Safer Schools: Christine Creter on the Food Allergy Management in Schools Recommendations

Heading back to school can feel stressful for families managing food allergies. Last year, new recommendations for food allergy management in schools were released, offering schools a roadmap for keeping students safe and included. In this episode, I’m joined by Christine Creter to break down what they mean, how they can be applied, and how parents can utilize them to support their child’s safety and success at school. We hope that as your school year is getting started, this episode will give you practical takeaways to help you breathe a little easier this school year.

FAMS Recommendations: FAMS_ExpertRecs_English_9.18_Final.pdf

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Special thanks to Kyle Dine for permission to use his song The Doghouse for the podcast theme!
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-thefoodallergypsychologist.com
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-Facebook: Dr. Amanda Whitehouse, Food Allergy Anxiety Psychologist
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Transcript

Speaker: 0:01

Welcome to the Don't Feed the Fear podcast, where we dive into the complex world of food allergy anxiety. I'm your host, Dr. Amanda Whitehouse, food allergy anxiety psychologist and food allergy mom. Whether you're dealing with allergies yourself or supporting someone who is, join us for an empathetic and informative journey toward food allergy calm and confidence..

0:22

Back to school season is upon us. Some of you are already back and some of us here where I live are getting ready to head back after Labor Day. Whatever your connection to food allergies is, you know how much planning this involves. So I sat down with Christine Creter, who is one of many amazing contributors behind something that was released last year, the Food Allergy Management in Schools, expert recommendations for Grades Kindergarten through 12. Christine is the founder of the group of business combining creative design and content development for live and digital learning programs. And Christine is connected to the food allergy world because she and her son manage life-threatening food allergies. She was involved in managing and coordinating this project, which pulled together an advisory council of some of our top experts and leading organizations in food allergy management to consider and update our recommendations about how to keep our children as safe as possible in schools. Christine, or Chris, as she goes by, is here to talk about how these were developed. Unpack what they mean and to help us understand how schools can put them into practice and what parents can do to collaborate with the schools to make sure that their child is set up for a safe and successful school year. So as you're thinking about your child and what that will mean for the year ahead, I hope that this conversation will give you some helpful information and it certainly will lead you to a really great resource to help you do that.

Amanda Whitehouse, PhD: 1:45

Thank you so much for joining me, Chris. I'm excited to have you here on the show to talk about the food allergy management in schools guidelines that you were a big part of.

Chris Creter: 1:52

Thanks. Happy to be here.

amanda-whitehouse--phd_2_08-21-2025_161723: 1:54

Let's get started by introducing you a little bit. What's your involvement with food allergy personally and professionally?

chris-creter--she-her-_1_08-21-2025_161721: 2:00

Sure, I'll start personally. So, almost 15 years ago I had my little boy, my one and only, and the first time I nursed him, his little face swelled up and we didn't really know why at first. And so we. They took him into the nursery and they checked his face and brought him back, and then I ate and fed him again and it happened again. And so, by day four or five, he was covered in eczema and reacting and. By five months old, we diagnosed him with 10 life-threatening food allergies, and we have since found another seven. So he has 17 life-threatening food allergies plus eosinophilic esophagitis. In that kind of same period of time, I developed five adult onset allergies of my own, which I had eaten all of those foods and I love those foods and no longer can eat. Five, which is sesame peanut, tree nut, coconut, and, scallops. Which is a strange one. And then I also for a career have worked in the healthcare industry doing training. So a lot of times, pharmaceutical training, biotech training, healthcare training with hospitals. And so I started working with nonprofit organizations to do some training initiatives, some strategy work. And most recently had the privilege of spending over a year working on the food allergy management in schools expert recommendations, which was a. Project from the CDC and the AAP.

amanda-whitehouse--phd_2_08-21-2025_161723: 3:17

And that was a group project with a lot of amazing organizations involved. So I know very little. Other than the end result, will you tell us about that process and your involvement?

chris-creter--she-her-_1_08-21-2025_161721: 3:28

Yeah, it was, uh, it was like being on the Food allergy Dream team the first step was to. Figure out how are we gonna do this? We had one year with the grant that we were given from the CDC and the a EP. So we came up with a plan and a strategy for how we were going to approach this. And we wanted to assemble a team of experts that really understood schools. So the first step was to assemble the, the dream team, so to speak. Dr. Pistiner, who many people know, Dr. Michael Pistiner, he agreed to be our chairperson. And then we started grabbing people who agreed to sign on from all different realms of schools. So for example, we had first, the a EP had a couple of representatives with Brooke Bashan and Dr. Wang, Julie Wang. We then had the,, American School Health Association involved, which was Andrea Boudreau. We had representation from the Institute of Child Nutrition with Liz Dixon. We had the School Nutrition Association, Susan Matthew. We then wanted to make sure we encompass school nurses, so the National Association of School Nurses, had Linda Newman join us. We then wanted to also make sure administrators were involved. So we had, Kayla Jackson from the School Superintendent's Association, and then a bunch of nonprofits.'cause they didn't want this. Even though Fair kind of was taking the charge, we had fact, FARE. Jenna from AAFA, um, and Thomas Silvera from the Elijah-Alavi Foundation. And then I certainly cannot forget the attorneys. So it was Mary Vargas and Amelia Smith, that both. out the kind of civil rights and, and legal standpoint. It was the dream team, like the the Food allergy Dream team in one, one room for two days. But we worked together over the course of the year to come up with what the recommendations would be.

