1. Prevention and management of allergic reactions to food in child care centers and schools: Practice guidelines
- Author
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Jonathan O'b Hourihane, Richard Loh, Carlos A. Cuello-Garcia, Jan Brozek, Derek K. Chu, Lana Rosenfield, Lisa Galloway, David Fahmy, Greg Gartrell, Brenda Weitzner, Kyla J. Hildebrand, Susan Waserman, Michael Langlois, Nicola Hamilton, David Fleischer, Mimi L.K. Tang, Theresa Bingemann, Douglas G. Mack, Julie Wang, Sally Schoessler, Heather Cruickshank, Motohiro Ebisawa, Antonella Muraro, Laura Bantock, and Matthew Greenhawt
- Subjects
medicine.medical_specialty ,Child care ,business.industry ,media_common.quotation_subject ,Selected interventions ,Immunology ,Psychological intervention ,medicine.disease ,Health equity ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Food allergy ,Family medicine ,medicine ,Immunology and Allergy ,Health education ,Quality (business) ,030212 general & internal medicine ,business ,Grading (education) ,media_common - Abstract
Food allergy management in child care centers and schools is a controversial topic, for which evidence-based guidance is needed. Following the Grading of Recommendations Assessment, Development, and Evaluation approach, we conducted systematic literature reviews of the anticipated health effects of selected interventions for managing food allergy in child care centers and schools; we compiled data about the costs, feasibility, acceptability, and effects on health equity of the selected interventions; and we developed the following conditional recommendations: we suggest that child care centers and schools implement allergy training and action plans; we suggest that they use epinephrine (adrenaline) to treat suspected anaphylaxis; we suggest that they stock unassigned epinephrine autoinjectors, instead of requiring students to supply their own personal autoinjectors to be stored on site for designated at-school use; and we suggest that they do not implement site-wide food prohibitions (eg, "nut-free" schools) or allergen-restricted zones (eg, "milk-free" tables), except in the special circumstances identified in this document. The recommendations are labeled "conditional" due to the low quality of available evidence. More research is needed to determine with greater certainty which interventions are likely to be the most beneficial. Policymakers might need to adapt the recommendations to fit local circumstances.
- Published
- 2021
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