Safe School Lunches for Allergic Kids

Food allergies are on the rise. In children, in fact, food allergies increased by at least 50 percent between 1997 and 2011 according to a study by the Centers for Disease Control. It has also become common for children to have multiple allergies which really makes mealtimes tricky.


While most parents of food-allergic kids have learned to avoid trigger foods with skill in their own kitchens, sending the kids out the door for meals at school can be unnerving. Tragedy helped shine a spotlight on this issue when 13-year-old Sabrina Shannon actually died at school in 2003 after a reaction to cross-contaminated French fries from the school cafeteria.

The safest option for parents is usually to pack their child’s lunch, ensuring that the contents are safe, but there are often more variables at play. Kids may swap foods at lunch and fellow parents may bring in allergen-containing birthday treats for the class to celebrate classmates’ special days. In the cases of the severely allergic, even airborne food particles from other kids’ lunches can trigger a serious allergic immune response.

So how do you master the unknown? Start by working as a team with your child’s school administrators, teacher, and nurse. Meet with them before school starts and present them with a food allergy and anaphylaxis emergency care plan. Download one here if you don’t already have one, or check with your child’s school to see if they have a preferred form. The form should include:

  • An exhaustive list of the foods your child reacts to
  • A list of your child’s allergy symptoms
  • The treatment you want to be administered to your child and the circumstances that merit it
  • Emergency contacts (family, physician, etc.)
  • A photograph of your child.

You should also provide the school with at least one epinephrine auto-injector pen. You may even opt to provide two just in case an additional dose is required.

School Lunch

Sometimes, kids may prefer to buy a school lunch to “fit in” with peers or because they really enjoy the cafeteria’s options. Indeed, according to the United States Dairy Assocation, the school is required to provide your child with “a safe, non-allergic meal” if it has been determined that their “condition is disabling.”

Don’t leave it in the school’s court, though. Check with the cafeteria director to find out what meals your child can and can’t eat. Make sure cafeteria workers aren’t contaminating by using tools or counter space for your child’s food that may have touched allergy-causing foods. Also, make sure that you are informed about any ingredient changes. For example, if the school switches from a bread that didn’t formerly contain egg products to one that does, parents of allergic kids need to know.

If you do pack a lunch, you can keep it exciting for your kids by “mixing it up” with tips from websites.If your child has severe food allergies or allergies that are significantly interrupting their quality of life, consider sublingual immunotherapy (SLIT) for food allergy treatment. SLIT operates on the same principles as allergy shots, only the allergy serum is taken as liquid drops under the tongue rather through shots. Allergy drops for kids have been shown to be safe and effective. They have also been shown to be an effective eosinophilic esophagitis treatment. This disease is common in children and often mistaken for reflux, but it is allergic in origin and often stems from food allergies.

About The Author

Stuart H. Agren, M.D.

Stuart H. Agren, M.D. completed his undergraduate studies at the University of Utah and went on to earn his Doctor of Medicine from Tulane University School of Medicine in 1974. He completed additional training at L.D.S. Hospital in Salt Lake City, Utah and then established his private medical practice starting in 1975. Dr. Agren completed a mini-residency in Industrial Medicine at the Robert Johnson School of Medicine at Rutgers University and also completed training to become a certified Medical Review Officer.

Dr. Agren was the Medical Director at TRW and McDonnell Douglas in Mesa, Arizona and at Stauffer Chemical and Kennecott Copper in Salt Lake City, Utah. He also served as an adjunct faculty member at Arizona State University.

In his private medical practice, Dr. Agren specialized in family practice and allergy. In his work as a private practice allergist, he was one of the first doctors in the country to prescribe sublingual immunotherapy to his patients as an alternative to subcutaneous immunotherapy (allergy shots). He has also been a trailblazer in the field of food allergy treatment and research, developing a program to treat multiple food allergies simultaneously using sublingual immunotherapy. Dr. Agren has been featured on local CBS, NBC, and ABC news affiliates and won the peer-nominated “Top Doc” award from Phoenix Magazine.

After 20 years in private practice, Dr. Agren became the Founder and President of AllergyEasy, which helps primary care physicians around the country offer allergy testing and sublingual immunotherapy treatment to their patients. Over 200 physicians in over 32 states use the AllergyEasy program to help their patients overcome environmental and food allergies and asthma.