Managing Food Allergies in International School Communities
WHAT’S THE ISSUE: Linda Mueller is a certified Life Coach who empowers international women to create a globally-mobile life that they truly love. One of the biggest challenges Linda faced when creating a life that she truly loves was the stress of managing her daughter’s food allergy diagnosis and management while living in three different countries; each with its own unique international school community.
In this article, Linda shares valuable insights and resources to enable international school communities – from administrators to student families and everyone in between – to support food allergy families in their community. Topics include:
- Understanding food allergies.
- The impact of food allergies on global mobility and the role of international schools.
- Five simple ways to protect and include international students with food allergies.
- Resources international schools can use to help build food allergy awareness in the school community.
DISCLAIMER: I want to make it clear that I am a food allergy mom and not a medical professional. The information provided here is not intended to replace professional medical advice. It is based on research I have done to keep my daughter alive as we navigated varying healthcare systems, levels of food allergy awareness, and international school protocols across the globe.
WHAT IS A FOOD ALLERGY?
“There is no such thing as a ‘mild’ food allergy” from RedSneakers.org
In simple terms – a food allergy is a medically-diagnosed health issue that can be life threatening. Food allergies are often confused with food sensitivities/intolerances, which typically result in some form of discomfort (e.g., digestive issues or a rash). The most common causes of food sensitivities are lactose/dairy and gluten/grains. I say this not to minimize the impact of a food sensitivity on a person’s life, but to highlight that it differs from food allergies in that it is NOT life threatening.
When someone has one or more food allergies, allergens appear as poison to the body and trigger an immune response. Symptoms can range from mild (e.g., a slight rash) to extreme and life threatening (i.e., anaphylactic shock).
Reactions vary not only in terms of symptoms, but also in severity, time to appear, and time to resolve from person-to-person and also from reaction-to-reaction for an individual. This is a complex condition that is especially challenging to manage in a country with an unfamiliar language, traditional food, and medical system.
While there is no proven prevention method or cure for food allergies, many are under development. In the meantime, allergen avoidance is the standard management practice and reactions are treated as they arise. People with known food allergies are typically provided with an individualized emergency treatment plan.
According to Food Insight, somewhere between ~1-10% of the global population has one or more food allergies. More recent research estimates that 7-8% of school-aged children worldwide suffer from food allergies. Due to environmental and genetic factors, the rates tend to be highest in westernized nations. For several reasons, there is a lack of global data on how prevalent food allergies are worldwide and which foods serve as top allergens globally. What IS known is that the numbers are increasing globally year-over-year, especially in children. Therefore, this is a challenge that international schools around the world will continue to face for the time being.
Food allergy awareness within the general population, as well as the medical community, appears to be directly related to the number of people impacted within that country. Low general awareness makes those who suffer from food allergies unsafe as support, information, and understanding, especially during a medical emergency, are lacking.
In short, food allergies are a complex and life threatening condition that make global mobility challenging for families managing them. It is a growing problem around the world and one that impacts international school communities whether they realize it or not. Until a guaranteed food allergy cure is found, they may end up being the main reason that a family decides not relocate to a foreign country, as has been the case on multiple occasions for my own family.
managing food allergies abroad
OUR FAMILY'S EXPERIENCE
International school communities are typically a “home base” for globally mobile families with children. In addition to education, expat families turn to this community – its administrators, educators, counselors, nurses, and also other school families – for a wide range of support, including social connection, adaptation to the host country, support when challenges arise, and local resources and recommendations.
There is also an underlying expectation that the international school will be a safe and welcoming oasis within an environment that may otherwise feel very foreign. When a food allergy family approaches an international school – typically the one place where parents must take a leap of faith by letting others supervise their child’s safety – and feels a lack of support, they may decide that it’s too dangerous to move to the host country.
“My vigilance is about keeping my child alive, not about being picky or overprotective. We did NOT choose this life; but it is what we must deal with on a daily basis.” – Kimberly, Food Allergy Mom from kidswithfoodallergies.org
I’ll share some highlights from my family’s international journey to paint a picture of the challenges faced by globally mobile food allergy families.
When we suspected that our then-5-year-old daughter had a nut allergy, we were living in the U.A.E., which had little-to-no nut allergies of record at the time. Therefore, there was also a low level of awareness in the general population, as well as the medical community.
As a result, we were not able to get valid testing or a prescription for potentially life-saving medicine – epinephrine. We assumed that our daughter’s international school would be able to guide us. Not only did the school not have a food allergy policy, but no one we spoke to knew anything about food allergies or supporting local medical care. (Thankfully, our daughter’s teachers partnered with us to keep her safe at school while we figured out next steps.)
We were frightened, stressed, and disheartened by the lack of support. We self-educated and helped our young daughter attempt to avoid all nuts. The suspected food allergy infiltrated nearly every aspect of life from where to buy safe food for home, to how to safely eat or spend time away from home, to how to travel, and the like. We felt isolated and frustrated by the lack of support. Our daughter was forced to grow up quickly as she had to self-advocate at a very young age. Our mental health was impacted by this experience, as we all felt isolated and frustrated by the situation.