amanda-whitehouse--phd_2_08-21-2025_161723: 5:14

Were you literally in one room together? All of those people met in person, which is unheard of these days.

chris-creter--she-her-_1_08-21-2025_161721: 5:20

my gosh. Yeah. Well, we worked virtually at first to kind

amanda-whitehouse--phd_2_08-21-2025_161723: 5:23

Mm-hmm.

chris-creter--she-her-_1_08-21-2025_161721: 5:23

our thoughts and kind of get us into categories of topics that we wanted to make sure we addressed.'cause this is meant to be an extension of. The the 2013 CDC guidelines, but they're not updated. They're not current based on evidence that we have. So the idea was we kind of knew some topics, we drilled it down, and then eventually, once we got to the point where we really had to hash through things, we flew everybody into DC and we were in a room for a couple days, and had some really incredible dialogue

Amanda Whitehouse, PhD: 5:52

I would've loved to have been a fly on the wall. It sounds so interesting. It's hard to even know where to start, but I wanna let people know this is a document that's available. There's a summary at the beginning, that goes over the main topic, areas that were covered, almost like checklist style. Where do you wanna start in terms of letting people know what's in here or what the changes or the most important updates were?

Chris Creter: 6:11

Yeah. Well first just, and how to find this document, it's if you Google Food Allergy Management in schools or fams.org, it does live on the food allergy Research and education or fair website. but you can pull up the whole document and you're absolutely right. There is a two page summary, that starts around page eight, and it looks like a checklist, just like you said, and it organizes the four topic areas and what questions schools might have. To answer. So to just briefly kind of go high level, the four topics were personnel training and education. and the two questions we answer under that were what information should schools even include in food allergy training? And so we addressed that. The second question was, how should schools implement food allergy training?'cause that's a question that came up a lot in our conversation. So that was the first topic. And there are. I think seven or eight recommendations under there. I do wanna point out, this is a 25 page document. It is not the 113 pages of the CDC guidelines. Our goal was to make this shorter and consumable and actionable and it worked. But anyway, that was the first personnel training and education. The second is preventing allergen exposure, which that's probably the hottest topic to discuss because there's a little bit of controversy in how to do prevention'cause it's different in different realms, different age groups, et cetera. And then the third bucket was preparing for emergencies. So that's really responding, and what protocols and procedures to put in place. And then the fourth is about communication and collaboration within the school environment.

Amanda Whitehouse, PhD: 7:47

number one is important with the training and education, but as far as my audience, most of us don't have a say in that part of it, right? That's up to school administrators and. Personnel. So maybe we could start with part number two, which is preventing exposure, which is always a hot button topic. The thing that jumped right out at me is what was the conversation like around, should we have allergen free classrooms in schools? I think that's one of the most heated topics in our community,

Chris Creter: 8:13

It is. And So what you probably saw is that there was not a recommendation on

Amanda Whitehouse, PhD: 8:18

right.

Chris Creter: 8:18

I was a fly on the wall. I was not considered on the expert team. I was the organizer of the expert team, so I had to listen and try not to be biased, which was challenging at times. But it was fascinating because the insights that the various audiences brought. helped us bring light to why we might need a recommendation. So should we have an allergen free room or an allergen free school, was a big topic of conversation and the evidence that people brought up was, well, from a anaphylaxis standpoint, there is not really much evidence that having an allergen free school and by the allergen, what allergen are you even talking about, right? Because. That's a problem, but it's an allergen-free school doesn't necessarily reduce the rate of anaphylaxis in schools, there's considerable evidence to show that. Now there's a lot of other factors that do need to be considered, which is emotional social components. Are there schools that perhaps have people with developmental, challenges where it's just too challenging to try to monitor all the foods and it's just easier to eliminate it? these would be isolated in individualized cases. And as our fabulous attorneys pointed out, you know, this is where section five oh fours come in, and this is where there might be individualized needs to have allergen-free rooms airborne, for example. There might be the case for that, but we can't make a overall recommendation. to have, you know, food free schools or food free rooms or no, because really it might not be what's in the best interest of our food allergy students to do that. So it was just fascinating'cause I went in with a very firm opinion of what I thought was important. And I have to admit, I really, I learned a lot in this process.

