Foods Blanket-Ban: Evidence-Based or Fear-Based?

The childcare centre I was doing casual work at for many years had, like many, “nut-free zone” posters at several spots throughout. Even though we hadn’t had an allergic to nuts child over all the years I was working there.

One day, the signs were replaced by “nut and sesame free zone” ones. I asked why and was told that a child who was anaphylactic to sesame started attending the service.

All good, all fine. We were all informed of this and watched children’s lunchboxes carefully, daily, to make sure no nuts and no sesame products were sneaked in the “free zone”.

One afternoon, I was in charge of applying sunscreen on the younger children of the 3-5 years’ room, and when I called one of the girls for her turn to get sunscreened, she went “I can’t use that one”, pointing to the bottle of sunscreen I had on the table next to me.

I asked her why and she said that it was because that sunscreen had sesame in it - she’s the child who caused the “nut and sesame free zone” posters to come to an effect. I checked the ingredients list on the bottle and there was indeed a warning about the product containing sesame seed oil!

To cut the story short, the point here is that what kept that little girl safe that day wasn’t the “sesame-free zone policy”. EDUCATION did. She was well aware and instructed about what could potentially cause her harm. Probably by her parents and health professionals.

The LACK OF EDUCATION by me and my colleagues put her at risk and the “nut and sesame free zone” posters to shame.

In the Best Practice Guidelines for anaphylaxis prevention and management in CHILDREN’S EDUCATION AND CARE SERVICES – our most current resource, commissioned by the Australian Department of Health – the recommendation is that “An allergy aware approach is recommended rather than implementing food bans. Banning foods, and use of terms such as ‘nut free’ is not an effective strategy for preventing or managing anaphylaxis in CEC services.”(1).

Bingo! We had the posters, but were not aware of all the sources of sesame coming into the “sesame free zone”.

Education is key, and training, mandatory

A survey published in 2019 reported that almost 10% of ECECs in the country (excluding WA) don’t require anaphylaxis training from their staff which is not in accordance with current legislation (2).

The same survey found that, in the view of centre directors/managers, their staff were appropriately able to respond to an anaphylaxis emergency, but they also stated that their EpiPens were kept in a locked-up location which is against recommendations (2). This suggests that there is a gap between recommendations and information given away in training, and the actual practice. It also tells us that the perception of safety is higher than reality shows.

Experts, time-and-time-again, take the opportunity to highlight the importance of prioritising education and training for ECEC professionals.  In their article titled Childhood food allergy and anaphylaxis: an educational priority, Dr. Raymond Mullins and Dr. Richard Loh, of ASCIA, mention that “Risk management requires patient and carer education on reducing the risk of exposure to allergic triggers…” (3). That’s what makes the “allergy aware zone” an “allergy safe zone”.

Blanket-ban of certain foods may have their place in specific circumstances, but that’s a topic for another article.

In general, current training on allergy and anaphylaxis management for staff, and proper implementation of monitoring processes are more effective than foods blanket-bans to keep the ECEC setting allergy-safe.

We created a workshop to help you keep nutrition on your children’s plate while managing allergies and intolerances at your centre. Learn more about it here.

References:

(1) Best Practice Guidelines for anaphylaxis prevention and management in CHILDREN’S EDUCATION AND CARE SERVICES (including outside school hours care) (2023).

(2) Food allergy management in Early Childhood Education and Care Services in Australia (Study, 2019, Australia)

(3) Childhood food allergy and anaphylaxis: An educational priority (Study, 2015, Australia)