Managing Milk Allergy in Canadian Schools

in Managing Allergies, Parenting & School
Published: August 21, 2014

Lynne Glover and Elodie close upLynne Glover with daughter Elodie.
From the archives: Allergic Living’s report on how to protect kids with milk allergy in Canadian schools, given how pervasive dairy is. Cheese, milk yogurt, pizza, popcorn, you name it – dairy is in everything. For the U.S. article, click here.

LYNNE GLOVER breathed a sigh of relief as she piped icing onto the last of 560 allergy-safe cupcakes she created for a special event at her daughter’s school. Running back and forth between two ovens, Glover and another parent had spent the past two full days at school baking. The week before, she had done the same thing – except with cookies – all to allow her daughter Elodie, 6, to participate despite her severe allergies to dairy and eggs. But Glover’s efforts were thwarted on that occasion: the cookies had been served alongside dairy-based hot chocolate.

This time would be different, vowed the mother of five from Hamilton, Ontario. After all, the school had approached her beforehand to ensure the event could be allergy safe. And this time, it was different: instead of hot chocolate, milk cartons were handed out to all the kids.

The last straw for Glover came when Elodie was dismissed from school because of respiratory issues. It happened once after popcorn was microwaved and Doritos were eaten in class. Then again, after the kids in her class had been eating chips. All these foods were coated in dairy-based powder.

Glover cupcakesLynne Glover works on the 560 cupcakes.
“So that was it,” she says. Glover refused to send Elodie back to the school and filed a complaint against the Hamilton-Wentworth Catholic District School Board with the Human Rights Tribunal of Ontario, in which she seeks an accommodation plan for her daughter.

As for the school board, spokesperson Toni Kovach says she can’t comment on this specific case, but that the board does have “very comprehensive procedural strategies of what individual schools do to protect the child with the allergy.” Still, she notes the board is in the process of reviewing its anaphylaxis policy with input from parents of allergic pupils.

Pulled Out of Canadian School

Elodie, who is still enrolled, is now receiving home instruction – a teacher from the school visits the house every morning for an hour and drops off exercises for the rest of the day. Glover feels she was forced to bring Elodie home: it was a tough call, but she simply no longer felt her daughter was safe at school.

Sending a child with food allergies to school is always nerve-racking, especially in the early grades. Even with adult supervision, a room full of rambunctious children eating in close proximity, spilling, playing and getting sticky with food can be a scary image. You need to have a good management plan in place with the school, which includes measures to significantly cut the chances of allergen exposure.

Dairy allergy, however, presents three unique challenges. First, it’s often misunderstood and dismissed as lactose intolerance. Second, dairy products are seen as essential for kids’ bone and brain development. And above all, there is the staggering number of food products contain dairy, making it extremely challenging to avoid. Given the combination of concerns, it’s no wonder that many parents lose sleep over sending dairy-allergic kids to school.

“It’s in crackers, chips, medications, it’s just crazy the minefield we have to navigate on behalf of our kids until they can do it themselves,” says Stephanie von Dehn, a food allergy parent and co-coordinator of the Metro Vancouver Anaphylaxis Group. “All of us in the group with kids with multiple allergies say that, if we had a magic wand, dairy would be the first one we would get rid of. It’s the hardest allergy to manage.”

What’s worse is that many of the messier, more smearable dairy-based foods are manufactured specifically for kids, complete with colourful cartoon characters on the packaging: cheese strings, yogurt tubes, chocolate milk and pudding cups. School traditions like pizza days, birthday parties, milk programs and bake sales all hinge on foods that contain dairy, and it can be isolating for a child to be continuously excluded from the events.

Canadian Schools Not ‘Getting’ Milk Allergy

Implementing strategies to reduce the risk of exposure for the allergic child is clearly the better route, but that requires awareness that dairy allergies can be severe. Many people still don’t understand the difference between a life-threatening dairy allergy and lactose intolerance. “At her school, they’re not understanding that dairy can kill,” says Glover. She’s not alone in this sentiment. In interviews conducted by Allergic Living, many parents of dairy-allergic children echoed this concern.

Danielle Stewart_Disney 005Danielle Stewart and Olivia, who has a milk allergy.
“They just don’t get milk allergy,” laments Danielle Stewart of Ottawa, whose 6-year-old daughter Olivia has multiple food allergies, including dairy. “Nobody thinks that you can be as severely allergic to milk as you can to peanuts.”

Dairy is typically regarded as something children need. Keeping peanuts and even tree nuts at home is relatively easy to manage, but ask parents to add dairy to the no-fly list and it could be perceived as an affront to their child’s well-being.

This remains the case despite the fact that Canada’s Food Guide only recommends two servings per day of milk for children aged 8 and under. This means kids without the allergy could get all the dairy they need simply by drinking a glass of milk in the morning and a second one after school.

But in this complex and emotionally charged landscape, most parents of dairy-allergic children don’t think a so-called “food ban” is viable, or even desirable. “I know how hard it is for me to pack a lunch for my daughter – I wouldn’t want to wish that on anybody else,” says von Dehn. So the question becomes, how can we straddle the line between keeping students with dairy allergies safe, and not asking too much of the community?

Howls of Protest over Food ‘Bans’

In Ontario, one school board faced great howls of protest in 2012 after taking the route of restriction and telling parents that neither dairy nor egg products were allowed in two kindergarten classes at one  school. But Glover’s human rights complaint has nothing to do with trying to make her school or even Elodie’s classroom a dairy-free zone.

“I’ve never used the word ‘ban’, I’ve never put forth any demands,” she says. “This comes down to being denied an accommodation plan, to actually plan out what would be appropriate. We’ve just been winging it all along.”

