The search for a daycare and the first few days of a child’s integration are often anxious moments in a parent’s life. It goes without saying that, this process can be even more demanding when food allergies are involved. Below you will find tips to keep your child safe in their new environment as well as an overview of the different protocols and procedures already in place in Quebec daycare centres to accommodate children with food allergies.
Tips for a safe integration
On your child’s first day at daycare
- If not already done, ask your allergist to complete an individualized emergency plan.
- Read the daycare’s documentation and policies in order to fully understand the daycare’s integration program and how child identification, meal planning, and field trips will take place. These documents can be used as a starting point for discussions with the daycare centre.
- Report your child’s allergies before or when registering your child.
- Make an appointment with the daycare before your child’s first day. Try to keep an open mind; good communication and collaboration between parents and the daycare is vital to the success of your child’s integration.
- At this first meeting, the daycare will ask you to fill out certain forms. You will need to provide an accurate list of foods already integrated in your child’s diet. During this meeting, you will also discuss the child’s allergies and the individualized emergency plan in case of an allergic reaction, as well as the different strategies in place at the daycare centre.
- Provide them with at least one auto-injector (be sure it’s not expired).
- Take note of its expiry date and be sure to replace it at the right time.
- Have your child wear a medical ID, such as a MedicAlert® bracelet or necklace.
Suggestions for developing your child’s autonomy
- Explain that some foods can make them seriously ill.
- Inform them of the allergens they should avoid.
- Get them used to wearing a medical ID, or a medical identification bracelet or necklace indicating their allergies.
- Teach them to recognize the symptoms of an allergic reaction and to tell an adult immediately if they occur.
- Teach them to wear their auto-injector at the waist (when mature enough).
- From an early age, involve your child in preventive measures (you are his role model!):
- Wash hands before and after meals.
- Wash the kitchen countertops before cooking.
- Take responsibility (e.g. put their placemat on the table before eating).
- Develop the reflex to always read labels before using or eating a particular food (teach them to ask an adult to do this if they are not old enough to do it themselves).
- Involve them in preparing their food.
Daycare Protocols and Procedures
Facilities that are able to accommodate children living with food allergies, whether private or public (CPEs), have protocols and procedures in place for their integration and safety, some of which are mandatory in Québec.
An allergic child’s identification documents, as well as protocols and procedures, are designed to ensure their safety. These will include, for example, meal and snack preparation, specially adapted menus, a list of dishes and snacks specifically for the child, personalized distribution of meals using a colour code or adapted dishes, a careful selection of ingredients (e.g. systematic reading of labels), as well as methods designed to limit cross-contact.
The daycare will also have to make sure that information about the child’s allergy is effectively transmitted to everyone within the daycare, including the administration, the person in charge of meals, the child’s educator and the entire childcare team. When a child is allergic, especially if they are at risk of anaphylaxis, it is crucial to know where they are at all times and how they will be treated in the event of an allergic reaction.
As part of their mandatory first aid course, daycare staff are trained to recognize the symptoms of anaphylaxis
With regards to hygiene and safety, special training is required for all operators of premises where food is prepared, including kitchen work methods to prevent cross-contact. This training is mandatory for daycares that care for more than 9 children, recognized by the ministère de la Famille
(Food Regulations, Chapter P-9, r.1
). As for home daycare owners, they must comply with several but not all sections of these regulations. For this reason some parents of allergic children opt for a daycare centre run by the ministère de la Famille
According to the Educational Childcare Act
, “A permit holder [for a childcare centre] must ensure that each childcare staff member holds a certificate not older than 3 years attesting that the member has successfully completed a minimum 8-hour early childhood first aid course including a component on the management of severe allergic reactions or a minimum 6-hour refresher course updating the knowledge acquired as part of the early childhood first aid course.” (art. 20)
Is the removal of allergens from childcare settings recommended and feasible?
It is utopian to eliminate all food allergens from the kitchen of a childcare setting, given the large number of foods that can cause severe allergic reactions. In this context, it is best to be well prepared and adopt effective methods that will prevent cross-contact and reduce the risks for children with allergies. It is crucial that the entire childcare team receive the same training on food allergies and/or food allergy management so that staff can collaborate effectively to ensure safety.
The childcare centre’s approach should also be shared with the parents of allergic children, in complete transparency. Actions should focus on prevention and the integration of safety nets to reduce risks for allergic children.
In some circumstances, temporary removal of allergens could be considered, for example, in a home childcare centre or in groups with younger children. This would give the manager and staff time to adapt and to put effective allergen management strategies in place.
Allergy Quebec offers training courses for daycares, schools, and other youth centres.