Starting preschool is a milestone for any child, but imagine being a 3-year-old who was accepted into a preschool but later denied admission because of a food allergy. That was the case for the Guiffreda family of Hawaii Kai.

Robin and Frank Guiffreda were excited their son Micah would be attending a preschool close to home. When filling out the application, they noted their son’s potential peanut allergies based on two contact reactions. The preschool requested a note from the doctor explaining the extent of Micah’s allergies.

Micah’s pediatrician advised the safest way to test him was to have him see an allergist. A blood test confirmed that Micah had severe allergies to peanuts and shrimp.

On the first day of school, the parents provided the test results and they were informed by the administrator that the school could not accept Micah because it could not guarantee a safe environment for him with the snacks they serve and the lunches children bring from home. The Guiffredas were devastated that their options suddenly became limited based on his food allergies.

A food allergy is when the body’s immune system overreacts to a food protein. The most common foods that cause allergic reactions are cow’s milk, eggs, peanuts, wheat, soy, fish, tree nuts and shellfish. Most children outgrow allergies to cow’s milk, egg, soy and wheat by their teens; only 20 percent outgrow a peanut allergy.

Food allergy symptoms include a tingling sensation in the mouth or swelling of the lips, cramps, upset stomach or diarrhea, itchy skin with hives, stuffy nose, wheezing or shortness of breath, dizziness or feeling light-headed. The most serious reaction to a food allergen is anaphylaxis, which occurs suddenly and may include difficulty breathing, dizziness or loss of consciousness.

This is a life-threatening reaction. Without immediate treatment from an epinephrine auto-injector, anaphylaxis can be fatal. If a child has an anaphylactic reaction after eating a certain food protein, call 911 and administer epinephrine. It is essential to go to the emergency room, even if symptoms subside.

The American Academy of Pediatrics reports that about 1 in 25 school-age children are affected by food allergies. Research indicates that roughly 18 percent of children with food allergies experience a reaction while in school. Therefore, it is critical that parents, teachers, school administrators and the child are trained on what to do if the child is exposed to the food protein.

Parents must be vigilant about educating their child and their caregivers, whether that is grandparents or school personnel, about their child’s food allergy. If a child is known to have severe reactions to a particular food, it’s important to have a management plan to prevent a tragic situation.

For children with severe food allergies, the following steps should be taken:

» Make sure your child sees an allergist and has the doctor’s contact information available.

» Have an allergy kit available at all times that includes an epinephrine auto-injector.

» Have your child wear a medical alert bracelet.

» Make sure your child’s school has an allergy kit and knows how to use it.

I’m happy to report that Micah is now enrolled at Holy Nativity Preschool. The Guiffredas recommend that parents research their child’s school options thoroughly and early, as some schools are unable or unwilling to make accommodations for children with severe food allergies. Micah’s new school has been very accommodating and has procedures in place to ensure a safe environment for him.

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Dr. Jeffrey Kam is an allergist and immunologist at Straub Clinic & Hospital.