Food Allergy Quick Guide

For Staff

Food Allergy Symptoms & Action Plan


  • Itching and swelling of the lips, tongue, or mouth
  • Itching and/or a sense of tightness in the throat, hoarseness, “throat clearing” cough, and hacking cough
  • Hives itchy rash and/or swelling about the face or extremities
  • Nausea, abdominal cramps, vomiting and/or diarrhea
  • Shortness of breath, repetitive coughing and/or wheezing
  • Thready pulse
  • Not being able to speak clearly
  • Passing out

coughingChild Descriptions

  • The food is too spicy
  • My tongue is hot (or burning)
  • It feels like something’s poking my tongue
  • My tongue (or mouth) is tingling (or burning)
  • My tongue (or mouth) itches
  • It (my tongue) feels like there is hair on it
  • My mouth feels funny
  • There’s a frog in my throat
  • There’s something stuck in my throat
  • My tongue feels full (or heavy)
  • My lips feel tight
  • It feels like there are bugs in there (to describe itchy ears)
  • It (my throat) feels thick
  • It feels like a bump is on the back of my tongue (throat)

Action Plan

Should a child exhibit any of the above symptoms, staff should follow treatment specified for each child under their Individual Health Plan (IHP) and Food Allergy Action Plan.
If a child is having an anaphylactic reaction, administer the EpiPen immediately and call 911 and identify that an anaphylactic reaction was suspected and an EpiPen was used. 

School’s Responsibility

  1. Be knowledgeable about and follow applicable federal laws including ADA, IDEA, Section 504, and FERPA and any state laws or district policies that apply.
  2. Review the health records submitted by parents and physicians.
  3. Include food-allergic students in school activities. Students should not be excluded from school activities solely based on their food allergy.
  4. Identify a core team of, but not limited to, school nurse, teacher, principal, school food service and nutrition manager/director, and counselor (if available) to work with parents and the student (age appropriate) to establish a prevention plan. Changes to the prevention plan to promote food allergy management should be made with core team participation.
  5. Assure that all staff who interact with the student on a regular basis understands food allergy, can recognize symptoms, knows what to do in an emergency, and works with other school staff to eliminate the use of food allergens in the allergic student’s meals, educational tools, arts and crafts projects, or incentives.
  6. Practice/go through the Food Allergy Action Plans before an allergic reaction occurs to assure the efficiency/effectiveness of the plans.
  7. All medications are kept in the Health Office in a locked cabinet as per state regulations. Students who are so designated may carry "fanny packs" containing EpiPens. In order to meet the criteria they must have permission from their physician and parents and demonstrate responsibility for administering the drug. Staff members who have received Epi-pen training may administer the drug only to those students who have their own medication and medication orders. Those staff members MAY NOT administer EpiPen's to anyone else, ONLY the school nurse may give a NON-PATIENT SPECIFIC Epi-pen.
  8. Designate school personnel who are properly trained to administer medications in accordance with the State Nursing and Good Samaritan Laws governing the administration of emergency medications.
  9. Be prepared to handle a reaction and ensure that there is a staff member available who is properly trained to administer medications during the school day regardless of time or location.
  10. Review policies/prevention plan with the core team members, parents/guardians, student (age appropriate), and physician after a reaction has occurred.
  11. Work with the district transportation administrator to assure that school bus driver training includes symptom awareness and what to do if a reaction occurs.
  12. All buses must have functioning communication devices in case of an emergency.
  13. Enforce a “no eating” policy on school buses with exceptions made only to accommodate special needs under federal or similar laws, or school district policy. Discuss appropriate management of food allergy with family.
  14. Discuss field trips with the family of the food-allergic child to decide appropriate strategies for managing the food allergy.
  15. Follow federal/state/district laws and regulations regarding sharing medical information about the student.
  16. Take threats or harassment against an allergic child seriously.

Sources: American School Food Service Association, National Association of Elementary School Principals, National Association of School Nurses, National School Boards Association, Food Allergy Research & Education

School Forms

Food Allergy Action Plan
Confidential Health Concerns


Click for printable versions:

Non-Food Classroom Birthday Celebrations to Maintain a Safe and Inclusive Environment