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Attack of the Killer Peanut Butter Sandwiches

Note: This article explains why it is necessary for schools to enact a variety of measures to keep food-allergic children safe, and why it is not as simple as teaching the food-allergic children to "be careful." Parents, educators, and medical professionals may distribute this article in their local area. For media requests for reprint permission, please click here.


A few of your child's classmates have life-threatening food allergies, and it seems as though the entire school is being penalized for their misfortune. You just received a letter from the principal announcing that they're banning food in the classroom, food at class parties and food sharing at lunch time. They're setting up a special "allergen-free"table in the lunchroom. They're even considering banning peanuts and peanut butter altogether.

What's going on? Since when is peanut butter (the dietary mainstay of children across the country) a "killer food"? Why should the entire class or school be inconvenienced for the sake of a few kids? Why can't they just teach the kids with food allergies to watch what they eat?

If only it were that simple.

How Can Food be "Life-Threatening"?
Although you've probably heard many people claim that they have "food allergies," a true food allergy is a much more serious condition than a food intolerance (such as lactose intolerance) or sensitivity (such as "MSG gives me headaches"). A true food allergy is an immune system disorder in which the body believes that a particular type of food is harmful, and reacts accordingly.

When a severely food-allergic child eats even a tiny amount of the food to which he is allergic (or, in some extreme cases, merely touches or inhales particles of that food), his immune system releases massive amounts of chemicals and histamines. Symptoms, which can begin within seconds of exposure to the allergen, can range from mild – such as a few hives on the face – to an extreme, potentially fatal reaction known as anaphylaxis.

Anaphylaxis can make one or more bodily systems go haywire. The biggest danger is that the child's throat can swell shut, her blood pressure can drop rapidly, and she can literally "drop dead" – all within minutes of ingesting even a minuscule amount of allergen.

Managing a child's life-threatening food allergies can be quite a challenge. There currently is no cure, and the only "treatment" is complete avoidance of the offending foods.

So Why Can't the Kids with the Allergies Just Be More Careful?
Obviously, no one wants a child to drop dead in the lunch room. This would be a horrific tragedy, and quite traumatic for the entire school. But a lot of people wonder why the kids with the food allergies can't simply be taught what they can and cannot eat.

The answer is that these kids are taught what they can and cannot eat, and once they're old enough to understand most will only eat the approved foods. The biggest problem in the school setting is food residue. When the other children eat they get food on their hands, and the residue of this food can end up all over the school – on the lunch tables, playground equipment, classroom supplies, etc. If food is eaten in the classroom, food crumbs can blanket the classroom as well.

If the food-allergic child accidentally touches some of this food residue and then rubs his eyes or nose, or touches and eats his food, a life-threatening reaction can be triggered. Peanut butter is an especially troublesome food. This is because peanuts tend to cause the most severe reactions from the smallest amount of exposure, and peanut butter is a sticky and oily substance that is not easily cleaned off of hands or other surfaces.

What is boils down to is that expecting the food-allergic children to "be more careful" and avoid touching any and all surfaces while at school – including tables, chairs, playground equipment, papers, books, scissors, art supplies, and so forth – is not a realistic solution, especially for younger children.

Isn't There Some Sort of Medicine They Can Take?
So what happens if a child does have a reaction while at school? Can't you just give her some antihistamine or something?

Yes and no. Allergic reactions must be noticed and treated very quickly, preferably within 2 to 3 minutes of the exposure. Antihistamines will not affect an anaphylactic reaction. The child must immediately be given a shot of epinephrine (using an epinephrine autoinjector, a nifty device that doesn't have an exposed needle) and then be rushed to the hospital emergency room for further treatment and observation.

There is no guarantee that the epinephrine will work and that the child's life will be saved.

Even in the best-case scenario the child will be kept at the hospital for about 5 hours for observation, as many reactions will come back later for "round two." Of course, seeing a classmate taken away in an ambulance can be quite frightening for the rest of the students as well.

These Precautions Really Are Necessary
For reasons that have not yet been determined, a medical problem that was practically unheard of a generation ago is now becoming increasingly common. For an ever-growing number of students peanut butter sandwiches really have become "killer" foods. The challenge for our schools is to create a safe environment for all students. The challenge for you is to put yourself in the shoes of these students and their parents, and understand that the precautions that the schools are taking – while they can be inconvenient – really are necessary.

About the Author
Linda Coss is the author of "What's to Eat? The Milk-Free, Egg-Free, Nut-Free Food Allergy Cookbook," "What Else is to Eat? The Dairy-, Egg-, and Nut-Free Food Allergy Cookbook," and "How To Manage Your Child's Life-Threatening Food Allergies: Practical Tips For Everyday Life," all of which are available at


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