Managing allergies

December | 2019

Many children in education and care services experience an allergic reaction when exposed to certain foods or substances that affect their immune system. Some allergic reactions are severe and can be life-threatening, such as anaphylaxis. Whoever is trained to provide first aid in your service should be ready to call triple-zero (000) for an ambulance in the case of severe allergic reactions. However, it’s vital that all staff at your service are prepared and know what to do.

What is an allergy?

An allergy occurs when a person’s immune system reacts to substances in the environment that are harmless for most people. These substances are known as allergens and are found in house dust mites, pets, pollen, insects, moulds, foods and some medicines. If a child in your service has an allergy, it is important to know exactly what causes the reaction.

What is anaphylaxis?

Anaphylaxis is a more severe allergic reaction that can affect the skin, respiratory, gastrointestinal and cardiovascular systems. It requires immediate medical attention. Anaphylaxis usually occurs within 20 minutes to two hours after exposure to the allergen and can rapidly become life-threatening.

Knowing the triggers is the first step in prevention. It is important that children and educators in an education and care service are aware of a child’s food allergens and/or other triggers. Educators need to be able to recognise symptoms of anaphylaxis and be prepared to respond without delay according to the child’s medical-management plan.

Common triggers

Food: Milk, eggs, peanuts, tree nuts, sesame, fish, shellfish, wheat and soy are the most common food triggers. However, any food can trigger anaphylaxis. It is important to understand that some children may have a life-threatening reaction from exposure to even very small amounts of food. In some extreme instances, just the smell of particular foods being cooked, or even touching someone who has eaten the food, can trigger a reaction.
Bites and stings: Bee, wasp and ant stings are the most common triggers of anaphylaxis to insect stings. For some children, ticks can also trigger anaphylaxis.
Medication: Both over-the-counter and prescribed medications can cause life-threatening allergic reactions for some children, as can some herbal medicines.

Common symptoms

In some instances, educators may not be aware that a child has an allergy, as the child’s first allergic reaction can happen at the education and care service. Here are some symptoms you may see.

Mild to moderate allergic reaction

Nose and eye irritation
Hives and eczema
Tingling of the mouth
Welts or body redness
Swelling of the face, lips and/or eyes
Vomiting or abdominal pain

Severe allergic reaction (anaphylaxis)

Difficult/noisy breathing
Swelling of the tongue
Swelling or tightness in the throat
Difficulty talking or hoarse voice
Wheeze or persistent cough
Persistent dizziness or collapse
Pale and floppy (young children)

Your obligations

As an approved provider, you must ensure each service has a medical conditions policy that sets out practices about the management, support and care for children with medical conditions, including children with allergies.

These policies and practices must be reviewed regularly for each child, as their particular circumstance is likely to change over time.

If a child at your service is diagnosed as having an allergy, you must obtain a detailed medical-management plan for that child and develop a risk-minimisation plan to ensure that:

the risks of the child’s allergy are discussed and known by all staff
practices and procedures are in place for safe food handling, preparation and consumption of food that triggers the allergy
the procedures outline identifying the child and the details in the individual medical-management plan
it includes the management of risks during excursions
the child’s specific medication, such as an EpiPen, is accessible and current.

Putting the plan into practice

You also need to consider how to manage the day-to-day healthcare needs of each child. Ongoing communication is one way of ensuring this. As part of the communication plan you must ensure the following:

All staff at the service, including relief staff and volunteers, must:
- follow the service policies and practices
- be aware of all children in the education and care service who have allergies
- be aware of the triggers that cause the allergy for each child
- understand food ingredients and ensure that ingredient labels are checked regularly
- be aware of mealtime procedures for children with anaphylaxis and/or allergy conditions
- adequately support children with allergies to tell others about their allergy and not accept food from others
- help other children be aware of the potentially serious nature of a child’s allergy and how to help them if needed.

Note: It is important that you regularly review mealtime procedures so all staff are involved in ongoing discussions about the procedures and identifying any areas for improvement.

All parents and families should be aware of the known triggers that pose a risk to each child to prevent these triggers being brought into the service.
You should have a clear process in place to outline how parents can communicate any changes to the medical-management and risk-minimisation plans and how these changes are effected in the service.
You should have signs, photos and information on how to respond to anaphylaxis on display and accessible throughout your service.

Approved training

Whenever children are being educated and cared for, there must be at least one staff member who holds a current qualification in ALL of these areas:

first-aid
anaphylaxis management
emergency asthma management.

To meet this requirement, the same person can hold one or more of the above qualifications. However, the educator must be onsite and immediately available in an emergency. Training qualifications must be maintained.

The list of approved first-aid qualifications is provided on the ACECQA website.

Useful information

Contact details

Education Standards Board
Phone: 1800 882 413
Website: www.esb.sa.gov.au
Email: educationstandardsboard [at] sa.gov.au

This fact sheet provides guidance for approved providers of education and care services to help them operate in line with the National Quality Framework. We also recommend referring directly to the legislation:

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