Amanda Whitehouse, PhD: 10:06

Well, and it's so tricky. Depends on, I feel, which hat you're wearing, because as a food allergy mom, I'm like, no one should ever have peanuts on the playground. But of course then there's a kid sitting next to me with dairy allergy and I, I, I've got my coffee in my hand. You know, so, so we, we have that perspective. But then as a psychologist, I think how avoid. Begets more avoidance and fear, and it's good for kids if there's not a true medical risk to be in proximity and to be comfortable being near their allergens and knowing how to keep themselves safe, which is different for a preschooler than it is for a senior in high school.

Chris Creter: 10:38

Exactly. And that's where, um, I should point out, these are specific to K 12. There was another group working on preschool, recommendations. I know Thomas and the Elijah Alavi Foundation is very instrumental in all of that. And the

amanda-whitehouse--phd_2_08-21-2025_161723: 10:52

Yes.

Chris Creter: 10:52

work going on. As we saw at some of the conferences we've been to, um, but this is very specific to public schools, K through 12, with the hope that maybe private schools would use it as well for the same age groups, but even within K 12 there are some pretty, significant differences in expectations at the older child age groups versus the younger child age groups. So we wanted to take that into account as well as we went through all of these recommendations.

Amanda Whitehouse, PhD: 11:19

What other parts of that area of the, guidelines do you think are important for us to talk about the, the preventing exposure.

Chris Creter: 11:28

So there's a few questions that we're trying to answer. How should schools identify and document food allergies is a big to topic that came up and what we hear is, in some cases, parents just, they don't wanna have their kids stand out and we don't wanna. tell anybody it's just one allergy and they can manage this. This happens a lot in the older schools, so making sure there's protocols and open door kind of welcoming processes in places in schools to make sure parents feel welcome and it was important that we don't tell schools exactly what to do as long as you're following the guidelines. So for example, how do we identify and document food allergies?'cause there was a lot of conversation between the nurses and the school nutrition staff, for example. The nutrition staff saying, well, I need to know. So that we can put it in the computer system and make sure we don't accidentally give the kid some food. And the nurses are saying, well, I might get this information in, but what's the system and process in place to get that allergen information to the cafeteria? Or a kid comes up in line of cafeteria and says, oh, I can't have that. I'm allergic. And they don't have it in the system, and the nurse doesn't know. So it's making sure that they can identify and document and create a path between. What are like not usual and typical lines of communication within a school system.'cause the nutrition services often didn't have a reason until food allergy to really overlap. So that was just one of the examples that we say established standardized procedures for identifying known food allergies in students. what, no matter where you're hearing that from, have a procedure in the school. So again, we don't say how it's, how is up to the school, the financial impact that this could have on some schools. We were very conscious of Title one schools that may not have the resources to put in computer systems and, you know, all of this. So we were really, really careful not to make, recommendations that would be impossible to implement. Another one was standardizing documentation and communication. Of the known food allergies. That's different than establishing the procedure for identifying known food allergies. So it's funny'cause we would start talking and realize we were almost arguing about two separate things and it would split the recommendation into two. We also had a lot of conversation around 504's and the utility and the need for 504's. And what we kind of came to, well first 5 0 4 is the only legally. document that anybody has to support the accommodations required for their disability, food allergy being a disability. And what I found interesting was the, the fear of the 5 0 4 from a staffing standpoint at the schools, or they don't really need it, or, you know, the, the conversation was just absolutely fascinating about 504's in general. And what we kind of came to was we need to make sure people are aware of. The 504 process and what the needs are of students, if you have solid procedures and policies in place, then many students might not even need the 5 0 4 because theoretically, the school will have the accommodations baked into their policies and procedures Now. Most schools we know don't have that level of policy and procedure or the investment in time in the policies and procedures to allow for that, which then results in the need for a 504 to protect the student. So there is a whole section on defining. The difference between an AAEP, you know, our allergy and anaphylaxis emergency plan, which comes from our healthcare provider, which theoretically goes to a nurse. If the school has a nurse, that becomes an IHP, which is individualized healthcare plan. And then if we need further accommodations, there may be a request for a 504 plan, which is that. You know, the legally allowable right of anybody with a disability to establish what accommodations are necessary in order to keep that student safe and able to learn in the school environment. So this is very carefully laid out and detailed.'cause what we have found is a lot of people were misusing or misunderstanding that process and that cascade,

Amanda Whitehouse, PhD: 15:36

Parents get overwhelmed and confused. There's also then an IEP, which would be used for a child who also then is identified with a learning need or a learning disability, and then the. Accommodations can be looped into that as well,

Chris Creter: 15:47

Yes.