When an opportunity to move to the U.K. presented itself, our daughter’s food allergy was one of the key reasons we decided to go. The level of awareness in the general public and the medical community was much higher. That equated to freedom and safety for our family.
Daily life became much easier as we found reliable medical care and received an emergency treatment plan with potentially life-saving medication. The new international school had a no-nut policy, as well as a School Counselor who supported our daughter. The government mandated that food packaging and restaurant menus list allergens, which made the simple act of eating much less stressful.
Yet, we had to remain vigilant. We had to plan ahead and double check any event with food; often feeling burdensome to others. Our daughter was excluded from parties and playdates on occasion due to her nut allergy. We also had to manage our daughter’s stress so that her self-esteem and grades didn’t suffer.
The list of underlying challenges goes on, but one of my most specific memories is a very heated nut-related discussion at our international school. A parent complained that the nut-free policy deprived her children of a healthy snack. Another responded that she would withdraw her child from the school if the no-nut policy was reversed. It was heartbreaking for those of us who felt that the policy not only kept our children safe, but also gave us a common language to use with friends from countries with low food allergy awareness.
We repatriated to the U.S. a few years later. Once again, the decision was driven in part by our daughter’s food allergy. We learned of a medically-supervised tolerance-building treatment called oral immunotherapy (OiT). After completing the treatment, our daughter is still technically allergic to four tree nuts and must carry epinephrine, but she can now eat those nuts without reacting. Our family’s stress has been reduced, freedom has been restored and, most of all, our daughter is no-longer singled out for her allergy.
All of this to say that, in addition to danger, globally mobile food allergy families often face social and emotional stress due to isolation and various forms of bullying. International school administrators and teachers have the power to help prevent this from occurring in their own communities.
creating safety & inclusion
There are many benefits to building food allergy awareness within an international school community, including:
- Teaching compassion and inclusiveness at a young age develops good citizens. This is what creating a safe and welcoming environment for food allergy students teaches all students.
- Positioning an international school as a safe-haven for those with food allergies is a positive differentiator or will at least meet parent expectations, depending on the level of food allergy awareness within the local environment.
For those international school communities that do not currently have a food allergy policy, there is no need to recreate the wheel. The information that schools need to create a safe and inclusive environment is readily available. All that is needed is an internal advocate for the policy and an implementation plan that suits your international school’s specific situation.
A comprehensive, resource-filled guide is the U.S. Center for Disease Control‘s recommendations for five priority areas that should be addressed by a school food allergy management plan:
- Ensure the daily management of food allergies in individual children.
- Prepare for food allergy emergencies.
- Provide professional development on food allergies for staff members.
- Educate children and family members about food allergies.
- Create and maintain a healthy and safe educational environment.
The plan includes tip sheets, training materials, and resources for specific roles within the school, including administrators, teachers, counselors, nurses, cafeteria, and more.
School resources are also available from AnaphylaxisUK, FAACT, FARE.US FAA.AU, and KFA. Take a look to see what is best suited for your international school community.
2023 Food Allergy Awareness Dates
These weeks provide an opportunity to focus on food allergy awareness within your international school community:
- 14-20 May: U.S. Food Allergy Awareness Week
While May is U.S. Food Allergy Awareness Month, 14-20 May is a focused week targeting government and public awareness. Focused efforts during this week amplify awareness of the 32 million Americans who have food allergies, including 5.6 million children under the age of 18 (i.e., 1-in-13 school aged kids). Because of these numbers, the U.S. has become a leader in food allergy research. The 2023 theme is Food Allergy Ally, which invites all to join FARE in promoting awareness, education, and support for those with food allergies.
- 5-11 June: World Allergy Awareness Week
World Allergy Awareness Week is an annual event sponsored by the World Allergy Organization, which is an umbrella organization that aims to raise awareness of allergic diseases, including food allergies, through research and education. The theme changes every year. In 2023, the theme for World Allergy Awareness Week is Anaphylaxis.
FOOD ALLERGY TALKS BY LINDA MUELLER
- Expats on Purpose, “Food Allergies – What you need to know even if you don’t have one”.
- Small Girl Abroad Podcast, “Episode 8 – Globally Mobile Mom”.
Linda Mueller is a certified Life Coach and Mentor who empowers expat partners to create a globally mobile life that they love. With 10+ years of expat partner experience in Asia, the Middle East, and Europe, as well as several repatriations to the U.S.A., she utilizes all that she has learned and experienced to coach with compassionate accountability during all stages of her client’s international journey. From preparation for an international move to adaptation abroad to repatriation, Linda uses proven strategies and tools to help her clients to find purpose, connection, and a renewed sense of self that is independent of location. To learn more about Linda and her services visit: TheExpatpartnerCoach.com.
MORE WELLBEING TRAINING RESOURCES FOR SCHOOLS
- “Expat Spouses: You Matter”, by Linda Muller.
- “Overcoming Self-Sabotage: Helping Teachers Thrive”, by Carolyn Parse.
- “School Mission and Core Values: Matching Words with Action”, by Cecilia Bieganowsika.