PEDIATRICIAN DR.PAUL ANSWERS: Your question reminds me of the time I was in a meet the teacher meeting for my daughter, when she started grade 1, about 7 years ago. One of the parents was introduced by the teacher as having an important request. The mother explained that her child had severe peanut allergy and asked(actually pleaded) that the parents not send any peanut or nut containing products to school. I was shocked to see the reaction of some of the parents who felt this to be a great inconvenience. One parent actually suggested that the mother take the child to another school. I sat quietly up to this point, but had to speak. So I identified my self as a pediatrician, and gave a quick talk on peanut allergy and its potential consequences. I explained that a peanut allergy can result in "Anaphylaxis" or a generalized allergic reaction. Children with such a reaction, will within moments of coming into contact with what they are allergic to, will start to get symptoms including hives, swelling of the face, mouth, tongue, difficulty breathing, and possibly collapse into shock if untreated. I also bluntly explained that anaphylaxis can result in death, and that indeed as a pediatrician, I have actually witnessed this first hand. The room went silent for a moment and the teacher thanked me for clearing things up. Since then, this particular school has declared itself to be "peanut and nut free".

As a parent of a child with peanut allergy you understand that coming into contact with even a small amount, I mean even microscopic amounts, of peanut (butter) may trigger an allergic reaction. Some children can get a reaction just by smelling peanut odor. Others can get a reaction by playing with some one who ate peanut butter without having washed his hands and/or face. Obviously the younger children are, the more likely that accidents will happen. So I do believe that declaring a school or a day care "peanut free" is appropriate, and most parents will come to understand the necessity if the potential consequences are explained.

Today, most schools are fully aware of this, and a growing number, not only are "peanut/nut free", or designate peanut/nut free zones(especially in younger classes), but have protocols on how to handle a reaction if it occurs, including having the necessary medications on hand, and knowing how and when to use them in an emergency.

Some people criticize peanut-free schools or zones arguing that we are exposing peanut allergic children to a kind of "artificial setting". They say that in the real world one cannot expect to have such peanut free zones. I believe however, that is absolutely necessary to protect children for inadvertent exposure to peanuts and peanut-free schools(or zones) are the best way of achieving this goal. As a peanut allergic child gets older, he or she will learn to read labels and avoid peanut containing foods on his/her own in the real world. In the interim, it is important to ensure that their school or day care setting is peanut-free.

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