Amanda Whitehouse, PhD: 15:48

it's overwhelming for parents to understand the difference.

Chris Creter: 15:50

overwhelming. All these things. Absolutely, and you're right, the IEP is listed there too, but typically the disability doesn't necessitate the IEP, but an IEP may incorporate. The food allergy disability and 5 0 4 accommodations. So yes, again, another area where I learned a lot, a lot, um, especially from Amelia and Mary Vargas on the, you know, their perspectives on all of this. It was really found fascinating.

Amanda Whitehouse, PhD: 16:15

For the audience, there's a really nice chart inside of the document that explains these, and I think for any parent sending a kid off to school, it's very helpful to know the differences between these so that when you're having a conversation with the school, you, they are used to using this language all the time, and hopefully they're explaining it. But

Chris Creter: 16:31

Yeah.

Amanda Whitehouse, PhD: 16:31

they're, you know, throwing out all of these acronyms and you don't know what they mean, it's a really great chart to have in front of you to help you distinguish between the differences of what they're talking about.

Chris Creter: 16:40

absolutely. I, I, truthfully, just to my humble, you know, lack of knowledge when I was on this, I didn't even know what an IHP was. didn't know that step even happened in a school. And I've been doing this for 14 years with my son. So it was just that knowledge. That's why I keep telling everybody just read this document'cause it's so concisely summarizes what we need. Uh, the next chapter after this in the document is all about school nutrition. about another area where I learned so much. I just, just got back from speaking about FAMs at, the School Nutrition Association Conference in San Antonio. And it was great'cause people are so eager to learn about this and what we do about it, I think we don't appreciate how much goes into the school nutrition and the nuances and following USDA code and. school code, let alone disability requirements. And so this is where I think a lot of these recommendations were really helpful. And then at the school nutrition conference, people just flooded the room. They wanted to stay late, they wanted to ask more questions. So they, they are eager, like a lot of the school lunch programs and, you know, services that are, are conglomerates that are around the country are eagerly and really actively trying to incorporate food allergy information in there. Point of sale digital services and ingredient listing opportunities. So what FAM says is to make sure that we kind of structure our school nutrition services in some way, knowing that this can be a huge undertaking, especially for really large districts, to make sure we create these child nutrition programs and allow students, no matter, if they're on a free lunch program or if they're in a rural area where it's hard to access some allergy safe foods. We still are required by law to do that in most cases.

Amanda Whitehouse, PhD: 18:31

My audience is, is parents, a lot of parents and families. So from their perspective, what should they know about that part?

Chris Creter: 18:36

I think what's really important for families to know from a school nutrition standpoint is that there's a lot more in play than just the food allergy itself. Making sure that you work with the nurse, but you have to point blank, say to the nurse, I need to have this communicated. With the school nutrition staff, who can I meet with Don't assume the nurse can translate everything to school nutrition services because like I said, there's USDA and guidelines that school nutrition has to abide by certain foods, and food types have to be on a plate that goes to any student, and they have to find that balance of different types of nutrition. For every single student, regardless of the the allergy needs. So maintaining what they call medical statements, um, from a state licensed healthcare professional, and that state li medical statement is to require the alternative food and often to give suggestions on alternative foods. Now what happens is you go to your allergist, you say, I need a medical statement. The allergist doesn't know every brand of food that's out there and for a long time. A state licensed healthcare professional was only like a prescribing physician or a nurse, but now they've actually just recently the USDA changed their guidelines where they can actually have a state licensed nutritionist, uh, be that person to write the food modification statements requirements. The reason the nutrition people need this medical statement is for reimbursement purposes, they will not get reimbursed by the state. if they don't have the correct documentation. So this is where for families, they're not just trying to be a pain in your neck and make you go through the rigmarole, it's because they have to make sure that they follow the rules, they get audited, they have to make sure they get refunded, especially for the excessive costs for a lot of the foods for that some of our food allergy kids need. So this was an area that I have such respect for school nutrition professionals and what they're doing. And then just the level of care that goes into the detail you're trying to feed In some of these schools I learned about, I mean you're talking thousands of kids are coming through in minutes, you know, across some states, and to be able to pause and safely make sure you provide. School meals for this nuanced community is exceptionally hard. And you think about people who sign up to be a lunch person, didn't necessarily sign up to save people's lives every day or to prevent children from, you know, a severe allergic reaction. So it's making sure we do the proper training and allow the funding for the time for those staff to be trained. This document just says, basically ensure that students with food allergies as determined by that state licensed healthcare professional, have full and equal access to foods offered by the school nutrition program. And so the training goes into that and a lot of other things. Um, the other thing for all families that. Is a lot harder than I ever realized, which is the publication of meal plans and calendars. Um, so one of the, the recommendation 2.5 to be exact, uh, is to publish weekly or monthly school menus. And that way parents can look at the menu in advance and decide, is this safe for my kid? Do I need to call and find out if there's an alternative or make arrangements or send my own food in? Um, and they can have enough notice to do that. Some of the challenges that come in are school supply issues. The delivery of the chicken nuggets didn't come in and now we have to bob and weave and find a new meal. And uh, now I have to call this parent and I, so with that comes a lot. And what do you put on the menu? Is it all ingredient lists? Are we talking about precautionary labeling? So just putting, well, all we said is just publish a weekly or monthly menu. Like just start with that and then come up with policies and procedures for when those adjustments occur and what you have to do. And that may vary from district to district, depending on who they've subcontracted the, um, the food services too, if they have. And then what they, we absolutely were firm about was maintaining a current food label library. no matter what, it's 25% of all in-school. Anaphylactic reactions are first time reactions, so what we said is if that is a first time reaction, we have to be able to go back 24 to 48 hours and see everything that that child ate to try to dissect and learn. What could have been the culprit for that anaphylactic reaction. So that's that recommendation to me. We all, that was a no brainer. Everybody was like, yes, that needs to be in for sure. Um, but you know, it's not easy to do for, from a school nutrition standpoint. So, know, I, I encourage everybody, if you're involved in school nutrition or if you can read this document, there's so much fine print between these recommendations that kind of give you some. Understanding of how this isn't just so easy to publish a menu. Um, I, I hope that people can kind of have that new respect and create that communication and collaboration with, these folks in the, in the cafeteria and the school nurse and everybody else.

