Can adrenaline be dangerous?
Adrenaline is a safe, well-understood drug. If an adrenaline injection is administered correctly (into the child's thigh muscle) there is almost no chance of harmful side effects.
The injections that doctors prescribe - the EpiPen or the Anapen - are pre-loaded, single-dose injectors that can be administered by lay people.
Childcare staff who volunteer to administer the injection need to undergo a brief training session, led by a health professional. This training can be arranged through the local surgery, or through local health visiting and school nursing teams. Alternatively, the child's consultant may help.
Your child's early years setting should ensure that its insurance arrangements provide full cover for staff acting within the scope of their employment.
How can you educate your allergic child?
Learning begins at a very early age. Toddlers are taught not to touch a hot stove or to put small objects in their mouths. Likewise, it's important to start teaching children as soon as possible about avoiding certain foods, and knowing what to do if they eat something they react to.
Children are always quick to pick up on any anxiety that parents feel. To reduce your own anxiety, parents need to become well informed and talk through any concerns or problems with the doctor.
Here are tips for parents:
* Be matter-of-fact when you discuss allergies in earshot of your child.
Keep calm and be aware of the tone of your voice and the unspoken messages you are sending out.
* Be careful of the language you use when you talk about the dangers.
Although it's important to convey seriousness, references to death will not help.
* Involve your child when teaching others. Avoid talking about your child's allergies as if he/she is not present.
* Remember that the aim is to help your child to feel empowered to handle people and situations. Be careful not to instil panic or fear, which may overwhelm and stifle your child.
Can milk allergy be serious?
Most children with milk allergy experience mild symptoms, but a few have severe reactions. It is vital to find out which category each individual child is in. Special care and vigilance are needed. Even a splash of milk or yoghurt may cause a skin reaction in a severely milk-allergic child.
Spillages need to be wiped thoroughly and hands washed.
As with all allergies, food labels need to be scrutinised carefully. Milk can turn up unexpectedly in pre-packed food and the parents of any allergic child will need to offer firm guidance to childcarers on what can and what cannot be eaten. Milk can appear under the names casein or whey.
If the child has a milk substitute (such as soya) there needs to be a foolproof system for ensuring that the child is not given the wrong drink by mistake.
What activities require special care?
Where a child's egg allergy is severe, it's best to play safe and assume he or she could react to skin contact with traces of egg. Some nurseries now avoid using egg boxes or egg shells for growing cress.
It's probably best not to use face paints on allergic children. Some may be mildly allergic to the ingredients. It may not cause a bad reaction, but could cause an unpleasant rash.
Commercially produced play dough could contain allergens that allergic children react to. Nurseries can find out the ingredients from the manufacturer or make their own using flour, salt, water, bottled vegetable oil, cream of tartar and food colouring (ensuring that no children react to any of these). Vegetable oil bought in a supermarket is likely to pose a negligible risk for children with nut allergy, but your wishes on this should be respected.
If you have a nut-allergic child, their nursery should avoid putting together collages that use nuts.
Some pre-schools are worried about junk modelling using boxes that have contained nutty cereals. To play safe, they could use a non-nutty cereal box, and inspect all modelling materials thoroughly.
Bird feeders and pet food need careful scrutiny. If they contain nuts, it might be difficult to control the spread of nut protein from hands to play surfaces.
Children known to be allergic to animal fur or saliva need watching if their nursery or school keeps pets.