinephrine, also known as adrenaline. The guidelines are updated every five to seven years.
But the child’s parents still bear most of the responsibility, Weiss said. And that includes making sure the art teacher doesn’t use milk cartons or peanut butter for a class project.
The elder Michael Cunningham said getting family members to understand the risk has been challenging.
“We don’t even get invited to things anymore,” Cunningham said. “They know we’re not going to come anymore because they’re not going to make it safe for Caroline.”
Kathleen Cunningham said Caroline’s school has grown with them, though.
Caroline’s parents met with the school principal, Paul Smith, last spring to begin discussing preparations. They created a health care plan and an emergency plan with the school nurse.
The school also trained its staff in use of the EpiPen, an auto-injector containing a measured dose of epinephrine, or adrenaline in case of an allergic reaction.
“When school started, we had a very large staff meeting that included all the staff that might come into contact with Caroline,” Smith said.
Food allergies were even a part of the school’s Diversity Day this year.
Smith said Caroline’s aide will continue to look after Caroline during first grade and through elementary school, if Caroline needs her.
Kathleen Cunningham said many of her days are spent calling manufacturers to ask about products to be used in art class, or talking with the school nurse about how Caroline is feeling. But, she said, the precious state of her daughter’s life has made her realize it is all worth it.
“I’ve had the opportunity of not seeing her,” Kathleen Cunningham said. “So it makes you appreciate your children so much more. And it’s what gives you the strength to go on.”