Amanda Whitehouse, PhD: 23:52

Yes. I know how hard it is to run a household and feed three boys three times a day. I cannot imagine. Organizationally, all of the challenges that you're presenting, how much goes into it, how much coordination, so there's so much appreciation, that can come from understanding that why isn't it just so easy to just gimme a menu? Yeah.

Chris Creter: 24:12

So I, I worked with my school district to change, just to take a quick side story my son and I both sat on the wellness committee many, many years ago. So he was young. I mean, he was probably eight years old and we're on this board of education wellness committee.'cause we wanted to try to put some rules in place about like class parties. And there were so many times where my son had to leave the room. He never could participate. We always had his. Stash of treats, you know, for whatever. But inevitably somebody showed up with some, you know, oh, it's a rainy Wednesday. So I brought in cupcakes. I mean, it was a free for all. They'd eat Doritos in the computer room. Um, and so we started to say, can we just put some policy around this and limit the amount of food that is involved in school in a regular basis? So my little son sat in the wellness committee and we talked about policy and we were really working on it. Then he went into anaphylaxis school and we're pretty sure it's from the computer room where they would let the afterschool kids eat, freely, and of course at that point we went into overdrive and we were able to change the recommendations, but we had no. Framework. We had no guidepost or expert recommendations like this to put these rules in place. So we went to other schools, we went to more conservative school policies, and we went to less conservative school policies, and we crafted our own. This document will help the next section, which is called How Can Schools Prevent Food Allergy Exposure? This, to me, is the biggest thing for parents that they can take this document and literally go through this like a checklist and say, this is what the expert recommendations from the CDC and the A A P say is the best thing to keep students from having exposure to allergens at school. And the first one is, when possible discourage eating in classrooms. Now we also know that in a lot of schools there are no cafeterias, so that is, it's impossible to say we can't always eat in classrooms, so we finished that recommendation with if eating in classrooms is necessary, designate an area for eating that is separate from the learning spaces, especially younger children to prevent that cross contact. So that was the first big, big one. And we put in some best practices for how to do that within the document. So you can read that. The second recommendation that came right on its heels, and this was one of those that we were kind of battling and then it separated out was wash hands before and after preparing, serving, or eating meals or snacks so that we can avoid food. Allergen cross contact. And this includes surfaces. So two 2.10 is about hands. 2.11 is about surfaces. So those three together are discouraging in classrooms. But if you have to wash hands and wash surfaces what those three recommendations together say, and we did make a big call out that hand sanitizer and sanitizing sprays on tables is not effective. It is ineffective at removing food proteins and to make sure that no one does that with a citation. So, so you can use that with your schools when they're saying, oh, we can do. Parties and snacks and everything else.

