Partnering with educators when your child has asthma or an allergy

If your under five has an allergy, asthma or other health condition, the prospect of sending them off to child care can be daunting.

The bustling early childhood education (ECE) environment brings both opportunities and risks, and it’s common to feel trepidation when putting your little one’s health care into the hands of another.

You might be worried that your child will pick up traces of peanut, or have an asthma attack during outdoor play, but you can take comfort in the fact that ECE services must provide healthy and safe environments for all children, and they’ll work with you to ensure that your child’s specific needs are safeguarded, and emergency plans are in place.

Here, we see how you can approach and manage this relationship with your ECE provider, and what to do if things go wrong.

How can you collaborate to ensure your child’s ECE environment is allergy- or asthma-friendly?

From an ECE point of view, the government recommends that services implement four key strategies to create an allergy-friendly or asthma-friendly early learning environment. ECE services should:

1. Know how to recognise and respond to an allergy or asthma attack,
2. Develop and implement health and safety policies and procedures, reviewing these regularly,
3. Create inclusive systems that support everyone to feel safe, confident and included, and
4. Create an inclusive learning environment, with learning opportunities that minimise risk, reduce anxiety and support youngsters to manage their health and wellbeing.

Your ECE service will have general enrolment policies, food safety policies and medication policies in place, along with procedures for reporting, recording and investigating incidents (like allergic reactions). However, it’s important that you work with them to convey your child’s individual needs to minimise risks, reduce anxiety and foster inclusivity.

Here are three ways that you can collaborate with your ECE service for the good of your child’s health and your peace of mind:

1. Start by sharing your child’s medical history, possible triggers and emergency responses

During the enrolment process, it’s important to tell your ECE service about your child’s allergy or asthma.

Fill out your service’s standard medical form carefully (ensuring you answer any supplementary questions that they’ve added to identify learners with allergies or asthma) and give written consent for the administration of any medicines your child may require while at ECE.

If your doctor has written up an action plan for your child’s allergic reaction, anaphylaxis or asthma, make sure you provide an up-to-date version of this at enrolment and then review it annually.

An action plan helps educators to recognise a reaction or attack in your child, know how to respond (depending on the severity of the reaction), and know what medication to administer, and when. This plan provides crucial action in a life-threatening emergency, and it also explains your child’s allergens or triggers, so your service can avoid them.

If you need to provide your service with medication for your child (e.g. an EpiPen or asthma inhaler), then make sure it’s within its used-by date and stays that way. If the medication is used, it should be replaced as quickly as possible.

2. Meet with your ECE service to discuss your child’s individual needs, as well as your own

Staff and educators are on hand to support you through the enrolment process, and a face-to-face meeting is a valuable opportunity to build a relationship with them, discuss your child’s specific needs, and allay any concerns you have.

Your ECE service will likely organise the meeting proactively, and before you go along, think about any particular questions or concerns you have (e.g. ‘Who has authority to use an EpiPen on my child?’, ‘How quickly will I be called in an emergency? or ‘Will my child get to participate in cooking classes with the other children?’)

Once the meeting is underway, this is a chance to discuss risk minimisation strategies, develop a health care plan, and hear about your service’s health and safety policies and procedures for managing allergies/asthma.

3. Build the partnership by providing your input and expertise on a continuing basis

Once your child is settled in to their ECE service, it’s important to keep their medical information up-to-date and remain partnered with your provider. You know your child best, and the government calls on ECE services to value whānau expertise.

When it comes to allergies, they encourage your service to:

• Involve you in all levels of policy and procedure reviews focused on allergies,
• Listen to any concerns you have, and provide multiple ways to communicate with you (e.g. through newsletters, parents’ meetings, social media and posters),
• Ask you, your child and whānau, ‘What would help?’,
• Make time for regular and frequent discussions with you and your whānau to learn more about effective safety strategies, and
• Recognise the emotional toll that allergies can have on families.

This ongoing collaboration between parent and ECE service is also key if your child has asthma. In this case, you’re encouraged to share any concerns you have, work together to reduce common asthma triggers (e.g. dust mites, dog dander, pollen and mould) and collaborate with your service to create an asthma-friendly ECE environment.

As a parent you can also help your child to share their thoughts, feelings and views. For instance, if your under five is feeling anxious about having an asthma attack, or left out because they have different food from other children, it’s important to talk through these concerns with your service and find solutions (e.g. by showing them how easily an educator can access their inhaler, or sharing a morning kai of allergy-free foods). 

Quality ECE services are committed to creating an inclusive environment where your child can take part in the same educational and recreational activities as other children, and if your family isn’t happy with how something is being managed, or doesn’t feel included, it’s really important to speak up and make your feelings heard.

What happens if your child has an allergic reaction or asthma attack?

Despite the best intentions, accidental exposure to allergens can happen when under fives eat, play, share and touch; and it’s possible for asthma attacks to strike in the hours between drop-off and pick-up.

This is why it’s so important that your ECE service knows how to recognise and respond if your child has a health problem/emergency.

Your service will be guided by your child’s action plan (if they have one), and Allergy NZ says services should manage a mild to moderate allergic reaction (such as hives, swollen eyes or stomach pain) by:

• Staying with your child and calling for help,
• Giving medications, if prescribed, and
• Contacting you or another family member/carer.

In the case of anaphylaxis, emergency treatment is needed and your service should:

• Lie your child down flat,
• Give them adrenaline immediately,
• Call an ambulance,
• Contact you or another family/emergency contact,
• Follow standard resuscitation measures if their pulse/breathing is absent and give another adrenaline dose after five minutes if necessary.

If your child has an asthma attack, your service will react quickly, and specific first-aid responses are detailed here.

From an administrative point of view, ECE services, ‘Must record and investigate all allergic reactions, whether mild or severe, that require medication and teacher time/attention), and early learning services must report notifiable events to WorkSafe (e.g. serious injuries and illnesses).

You will also want to know what happened, and if it could have been prevented.

It’s important to talk things through with your service and raise any concerns you have. If you’re not satisfied (e.g. you suspect that health and safety policies and procedures were not followed), then you’re entitled to make a formal complaint by following your service’s complaint process.

If you’re not happy with how your complaint is then handled, or you’d like to make an anonymous complaint, you can get in touch with the Ministry of Education directly (for more information, click here).

What if your child has another health condition, like epilepsy or diabetes?

If your child has a health condition other than an allergy or asthma, it’s equally important to collaborate with your ECE service and help them get to know your child’s medical history and your needs as a parent.

There are resources available to teach ECE services about different health conditions, but you play a vital role in helping them to understand your child’s condition, avoid triggers, recognise symptoms, and spring into action in a health emergency.

Although you might feel anxious about sending your child to ECE, the best way to ease your concerns is by planning for the best, preparing for the worst and partnering with your child’s care-givers in a responsive and reciprocal way.

We wish you well as you embark on your child care journey together.

References

TKI: Guide to Asthma and Learning

TKI: Guide to Allergies and Learning

Allergy NZ