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Food Allergies in Schools

Food allergies are a growing food safety and public health concern that affect an estimated 4%–6% of children in the United States.1, 2 Allergic reactions can be life threatening and have far-reaching effects on children and their families, as well as on the schools or early care and education (ECE) programs they attend. Staff who work in schools and ECE programs should develop plans for preventing an allergic reaction and responding to a food allergy emergency.

What is a Food Allergy?

A food allergy occurs when the body has a specific and reproducible immune response to certain foods.3 The body’s immune response can be severe and life threatening, such as anaphylaxis. Although the immune system normally protects people from germs, in people with food allergies, the immune system mistakenly responds to food as if it were harmful.

Eight foods or food groups account for 90% of serious allergic reactions in the United States: milk, eggs, fish, crustacean shellfish, wheat, soy, peanuts, and tree nuts.3

Symptoms of Food Allergy in Children

Symptoms Communicated by Children with Food Allergies

  • It feels like something is poking my tongue.
  • My tongue (or mouth) is tingling (or burning).
  • My tongue (or mouth) itches.
  • 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).

The symptoms and severity of allergic reactions to food can be different between individuals, and can also be different for one person over time. Anaphylaxis is a sudden and severe allergic reaction that may cause death.5 Not all allergic reactions will develop into anaphylaxis.

Food Allergies In Schools

  • Children with food allergies are two to four times more likely to have asthma or other allergic conditions than those without food allergies.1
  • The prevalence of food allergies among children increased 18% during 1997–2007, and allergic reactions to foods have become the most common cause of anaphylaxis in community health settings.1,6
  • In 2006, about 88% of schools had one or more students with a food allergy.7

Tool Kit for Managing Food Allergies in Schools

CDC’s tool kit to help schools implement the Voluntary Guidelines for Managing Food Allergies in order to prevent and manage severe allergic reactions in schools. The tool kit includes tip sheets, training presentations, and podcasts for school superintendents, administrators, teachers and paraeducators, school nutrition professionals, school transportation staff, and school mental health professionals.

Treatment and Prevention of Food Allergies in Children

There is no cure for food allergies. Strict avoidance of the food allergen is the only way to prevent a reaction. However, since it is not always easy or possible to avoid certain foods, staff in schools and ECE programs should develop plans to deal with allergic reactions, including anaphylaxis. Early and quick recognition and treatment of allergic reactions that may lead to anaphylaxis can prevent serious health problems or death.

Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs

In consultation with the U.S. Department of Education and a number of other federal agencies, CDC developed the Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Centers [PDF - 10 MB] in fulfillment of the 2011 FDA Food Safety Modernization Act to improve food safety in the United States. Download Food Allergy Guidelines FAQS [PDF - 163 KB].

The Voluntary Guidelines for Managing Food Allergies provide practical information and recommendations for each of the five priority areas that should be addressed in each school’s or ECE program’s Food Allergy Management Prevention Plan:

  1. Ensure the daily management of food allergies in individual children.
  2. Prepare for food allergy emergencies.
  3. Provide professional development on food allergies for staff members.
  4. Educate children and family members about food allergies.
  5. Create and maintain a healthy and safe educational environment.


  1. Branum AM, Lukacs SL. Food allergy among U.S. children: trends in prevalence and hospitalizations. NCHS Data Brief. 2008;10:1-8.
  2. Liu AH, Jaramillo R, Sicherer SH, et al. National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol. 2010;126(4):798-806.e13.
  3. Boyce JA, Assa'ad A, Burks AW, et al; NIAID-Sponsored Expert Panel. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126(suppl 6):S1-S58.
  4. The Food Allergy & Anaphylaxis Network. Food Allergy News. 2003;13(2).
  5. Sampson HA, Munoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium. Ann Emerg Med. 2006;47(4):373-380.
  6. Decker WW, Campbell RL, Manivannan V, et al. The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project. J Allergy Clin Immunol. 2008;122(6):1161-1165.
  7. O’Toole TP, Anderson S, Miller C, Guthrie J. Nutrition services and foods and beverages available at school: results from the School Health Policies and Programs Study 2006. J Sch Health. 2007;77:500-521.