Amanda Whitehouse, PhD: 27:15

Yeah. And I, as a psychologist, I just, this is one of the things that I find the most often, um, that surprises the adults in kids' lives in terms of how much time kids spend the same way we do as allergy moms, you and I, when they're supposed to be learning a really hard new math concept or learning how to read, and all their thinking is, like you said, they had Doritos. It's on their, their hands. I can smell it. You would be shocked at the amount of time that kids explain to me that, that that's all that's in their head when they're at school. And then we expect them to be learning. It's not just, it is obviously first and foremost about their safety, but it's, they're at school to learn

chris-creter--she-her-_1_08-21-2025_161721: 27:50

Yes.

amanda-whitehouse--phd_2_08-21-2025_161723: 27:51

can't learn when that's their mindset and, and when they're in that panic or fear or hypervigilant state.

chris-creter--she-her-_1_08-21-2025_161721: 27:58

Absolutely. Absolutely. We have since put policy in place and we're currently updating it for these, these new recommendations in my town. But I sat at a parent night, it was at the end of the last school year, and I went into an elementary school classroom where they had this meeting, and this was for like a specific learning environment thing that my son's in and. All parents from all different age groups are in there, and one, it, it's food free. Now our, our building classrooms are now all food free at the elementary level. We're working on it at the other ones, but they, one mom pulls out a bottle of water, a bag of nuts, literally a bag of almonds. I'm allergic almonds, and all I could do is sit there and stare at her. I have no idea what this meeting was about because then all I'm sitting there, I'm thinking. Oh my gosh. I, I, I can't shake her hand. Oh. And I better make sure I stay after and I have wipes in my purse and I can give them to the teacher to make sure we wipe the desk off so a kid doesn't come in tomorrow and eat it. I spent my whole time thinking, and exactly what you just said, I was thinking. Wow. Like these kids do this. You know, these little tiny kids whose brains can't even really get around much else other than I know this is unsafe for me. They just need to be learning. Every single kid just needs to be learning. That's it.

amanda-whitehouse--phd_2_08-21-2025_161723: 29:12

Yes.

chris-creter--she-her-_1_08-21-2025_161721: 29:13

that, and.

amanda-whitehouse--phd_2_08-21-2025_161723: 29:14

Oh my gosh. Yeah. Yeah. And they, they're so little. They don't even know what it is in there. They just know that they feel afraid. It's, you know, it could take an hour long therapy session for a kid to actually have the help to put that into words, what you and I, as adults can articulate so easily. My heart, goes out to those little kiddos that are carrying this through school

Chris Creter: 29:32

I

Amanda Whitehouse, PhD: 29:33

all and everywhere they go.

Chris Creter: 29:34

then not isolate them either. So like some of these next recommendations were things like discourage sharing of food items among students, not

Amanda Whitehouse, PhD: 29:42

Right.

Chris Creter: 29:42

the allergy kid. They'll be like, okay, you guys can all share Lollipop, but this kid can't, like, don't give it to this kid. Just recently we had an incident where. The, there was a team eating, I guess they eat lunch together in the high school and a person in the school, like a teacher walked into the room and said, oh, you guys can't do this next year.'cause the, the, we have this allergy kid coming up and it's that moment of like, the allergy kid shouldn't create this wave of change if we have the right policies and procedures in place. Across all of our schools, then we're not isolating any one kid because of their specific needs. But I think discouraging sharing of food items, that's one. This one was huge. Encouraging the use of non-food student incentives and rewards in classroom celebration. So this was, you don't hand out lollipops because everybody got above the 90 on the test. You don't, uh, I had a teacher that would take the juices that the kids didn't want from their lunches, and then she froze them with Popsicle sticks in them and then handed them out to the kids thinking, well, it's a school lunch. Like I can give school lunch items out. And eventually had to communicate that. First of all, you're setting a precedent. Second of all, it could be potentially dangerous. You don't know if one of those kids is or is not allergic to that type of. or juice or whatever it is. And so this is where the education, again, is gonna fuel that. But stop with the food rewards. Give them exciting experiences. I'm sure you've heard of plenty of fun things to do at school that does not involve a cupcake.

Amanda Whitehouse, PhD: 31:15

Absolutely. Before we started recording, you were talking about the episode that I had done with Sarah Horing. She's a friend of mine and an administrator in the schools and the district that I live in. And this was a huge, thing that she, was trying to get across in the schools There's so many fun ways to celebrate and honor and connect and enjoy things with kids as humans. I think we need to learn to disconnect that. With from food. Food can be joy and pleasure and, and all of those things, but it shouldn't be the only source of it for a lot of reasons that just do reality.

Chris Creter: 31:44

that that episode was fantastic. She was

Amanda Whitehouse, PhD: 31:46

She's great.

Chris Creter: 31:47

and I completely agree. I've seen it done where people make a creative thing. So since our policy took place, they asked whatever non-food type celebration could think of, and someone's grandmother came in who was in the military and used Morse code. And so she came in and taught Morse code to all these kids. They talked about this for the whole year. Just because it was a unique different experience for her granddaughter's birthday, you know, and extra recess is very popular for the birthday and things like that, mystery readers. And you don't need the cupcake. You just

Amanda Whitehouse, PhD: 32:22

agreed. Agreed. Anything that fosters connection. That's the point of it, right?

