Nut-free lunch? Parents speak out

March 18, 2014 Volume 20 Issue 4
  • Parents of nut-allergic children vary in their views of how schools should manage their child’s lunchtime.
  • Most parents of children without nut allergies (58%) think schools should have nut-allergic children eat lunch in a designated area, such as a nut-free table.
  • Less than 40% of parents support a school-wide ban on nut-containing products.

Children with allergies to peanuts or tree nuts must be very careful about what they eat, or may face life-threatening consequences. At home, parents of nut-allergic children can monitor everything their child eats, but this is more difficult when children are at school.

Schools face challenges in deciding the best way to structure lunch and snack time for children with nut allergies, striving to ensure the safety of the nut-allergic children while not being overly restrictive with non-allergic children. To explore this challenge, the C.S. Mott Children’s Hospital National Poll on Children’s Health asked a national sample of parents of children 5-12 years about their preferences for handling lunch and snacks for children with nut allergies.

Peanut Allergy and Lunch Room Rules

Among 816 parents with children 5-12 years old, 5% reported that their child has a peanut or tree nut allergy.

Parents of nut-allergic children were asked how they think the school should manage lunchtime for their child; parents of children without nut allergies were asked how the school should manage lunchtime for their child’s classmate with a nut allergy (Figure 1).

Parents of nut-allergic children do not show a clear preference, though the most-selected choice is no restrictions on where their child sits or what their child’s classmates can eat. In contrast, most parents of children without allergies think the school should have a designated area (such as a nut-free table) where nut-allergic children should sit. Neither group has a majority in favor of banning nut-containing foods from the entire lunchroom or school. There are no differences based on whether children attend a public school vs a private or charter school.

Parents also rated their level of support for different school policies around nut allergies.

  • 61% support a policy that nut-containing lunch or snack items are not allowed for classes with a nut-allergic child
  • 43% support a policy that no food brought from home is allowed at school parties or special events
  • 38% of parents support a policy that nut-containing lunch or snack items are not allowed anywhere in school

There were no differences in the level of support between parents of nut-allergic children and parents of non-allergic children, or between parents of public school students vs private or charter school students.

Implications

There is no single standard for schools to manage the food environment for nut-allergic children, and no research that indicates which strategy is safest. Recent guidelines from the Centers for Disease Control and Prevention (CDC) encourage schools to consider the needs and preferences of nut-allergic children in deciding whether to designate a nut-free area or restrict nut-containing products altogether.

The results of this poll offer a national view of the preferences of parents of nut-allergic children. Results may be surprising in that the majority of parents of nut-allergic children do not support a total ban on nut-containing products.  Rather, the strategy with the most support among parents of children with nut allergies is having no restrictions at all on where their child sits or what other children are allowed to eat.

Among parents of non-allergic children, there is the greatest level of support for an approach that they perceive would protect a child with a nut allergy, such as designating a nut-free lunch table or restricting nut-containing products for classes that include a child with nut allergies.

Determining appropriate school policies around nut allergies can be challenging; this national poll dispels the notion that parents believe there is one “right” way. Because neither group of parents expressed opinions that were highly concentrated around one strategy, these results suggest that most parents will respect and understand the needs of others.

The take-home message is that there is strong support among parents for strategies that keep nut-allergic children safe while still allowing them to interact with their classmates. Most parents of both nut-allergic children and non-nut allergic children do not support restrictive policies that ban nut-containing items from schools.  Schools, governments, parents and doctors who may be involved in the decisions around school nut policies should not presume that all parents of nut-allergic children have the same preferences.  Seeking a broad range of input will help to craft a policy that meets the needs of all children.

Data Source

This report presents findings from a nationally representative household survey conducted exclusively by GfK Custom Research, LLC (GfK), for C.S. Mott Children’s Hospital via a method used in many published studies. The survey was administered in November 2013 to a randomly selected, stratified group of adults age 18 and older from GfK’s web-enabled KnowledgePanel® that closely resembles the U.S. population. Responses from parents with a child age 5-12 (n=816) were used for this report. The sample was subsequently weighted to reflect population figures from the Census Bureau. The survey completion rate was 54% among the parent panel members contacted to participate. The margin of error is ± 2 to 4 percentage points and higher among subgroups.

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Faculty Collaborator: Matthew Greenhawt, MD
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Acham Gebremariam, MS
Web Editor: Anna Daly Kauffman, BA

Findings from the C.S. Mott Children's Hospital National Poll on Children's Health do not represent the opinions of the investigators or the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.


 

These survey questions were asked of parents with a child age 5-12.

Q1. What type of school does your X–year old child attend?

  • Public school
  • Private school
  • Charter school
  • Home school
  • Does not attend school
  • Other

Many people have reactions after eating certain foods.  A food allergy is a potentially life-threatening reaction that may involve hives, difficulty breathing, vomiting, or shock.  A food intolerance is less severe, and may involve an upset stomach, behavioral changes, headache, chronic cold symptoms, or body ache.  

A common type of food allergy is peanut or tree nut allergy. 

Q2. Does your child(ren) have a food allergy?    

  • No  
  • Yes, a peanut or tree nut allergy 
  • Yes, another type of food allergy


Q3. Suppose a student in your child’s class has a peanut/tree nut allergy.

How do you think the school should manage lunchtime for that student? 
Select the best response.

  • Allergic child eats in lunchroom; no restrictions on nut-containing foods
  • Allergic child eats in classroom or other area away from lunchroom
  • Allergic child eats a one table in lunchroom designated nut-free
  • Entire lunchroom is designated nut-free
  • Entire school is designated nut-free

Q4. How do you think the school should manage lunchtime for your nut-allergic child? 

Select the best response.

  • Child eats in lunchroom; no restrictions on nut-containing foods
  • Child eats in classroom or other area away from lunchroom
  • Child eats at one table in lunchroom designated nut-free
  • Entire lunchroom is designated nut-free
  • Entire school is designated nut-free

Suppose 1-2 students in your child’s school (but not in your child’s class) have a peanut/tree nut allergy.

Q5. How much do you support the following policies related to nut allergies?

  Strongly support Somewhat support Somewhat against Strongly against
No lunch or snack items containing nuts allowed anywhere in school        
No lunch or snack items containing nuts allowed for classes with a nut-allergic child        
No food brought from home at school parties or events        

Participants were also asked demographic questions on gender, race/ethnicity, annual household income, education and insurance status.

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Faculty Collaborator: Matthew Greenhawt, MD
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Acham Gebremariam, MS
Web Editor: Anna Daly Kauffman, BA

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Parent views on how elementary schools should handle lunchtime for children with nut allergies

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