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Allergy in schools
Pre-schools - Common allergens
Common allergens
If you cater for food-allergic pupils, the ingredients used in school meals must be monitored scrupulously. Even tiny traces of an allergen can be fatal for severely allergic pupils.
Egg
Most children with egg allergy have only mild symptoms, but a few experience severe, life-threatening reactions.
Food labels must be thoroughly scrutinised for products containing egg or albumen.
The emulsifier known as lecithin (E322) can be derived from egg, although in practice this is uncommon. If you in doubt about any product, contact the retailer or manufacturer.
Some egg-allergic children can eat well-cooked egg (in cake, for example) without any ill effects but not raw or lightly cooked egg. Others are allergic even to egg which has been well cooked.
A lot of fresh pasta contains egg, but you will certainly be able to find a dried pasta that is egg-free. Some varieties may occasionally carry a very small risk of cross-contamination with egg. Check with individual companies to identify the safe ones.
Revisions in the EU labelling regulations mean that all major allergens will soon have to be named in the ingredient list. But food companies have until November 2005 to comply.
Many companies are improving their egg labelling ahead of the deadline, but you would need to contact the manufacturer if you are in any doubt about a product.
If a child has severe egg allergy, it is vital that the parents provide input into what their son or daughter can have.
Some supermarkets produce lists of their own-brand products free from egg.
Fish
Allergy to fish – such as cod and other white fish – may begin in childhood and is likely to be lifelong.
People who react to one type of fish are wise to play safe and eliminate all fish from their diet, as there is a high risk of cross-contamination between the different types (e.g. on the fish counter). Those with an allergy to fish may be able to eat shellfish, but again it is important to be aware of the risk of cross-contamination.
Some ingredients to look out for and avoid include surimi (a seafood product present in some processed foods), Caesar salad dressing, Worcestershire sauce and Caponata (all of which are likely to contain anchovies), and kedgeree (a rice and fish dish).
Note that exposure to a minute amount of fish can cause a reaction. People have been known to go into anaphylactic shock after inhaling airborne particles of the allergen at open markets.
Milk / dairy
Most children with milk allergy have only mild symptoms, but a few experience severe, life-threatening reactions. In severe cases, even trace amounts can trigger symptoms. Fortunately, revisions in the EU labelling regulations mean that all major allergens will soon have to be named in the ingredient list. But food companies have until November 2005 to comply.
Many companies are improving their milk labelling ahead of the deadline, but you would need to contact the manufacturer if you are in any doubt about a product.
The types of foods to think about include cakes, biscuits, pies, breads, crisps and other snacks, processed meats, ready made meals, most vegetable margarines, gravy mixes, desserts.
If a child has severe milk allergy, it is vital that the parents provide input into what their son or daughter can have.
The ingredient list may refer to cow's milk under a less common name, such as casein or whey.
Foods to be avoided by someone with milk allergy include butter, or anything with butter in the title such as buttermilk.
Also to be avoided are cheese, yoghourt, ghee, curds, ice cream
This list may not be exhaustive.
Peanuts
Roasting and heat treatment do not reduce the allergenicity of peanuts or tree nuts – they can trigger a reaction either raw or cooked.
Peanuts are also known as groundnuts, Earth nuts and monkey nuts.
It is fairly common for people with peanut allergy to react to tree nuts, and vice versa. Doctors often advise people with peanut or nut allergy to play safe and avoid all nuts.
A research team based in Southampton showed that refined peanut oil poses little or no risk for the vast majority of people with peanut allergy, in contrast to unrefined peanut oil, which is likely to retain its allergenicity. For full details, click here.
Beware of salad dressings containing unrefined nut oil.
Peanuts are legumes rather than nuts, but it is probably unnecessary for the child to eliminate other legumes (such as peas, beans and lentils) unless there is evidence that they cause problems.
Sesame
The rise in sesame allergy is probably linked to its increased use in cooking: it is often used for flavouring and decorative purposes in foods. People who are allergic to sesame must seek to avoid it completely, as even a tiny amount may trigger a severe reaction. Heating does not destroy the allergenicity of sesame.
Dishes containing sesame include tahini, gomashio, hummus and halvah. Chinese stir fry oils sometimes contain sesame oil. Sometimes it is to be found in Aqua Libra.
People have also reported allergic reactions to vegeburgers, breadsticks, burger baps, cocktail biscuits, Middle Eastern foods, Chinese and Japanese foods, stir fry vegetables and health food snacks containing sesame.
Sesame oil should be regarded as extremely risky because it is almost certain that it will be unrefined, and therefore contain the allergenic proteins that trigger allergic reactions.
Bread and other products bought from in-store bakeries must also be viewed as suspect because these may be contaminated by sesame seeds from other bread.
Shellfish
Adverse reactions to shellfish are rare in young children, and are usually not seen until the teenage years or adulthood. This may be a reflection of the fact that shellfish is not normally a part of the diet of young children.
Shellfish are biologically distinct from fish and can be divided into four main groups: crustaceans (e.g. crab, lobster, crayfish, shrimp, prawn); bivalves (e.g. mussels, oysters, scallops, clams); gastropods (e.g. snails) and cephalopods (e.g. squid, cuttlefish, octopus).
Those who are allergic to one type of shellfish are often advised to avoid all shellfish due to the risk of cross-contamination (one type of shellfish might touch another in a fish market). They often also avoid fish for the same reason.
Tree nuts
Tree nuts include almonds, Brazil nuts, cashews, hazelnuts, pistachios and walnuts. They are biologically distinct from peanuts, which are actually legumes. Tree nuts and peanuts are by far the most common allergen in the UK.
If you are allergic to almonds, avoid almond essence.
Roasting and heat treatment do not reduce the allergenicity of peanuts or tree nuts.
Food labels should be scrutinised thoroughly. Foods most likely to contain peanuts or tree nuts include cakes, biscuits, confectionery, veggie burgers, salads and salad dressings, pesto sauce and Indian,
Chinese, Thai or Indonesian dishes. Marzipan and praline are both made with nuts.
It is fairly common for someone with peanut allergy to react to tree nuts, and vice versa. Doctors often advise people with peanut or nut allergy to play safe and avoid all nuts.