Chris Creter: 32:26

yeah,

Amanda Whitehouse, PhD: 32:27

I think that's, that's so much more important.

Chris Creter: 32:29

What's scarier though is when it doesn't happen in, when it, when that same issue with exclusion happens in the academic setting. And so 2.15 says, ensure students with food allergies can fully participate by evaluating school materials, activities. Projects for potential food allergens and make those adjustments accordingly. So we give examples of, you know, you can't have Play-Doh if you have a kid with a wee allergy or unless you have Safe Play-Doh. And is it safe Play-Doh for everyone or is it just the food allergy student? Um, you know, you talk, think about the egg drop and the, milk cartons and the bird seed

Amanda Whitehouse, PhD: 33:06

Oh, and the Halloween. Squish our hands into mystery foods and pretend they're scary

Chris Creter: 33:11

Sensory tables. Yeah, it's a relatively abbreviated document compared to what had been there before. And there's hyperlinks. To ideas. KFA kids with food allergies, which is through AAFA, they have a link in there to like great ideas. I know FAACT has some and fair has some as well. To get ideas for what you can do in your classrooms, even in the curriculum. And this even happens in high school. The medium in science classes, the, if you were dissecting, if you have a child with Alpha G syndrome, they can't do the pig, you know, they can't dissect the pig. So we really have to think about. How much influence this can have in different settings.

Amanda Whitehouse, PhD: 33:49

Definitely there. There's so much here but let's touch on the third section, preparing for emergencies.

Chris Creter: 33:54

Sure. I'll have to say the preparing for emergency section was probably one of the easiest

Amanda Whitehouse, PhD: 33:58

Mm-hmm.

Chris Creter: 33:59

really aligned on, easiest to agree on, I should say.

Amanda Whitehouse, PhD: 34:02

Sure. Great. Because we need, everyone needs their epinephrine, right? Bottom line.

Chris Creter: 34:06

Exactly, and so really it, you know, the, the first bit was just about protocols and procedures and having an a a P in place and who knows about the A A P, the allergy and asthma emergency plan. Is it good enough if it's in the nurse's office? Probably not, because the teachers need to know. So all the right people that need to know and making sure that you don't. HIPAA at the same time. So we did have a lot of dialogue about that. Um, but really it's up to just, it's about maintaining those aeps year over year and making sure that your IHP, which is the internal document at the school that's educating the school nutrition and the gym teacher and everybody else on what to do is updated. And the 504 plan accommodations are also communicated. So that is really that intersection that needs to happen at a school. It's not just about having it on file, it's about making sure the accommodations are made and that the child isn't ostracized for having those accommodations, really the best practices around epinephrine was some of the most. Engaging, dialogue, and that's really around unassigned epinephrine or we know as stock epinephrine, maintaining a constant supply. And that's hard because we know that there's been gaps in the available resources. For ordering it, but what we saw was a bigger problem was actually who's responsible for it. So making sure that you have a person assigned, that you have it on the calendar when you have to update it, that you know when the expiration dates are of that epinephrine. your state allowed to use all different types of epinephrine? Because now that we have nasal epinephrine and we're soon to have sublingual epinephrine, does your state even allow you to have that as unassigned epinephrine? So I know for me in my state of course,'cause I am who I am, I went to my representative and. worked and just finally this month now have, different forms of stock epinephrine available for our schools. But that is not the case in the whole country right now. So it's not so easy. There are some links embedded, that you can access to get free stock epinephrine or unassigned epinephrine in schools, but making sure you have those procedures in place so that it's. don't have expired epinephrine on the wall is so, so important. and then allowing students who are deemed ready by their caregivers and healthcare providers to self-care or self administer. We've heard so many stories where they were told they can't or they're not allowed to. So this is where our recommendation, and this may mean we have to make some state district policy changes in order to allow this. And I think that's the biggest thing to know is your state may just not allow some of these recommendations to happen yet. So. Sometimes we might have to go to the state level or the, you know, state Board of education to, to fix some of this. But our recommendation is that if a student is deemed acceptable to self-care by their healthcare professional, then they should be able to self-care or self administer. And that's just for access reasons.'cause we found too many districts where it's still a, a rule to lock. The epinephrine up. And so that was number 3.5 is the next one that said store unassigned and assigned epinephrine in secure areas that are unlocked and easily accessible by staff. that was because we've just heard so many stories, so, so many stories of people that can't access their own epinephrine'cause of the rules of the school. So hopefully this can help change some of that state policy or the district policy that does still require the lockup of the epinephrine, which I still just don't understand

Amanda Whitehouse, PhD: 37:43

Right,

Chris Creter: 37:43

that.

