Food allergy treatment in kindergarten

First seek first aid and then trace the source, first treat and then communicate - as soon as a child is found to have suspected allergy symptoms such as redness and swelling around the mouth, skin rash, vomiting, suffocation of breathing, etc., stop eating the suspicious food as soon as possible, and the health care doctor will evaluate the status simultaneously. Orally take backup children's antihistamines for mild cases, and immediately inject an epinephrine pen and call 120 for severe cases. At the same time, contact the parents as soon as possible. You must not have any luck of "waiting and seeing if it will go away." No one can afford to delay the golden treatment time.

Last year, when our district’s maternal and child organization held safety training for private kindergartens, we mentioned a negative example from a kindergarten in the suburbs. There was a child in the small class who was severely allergic to peanuts. The parents had reported it in advance. However, when the kitchen was making egg tarts that day, the chef casually sprinkled some crushed peanuts as a decoration. The teacher who shared the meal did not pay attention. The child started rubbing his mouth after taking half a bite. The teacher thought it was egg tarts. The tart was too hot and burned, so I thought I would check it out after eating. Within ten minutes, the child's face was swollen and he began to be out of breath. Finally, he was sent to the hospital for rescue and it took him a long time to save him. The kindergarten paid hundreds of thousands of yuan in compensation, and the kindergarten was immediately closed for three months for rectification.

There are actually two different operating ideas for daily allergy prevention and control in the industry. There is no absolute right or wrong. It all depends on the actual situation of the kindergarten. One is the "zero contact principle" that is favored by many small kindergartens with more than ten or twenty children. As long as a child reports a certain type of food allergy, the entire kindergarten will directly cross out such ingredients from the purchase list. For example, if a child is allergic to mangoes, the whole kindergarten will not buy mangoes for a semester, eliminating the possibility of contact from the source. The advantage is that the risk is extremely low and the process is simple without additional control. The disadvantages are also obvious. On the one hand, there are too many ingredients and it is difficult to prepare meals in the kitchen. On the other hand, many experts in pediatric nutrition have mentioned that this complete avoidance method is actually not conducive to children's awareness of allergic foods. When they reach elementary school, no one will keep an eye on them, and it is easy to accidentally eat and cause accidents. The other is the "graded control model" commonly used in large kindergartens with hundreds of people. First, the children's allergy levels are divided into three levels: mild, moderate and severe according to doctor's advice. Children with mild allergies (only local rash after exposure, no systemic symptoms) only need to prepare allergy-friendly meals separately, place them separately when sharing meals, and feed them by dedicated personnel. Children with moderate allergies and above In addition to handling the meals separately, the kitchen must also prepare separate allergy-friendly cutting boards, knives, tableware, and even food containers that must be separated from those of other children to avoid cross-contamination. At the same time, children will be given popular science education to teach them the foods they cannot eat, and they must not take other people’s snacks or eat things given by strangers. The advantage of this model is that it is more flexible and can help children gradually build up their awareness of self-protection. However, it requires extremely high levels of kitchen management and teacher responsibility, and cross-contamination problems may arise if you are not careful. These two ideas occasionally cause conflicts between parents. Parents of allergic children think that all kindergartens should ban allergenic foods, while other parents feel that why my children can’t eat their favorite mangoes. Most kindergartens coordinate between the two parties, and if they really can’t come to an agreement, they will also recommend that children with severe allergies give priority to small kindergartens with a small number of people, which is more convenient to control.

I have gone through food safety inspections in no less than 30 kindergartens, and the most common omissions I have seen are actually not big process problems, but small, inconspicuous details. In the first aid kits of health rooms in many kindergartens, there are many expired epinephrine pens and antihistamines not intended for children. When asked, they would say, "I have never used them before, and I forgot to check the shelf life." When something happened, they would only find out that they could not be used when they took them out, and it was too late to cry. Some kindergartens receive allergy notices from parents and stuff them into their portfolios without updating them for a whole year. Little do they know that the allergic status of many children will change. Those who got rashes from drinking ordinary milk powder when they were young may have tolerated it by the age of three or four. There are also children who were fine eating eggs before, but suddenly become allergic to eggs after a cold. If they don't re-test every semester, they will easily get into trouble.

Last month, I went to a neighborhood kindergarten for a check-up. I happened to see a child in the kindergarten snatching the seaweed from his classmate and stuffing it into his mouth. The class teacher picked him up and ran to the health room. On the way, he called the parents. The health doctor induced vomiting and gave him children's loratadine. When the parents came over, the child's mouth was just a little red, but nothing happened. Later, I found out that when I asked about it, this teacher would save the photos and allergic foods of several allergic children in the class on the lock screen of his mobile phone every morning when he picked up the kindergarten. He would look at them whenever he had time and remember them clearly.

In fact, after all, the handling of food allergies in kindergartens can never be solved by relying on a thick book of procedures posted on the wall. It requires the kitchen chef to wash the cutting board more than once after cutting the allergenic ingredients, the meal-sharing teacher to take a second look at each child's plate to see if it is correct, the health practitioner to check the shelf life of the first aid kit every month, and the parents not to hide their allergy history with the mentality that "it's just a small rash, there is no need to tell it." After all, for three or four-year-old children, if the adults around them are more considerate, there will be an extra safety gate.