1. Special Diets & Food Allergies “Life is really simple, but we insist on making it complicated.” ― Confucius

2. Special Diets Training Objectives Ensure the daily management of food allergies in individual children. Prepare for food allergy emergencies. Provide professional development on food allergies for your staff members. Educate children and family members about food allergies. Create and maintain a healthy and safe educational environment.

3. Special Diets Federal Regulations –Disability Anaphylactic Allergy Diseases requiring modified diets –Metabolic Disorders –Celiac Disease –Diabetes –Non-Disability Non-Anaphylactic Allergy Intolerances Food aversions

4. Food Allergies Definition –A food allergy is when the body mistakenly reacts to a certain food or ingredient as if it were harmful. The food that causes the reaction is called an allergen.

5. Food Allergies Reaction Symptoms –Skin rash or eczema –Swelling of the tongue or difficulty breathing –Itching of the mouth and throat –Cramps, nausea, diarrhea, and/or vomiting –Drop in blood pressure –Loss of consciousness

6. Special Diets What is anaphylaxis? –Serious, quick reaction –Can restrict breathing & circulation –May cause death –Considered a disability

7. What does an anaphylactic reaction look like? Children with food allergies might communicate their symptoms in the following ways: It feels like something is poking my tongue. My tongue (or mouth) is tingling (or burning). My tongue (or mouth) itches. My tongue feels like there is hair on it. My mouth feels funny. There’s a frog in my throat; there’s something stuck in my throat. My tongue feels full (or heavy). My lips feel tight. It feels like there are bugs in there (to describe itchy ears). It (my throat) feels thick. It feels like a bump is on the back of my tongue (throat).

8. Special Diets Food Intolerance – Definition: Adverse Reaction to food that does not involve the immune system – Symptoms: Stomach pain & cramps Diarrhea Gas Nausea

9. Your Role in Food Allergies & Special Diets Food Allergy Report –RIGHTrak- Print report to keep at POS –Review with nurse Menu Substitutions –Special diet order group Using & Providing NutriSlice –Practice! Be able to show parents at Open House –Print off crossed-off menu if needed

10. Printing your Food Allergy Report In RIGHTrak 1.Click “Report Center” 2.Select the “Accounts” Tab 3.Scroll down to “Allergy Report” 4.Select your school from icon or type in school ID number 5.Click “Preview Report”

11. Reading your Food Allergy Report POS Message Key: If food allergy: –“FA: milk, soy, egg” If food allergy puts child at risk for anaphylaxis: –“ANA: peanut” If lactose intolerant: –“LI: lactose-free milk” If food intolerance: –“FI: bananas”

12. Reading your Food Allergy Report POS Message Key (continued): Pheylketonuria (PKU) or Argininosuccinic aciduria (ASA) or Methylmalonic academia (MMA): – “Low pro: no meat, dairy, grain, beans” Celiac disease/gluten allergy/gluten-free: –“GF: no bread-bun-pasta- pizza” Low sodium: –“Low sodium: lunch meat/cheese/salty snacks” Religious/Cultural restrictions: – “R/C: no meat”

13. NutriSlice How-To 1.Go to http://spps.nutrislice.com/http://spps.nutrislice.com/ –this can be found at ns.spps.org as well as on your school site 2.Choose Your Grade Level 3.Choose Your School 4.Choose a Menu Type 5.You can hover over entrée items for more detail, print a PDF, or add money to the account 6.Special Diets Filter and Carb Counts –You should also check out the menu’s Special Diets filter and Carb Counts tool. Just click the buttons on the right of the menu to identify foods with an allergen, see ingredients, or to see a list of foods with their carb counts

14. What are the “Big 8” allergens?

15. Emergencies What do you do if a child eats an offending allergen? What do you do if you think a child is having an allergic reaction?

16. Allergy Video http://foodallergy.k- state.edu/videos/story.html http://foodallergy.k- state.edu/videos/story.html

17. SPPS Case Study Student with Anaphylactic dairy allergy eats chicken stew (which contains butter) –You realize 15 minutes after lunch –Student has gone on field trip; epi pen was left at school –What do you do?

18. Handling Emergencies Know your schools’ plan Know your nurse/health staff Are there students with epi-pens? Where are they stored? Who in your building is trained for their use? If you suspect anaphylaxis, dial 911 –Then contact school administration –Lastly, loop in office at 1930

19. Special Diets Prevent cross-contact during food preparation –Wash hands before preparing foods. –Wear single-use gloves. –Use a clean apron when preparing allergen-free food. –Wash, rinse, and sanitize all cookware before and after each use. –Wash, rinse, and sanitize food contact surfaces. –Designate an allergy-free zone in the kitchen. When working with multiple food allergies, set up procedures to prevent cross-contact within the allergy-free zone. –Prepare food items that do not contain allergens first. Label and store the allergen-free items separately. –Use a clean, sanitized cutting board when preparing food. –Use clean potholders and oven mitts for allergen-free foods to prevent cross- contact

20. Special Diets Prevent cross-contact during meals –Set aside food for students with food allergies from self-service food areas, such as salad bars, before the food is set out. –Use dedicated serving utensils and gloves for allergen-free foods. –Label items on the serving line correctly and clearly so that items containing food allergens are easily recognizable. –Ensure that tables and chairs are cleaned and sanitized before and after each meal and when needed.

21. Special Diets Accidental Ingestion –What do I do now?! Notify Nurse/Health staff Follow school procedure Take all complaints from a child with food allergies seriously, even if they look fine Any signs of anaphylaxis- call 911

22. Special Diet Accommodation Recap Preparing special meals –Cross-contact –Make special meals first –One staff member responsible –No fruit, no milk everyday Training your staff –All staff should be aware of special diets- first name basis –Have a plan in place for handling special diets daily

23. Food-Learning Connection Children cannot learn without healthy, safe food! –Regular milk consumption by someone with a lactose intolerance can cause upset stomach, cramping, nausea, gas, diarrhea—not ideal conditions for learning + [Good Nutrition] + [Whole Community + School + Child Health] = [Student Achievement] =

24. Safe Food If you suspect food borne illness… FBI Form- NS Forms –Listen carefully. –Do not become defensive –Never speculate Fax in form, production records (with packaging information, &temp logs) Call 1930- Mari Lowry is point person If you can, keep a sample from the last meal served, label and freeze (will be sent in for testing if needed) Contact your nurse to see if anyone else reported illness

25. Questions?