There are various situations where children may have an adverse reaction to a food because of an allergy, intolerance or sensitivity.

Food allergies

Food allergies are caused by a reaction of the immune system to a protein in a food. The most common sources of food allergy in children under five are cow’s milk, soy, eggs, peanuts, tree nuts, wheat, sesame, fish and shellfish. Even very small amounts of food can cause an allergic reaction. Food allergies occur in around one in 20 children, and some of these allergies are severe. Symptoms of an allergic reaction are usually immediate and can include hives or a rash on the skin; swelling of the lips, tongue or mouth; vomiting; diarrhoea; or difficulty breathing. Severe cases of allergic reaction can lead to an anaphylactic reaction, where breathing becomes extremely difficult. This can cause loss of consciousness and severe injury or death.

When children have a severe food allergy, it is likely that parents will already have an allergy management plan that has been developed with their doctor. Individual allergy management plans must be developed by families, in conjunction with the setting’s director or coordinator. Refer to the Australasian Society for Clinical Immunology and Allergy (ASCIA) website for more information on allergy management plans:

Ensuring that children avoid exposure to foods they are allergic to is the only way to manage a food allergy. This means avoiding exposure at all times – mealtimes, during cooking, and craft activities. Everyone working with children needs to be aware of the early symptoms of a food allergy, and must be trained in how to manage allergic reactions. Each setting should have its own allergy management policy, in addition to individual allergy management plans.

Food provided by the setting It is important to ensure that safe, allergen-free foods are provided to children with allergies. In some instances the easiest way to do this may be to exclude foods from the menu to which children attending the setting have been diagnosed as allergic. An alternative is to prepare meals and snacks specifically for children with particular allergies, or sometimes, after discussion with the family, it may be decided that the safest option is for the child to bring food from home. Children with food allergies must be closely supervised at meal and snack times.

Food brought from home

Children should be discouraged from swapping or sharing food. If a child attending the setting has a severe allergy, it may be necessary to have a policy that prohibits children from bringing snacks and lunches containing that particular food. For example, if a child has a peanut allergy, the policy may be that no peanuts or peanut pastes are allowed in the setting at any time. The policy and its implementation will depend on the types and number of foods that may need to be avoided, the severity of each child’s allergies, and the possible nutritional impact on other children of omitting those foods. Again, close supervision at meal and snack times is essential.

Food intolerance

Food intolerance or sensitivity typically results in less severe reactions than allergies. Usually, a larger dose of food is required to cause a reaction from food intolerance. Symptoms of food intolerance can include headaches, skin rashes and stomach upsets. It is important to work with parents to develop a plan to manage a child’s food intolerance which minimises the child’s exposure to particular foods.