Preventing Allergic Reactions and Anaphylaxis

The best way to prevent allergic reactions is to avoid serving children foods that cause reactions. These best practices will help you and any staff members keep children safe at snack and meal times. Hands can harbor unseen germs that can contaminate food and surfaces and ultimately make people sick. They can also transfer allergens to allergen-free foods. The good news is that proper handwashing and glove use are simple yet effective practices that can help prevent the spread of foodborne illness and allergen contamination .Washing Hands with soap and water is the best way to prevent and minimize allergen exposures. Hand washing prevent cross contamination and clean and sanitized food preparation spaces and feeding practices prevent cross contact of food allergens.

Select each tab to review the best practices.

Prepare and Prevent

Prepare a master list of children in your program with known food allergies. Label the list "Must Know Details".

- Include each child's name, age, and allergy type.
- Note whether the child has a treatment/action plan and its location.
- Keep the list in a handy location and inform all staff, substitutes, and volunteers where to find it.

Hold all adults responsible for knowing which children have known food allergies and how to respond. Keep emergency contact numbers near the telephone.

- Post the numbers for 911 and Poison Control (800-222-1222).
- Call 911 if a child has difficulty breathing or if the child stopped breathing or collapsed.
- Call Poison Control if a child ingests something accidentally but is alert and awake.
- Keep the emergency medication( Epinephrine-EpiPen) at easy and ready to use access .
- Keep child's Emergency Contact list handy and call the parent/guardian promptly when calling 911/poison control

Suggest to families that children wear a medical alert bracelet indicating the allergy. Provide training for staff on how to handle an emergency. If an incidence occurs, debrief with the staff to prevent future occurrences.

Snack & Meal Times

Handwashing
- - Follow required handwashing procedures before and after snack and mealtimes.
  - Post proper handwashing procedures near sinks as a reminder.
  - Hand washing prevents Cross -Contact and Cross Contamination( transfer of microorganisms from hands-to-food, food-to-food, or equipment and food contact surfaces-to-food).
Supervision
- - Supervise children at all times and watch for allergic reactions.
  - Sit near children with known food allergies for careful observation.
Labels
- - Read food labels and look for ingredients that may cause an allergic reaction
  - Label cups, plates, and utensils with children's names to avoid cross-contamination(accidental transfer from a food containing
    an allergen to a food or surface that does not contain the allergen).
Planning, Serving, & Storing Food
- - Follow the child's modified snack and meal plan.
  - Serve only food provided for the child.
  - Keep a child's food away from the food of other children. Some allergens are air-borne and can contaminate a child's food.
  - Store food brought for a child separate from other food.
  - Avoid sharing food.
  - Avoid Cross -Contact of food Allergen: Occurs when an allergen is accidentally transferred from a food containing
    an allergen to a food or surface that does not contain the allergen

Clean & Sanitize

Follow the 3Cs:

Clean surfaces (counters, tables, refrigerator, sink handles, etc.)
Clean utensils (equipment used in food preparation)
Clean hands (avoid hand sanitizer as a substitute)

Clean and sanitize before and after food preparation.

Use soap and water or all-purpose cleaning products that meet state and local food safety regulations

Cleaning with water alone will not remove food allergens.
Avoid substituting hand sanitizer for soap and water or other cleaning products. Hand sanitizer will not remove allergens or chemicals.

Post signs as reminders to wash hands, surfaces, food preparation tools, and all dishes used during snack and meal times.

Special Occasions and Activities

Find different ways to celebrate special occasions that avoid food, and plan activities like field trips carefully.

Use nonfood items for incentives, rewards, or celebrations.

Extra playtime, special privileges, or favorite games and activities are just as fun and rewarding.

Advise parents, guardians, and other adults to avoid proving treats for the whole group with known allergens.

Avoid using products with known allergens in classroom activities, such as arts and crafts, counting, science projects, celebrations, and cooking.

Training

Be sure to keep everyone in your program informed of best practices for preventing reactions to food allergies or food intolerance. That includes teaching the children about food safety.

It is especially important for adults to understand how one child's food may be life-threatening for another child. Remember communication and documentation are key to keeping everyone in your program safe and healthy.

The Medication Administration Training is a 6-hour training that includes information on asthma and allergy topics. The Asthma, Allergy, and Anaphylaxis Prevention and Management is a 4-hour training that covers program practices, polices, and strategies to prevent exposures to allergens and severe allergic reactions. Visit Maryland State Department of Education Office of Child Care (MSDE OCC) website for approved trainers.