Amanda Whitehouse, PhD: 37:43

right. And for right, because we hear, the stories that I hear are that it was locked in the nurse's room. It took someone 10 minutes or the nurse wasn't in the building and that's. That's terrifying if that's what your school is telling you, it, it's, we have so much more confidence going to the district with a document like this in our hands, explaining, sharing references, you know, it can, it can help us to communicate what we know to have this behind us.

Chris Creter: 38:05

Yeah, and The big thing for me now with this tool, the tool's, great. Right? This, this document, this is comprehensive. It's, I mean, it has links to free training programs. There's nothing in here that you cannot not implement, right? All the training, just click the link, give it to your school. They can do it for free. It's all in here. The problem is coordinating all the resources,

Amanda Whitehouse, PhD: 38:28

Mm-hmm.

Chris Creter: 38:29

the nurse, the administrators, the time it takes to do policy. Obviously, food allergy is not the top of mind for a school administrator. Everybody's under budget constraints now. Funding is, you know, going away from. Different sources. So people get worried. They're not focused on this. So really what it takes is us parents to bring this to the attention of a school board or a a school and to say, can we put procedures in place? And if we don't have a policy, you can still put procedures in place to make some of this stuff happen. And starting with your own principal and your own school nurse, and create a little collaborative team and try to say, oh, here, we can make this. Together. And I think that's the impetus and the effort that this is gonna require is grassroots people taking this and actually doing something with it now because it is not a requirement that people follow these recommendations. I wish it was, but right now it's gonna take us getting this out there and helping schools make the necessary changes to keep these almost 6 million kids with food allergies across the United States safe.

Amanda Whitehouse, PhD: 39:33

It's a great point that you make and so we all can be inspired to use it and to, advocate and collaborate and connect with the people that, we need to in order to enact what we know is based on all of the evidence and research and best practices and the minds of all, all of the people in the allergy world who are our leading experts. So I wanna thank you for the time you put into this, all of those amazing people and organizations, because we do feel overwhelmed as parents and families in something like this. Brings so much clarity and so much confidence in, in what to how to approach certain things that we don't know what to do about.

Chris Creter: 40:10

Well, thank you for allowing me to help get it out there and if anybody wants to reach out and. Ask me for more answers if I have them, or ways I can point you. I'm more than happy to help out. But I think the more schools, the more districts that can start to embrace this we'll just keep our kids safer until we have a cure for this, this thing that we're all dealing with.

Amanda Whitehouse, PhD: 40:30

Yes. Yes.

amanda-whitehouse--phd_2_08-21-2025_161723: 40:31

Thank you. I appreciate you taking the time to chat and explain this to us in such a great way that helps make it, something that we feel like we can grasp. Because the concept is big, but the document and the way you're explaining it are very digestible. Of

Chris Creter: 40:42

you. Thanks for having me.

Amanda Whitehouse, PhD: 40:44

course.

40:46

I hope that today's conversation gave you some clarity and some confidence about the steps that schools can and should be taking to protect children with food allergies. How to consider what might be the most helpful for your child and maybe some ideas for communicating and collaborating with your school if you feel like there's some work to be done in that area. These recommendations are a great tool to help you think through what a safe and inclusive learning environment looks like for your child. So here's some action steps to help you follow through on what we chatted about today. Number one, find the recommendations. They're easy to find if you just do a search for food allergy management in schools. They're housed on the FARE website, food allergy.org, and I'll put the link in the show notes Number two. Sit down and carefully consider your child's accommodations. Get out their paperwork. Look at the plan. Some of you may have just sat down with the team and reevaluated this, renewed your paperwork. Some of you, it may have been quite a while since you had a meeting to discuss this, so I'd encourage you to get it out, look through it, think about. What parts of your child's day seem to be going well, where there might have been some difficulties in the past, and if there are areas where you or your child don't feel so sure about how things are managed, number three, if you've missed it, this would be a great time to go back and catch episode 11 of the show. It's called From Home to the Hallways with Sarah Horning. She is a wonderful friend of mine and an amazing school administrator, and her discussion about how she influenced change in the school district that we live in is also a very positive and encouraging chat about similar topics that we discussed today. By working together with our schools and communities, we can help to protect kids with food allergies and make them feel supported and free to focus on their learning. Thanks for tuning in. If you enjoyed the show, I would very much appreciate a rating or a review. And if you would share this with anyone else who might enjoy listening, Here's to a safe and confident start to the school year. the content of this podcast is for informational and educational purposes only, and is not a substitute for professional medical or mental health advice, diagnosis, or treatment. If you have any questions about your own medical experience or mental health needs, please consult a professional. I'm Dr. Amanda Whitehouse. Thanks for joining me. And until we chat again, remember don't feed the fear.