In this family’s case, that’s the biggest issue – Elodie has an anaphylaxis plan at her school, but it simply says she has food allergies and exercise-induced asthma, and maps out the emergency steps to take if she begins having symptoms. There are no provisions to reduce risk of exposures to her allergens in order to prevent a reaction from occurring.

Yet Sabrina’s Law, which Ontario passed in 2005 following the death of 13-year-old Sabrina Shannon  requires school boards to establish an anaphylaxis policy that includes “strategies that reduce the risk of exposure to anaphylactic causative agents”. In keeping with the law, the Hamilton-Wentworth Catholic board’s policy states that schools must implement such risk-reducing measures, but it doesn’t specify exactly what these must be. There is clearly grey area here.

“Sabrina’s Law doesn’t get into those kind of details about how you do something – there are so many variables,” says Laurie Harada, former executive director of Food Allergy Canada. She stresses that risk-reduction measures are an essential part of any anaphylaxis plan. “The best strategies come with input from the whole community.”

Each case has to be custom fit: parents must work with their schools to develop strategies that keep allergy risks in perspective but also will be workable. Harada says these could include asking fellow parents to leave the more “spillable” dairy products at home, extra supervision during mealtimes, a separate eating area, classroom policies around food sharing and hand washing, and more. It depends on the individual student, the student’s needs, the school community and the physical school setting.

Canadian Schools’ Successes

It’s important to realize that many parents do, in fact, successfully send their dairy-allergic children to Canadian schools. This takes a combination of good planning, cool-headed communication, receptiveness from the school and continuing vigilance.

When a dairy-allergic child’s school enrolment looms, the first thing that parents should do is meet with the principal and teacher, well before the start of the school year. Bring a letter from an allergist that confirms the allergy’s severity and the importance of avoidance. Make sure the school has a formal written anaphylaxis plan for the child. Aside from including what to do in case of emergency, press to have risk-reducing measures included. This is crucial: if the plan states little more than “if there is a reaction, inject epinephrine”, then it’s not good enough.

If the province has a law or guidelines surrounding anaphylaxis in schools, bring a hard copy to the meeting. One parent explained how things changed dramatically after she brought in a copy of the province’s guidelines about anaphylaxis in schools. The school administration changed its tune on accommodations.

A lot of what happens next depends on the individual teacher. Some ‘get’ food allergies better than others. “You hit the jackpot when you get a teacher whose child has allergies,” Karen Eck, leader of the Ottawa Anaphylaxis Support Group says. Conversely, it should be remembered that not every educator has had direct experience with food allergies. It’s wise to counter knowledge gaps with patience and education, not frustration and anger.

‘Dairy Allergy Can Be Managed’

“Even in kindergarten, a dairy allergy can be managed,” says Isabelle Mercier, a teacher at Meadowlands Public School in Ottawa. Mercier begins the year by teaching the class about the allergy, what foods can cause a reaction, and what can happen during a reaction. She teaches kids to use straws and partially close containers of milk to reduce spilling.

If a spill occurs, the kids are to stop what they’re doing and get Mercier right away – only she is allowed to clean it up. “The same rule applied to yogurt and cheese,” she says.

At Simon Fraser Elementary in Vancouver, principal Bonnie Kent ensures that allergy information is sent home to parents of kids who share a class with a food-allergic child. Risk-reducing strategies include individual placemats, food allergy education for the children and strict policies on hand washing after eating and no sharing of food.

Eating is restricted to certain areas where proper clean-up is ensured. For the younger children, a support worker is present whenever food is in the class to help ensure there is no accidental contact.

If your school is short on teaching assistants, see if one who is present for another child can be permitted to keep an eye on both children when food is being eaten.

The teacher may also be willing to e-mail a list of ingredients to parents of milk-allergic children ahead of time whenever food is to be in the class. If anything looks unsafe, parents can suggest alternatives. In a similar vein, many allergy mothers send in a “safe treats box” or bake and freeze “emergency cupcakes” for unexpected food situations, so their child is never excluded. One parent group even succeeded in getting their school to require signed permission forms for food-related events.

Communication is Vital

The cornerstone of successfully managing this allergy is clearly communication. And it’s important to communicate the right way. Playing the role of the “hysterical parent” could make things worse – either by making school officials dismiss the concerns, or by scaring them into thinking the allergy is unmanageable. Go in prepared, and know the steps that you want to accomplish. It may help to relate if son or daughter has had an anaphylactic reaction and been to hospital, but then move forward with ideas to help the school accommodate and include your child.

“It becomes a delicate balance between keeping your child safe and having a positive presence in the community,” says Eck. “If you show up and you’re just a freaked out parent, they think you’re over-reacting.” That’s why she stresses it’s important to communicate calmly. “You have to learn when to kick up a fuss and get involved, and when to just breathe through the nose and relax. Try to present yourself with calm to the rest of the world. Go in assuming that they’re going to help you find solutions.”

Glover was close to reaching a partial agreement with the school board that would allow Elodie to return to school in autumn 2014. But there were still some issues to work out at a hearing. The results in this case have implications for food allergy management in schools in Ontario.

Meanwhile, Elodie is doing very well, her mother says. But the child still misses her friends. Let’s face it: being schooled from home because of food allergies isn’t anyone’s idea of a fair solution.

All children deserve to attend school in a safe, inclusive fashion, whether they are in perfect health or live with diabetes, asthma, a physical disability – or a severe milk allergy. Communication is the king of answers when dealing with such a condition: if school boards, principals, staff, parents of allergic kids and the school community at large are willing to work together to make it happen, then a dairy allergy should be a manageable challenge.

Update: Lynne Glover was able to reach an accommodations plan with the Hamilton school and district in September 2014. Elodie has returned to school. See here for details.

See also:
Food Allergy Bullying on the Rise
Schools and Allergies Resource Hub