My daughter has had multiple anaphylactic reactions to trace amounts of several foods, including and especially eggs. We did about 1/2 year of a public preschool program, secured a stellar 504 Plan, and then pulled her to homeschool. A few comments:

First, I don't know the interaction of IEP plans and food allergy plans because my daughter didn't qualify for an IEP. I will say that I would be very leery of only having an Individual Health Care Plan to address the food allergies. A 504 Plan (or IEP) has legal teeth. The school district MUST follow it with consequences if they don't. An IHP has no legal teeth. They are being "nice" and doing you a "favor" with no consequences if they ignore it. Also, a 504 Plan protects your child's right to "participate and access" school, unlike an IHP. A 504 Plan ensures your child doesn't sit in the principal's office or hallway while everybody else has a Winter party or goes on a field trip.

Many people find that the plan they initially get is the plan they get for the remaining school years. School's tend to be inclined to say whatever accommodations they have done in the past are sufficient for the present and future years. I approached our 504 Plan (or food allergy protection in an IEP) with that in mind. I needed to get NOW what I was willing to live with for my child's remaining school years.

Even with that, I decided not to utilize the bus. Too many kids eat eggs for breakfast, so the risk, I felt, to my child was very high. Even though they would have the bus driver trained and willing to administer an Epi Pen, they wanted to simply keep the Epi Pen on the bus. I feared that however carefully I explained how putting the Epi Pen in the glovebox during subzero (-30 degrees F) that for convenience my daughter's Epi Pen would end up being kept in the glovebox. The risk, of course, is that then the driver can go through all the motions of giving her an Epi Pen, but with no effect, because the medicine has been rendered inert by the extreme temperatures in the glovebox.

I would fight to the end to get the Epi Pen unlocked. I pulled research articles in pediatric allergy journals that cited locked Epi Pen's as a very dangerous practice that led to deaths. I also found their own regulations stating that Epi Pens must be kept unlocked and instantly accessible at all times. When a child is in rapid demise, you have a very, very scary situation. Fumbling to open locks and fumbling to find the keys can have catastrophic effects.

I would also be very careful that the school doesn't have a policy that only a nurse can administer the Epi Pen. Because our school had a nurse a few doors down from my daughter, they were firm that only the school nurse could administer the Epi Pen. Even with two school nurses in the building, invariably one is administering flu shots at a different building and one is sitting in the lunchroom because she needs a 10 minute break. In short, times invariably occurred where NO ONE was available who could give my daughter an Epi Pen.

Again, that article in the pediatric allergy journal that examined the dangers of school for kids with anaphylaxis and the key deficiencies responsible for fatalities at school assisted me greatly. That article cited a failure to train multiple people how to use the Epi Pen as a major, dangerous deficiency found in some schools.

I found it very helpful to keep away from "what mom wants" and point to "what pediatric allergy research shows" and other studies, like Massachusetts study and suggestions for preventing food allergy fatalities in schools, to get the measures implemented that I wanted. That approach, I felt, even more so because I presented it in writing, also put them in a position that they hopefully knew that if they refused to correct known "major deficiencies" that resulted in death/severe consequences to any child that they were in a precarious position.

I also would caution you to consider emphasizing that ANAPHYLAXIS LOOKS LIKE ASTHMA!!!!! A chilling cohort of kids die because it looks like they are having an asthma attack. They even say they are having an asthma attack. They and others grab their inhalers. They frequently die because what appeared to be an asthma attack was actually an anaphylactic reaction. I asked the head of a pediatric allergy clinic how I could distinguish (and tell others to distinguish) between an asthma attack and anaphylaxis. She said they are indistinguishable and told me that I should treat an asthma attack with an Epi Pen if there is any chance that my daughter has ingested her allergens. (Of course, double check with your own M.D.) But I had her write that into the emergency action plan for the school.

Hope this helps.

I would be careful about Epi Pen's on buses

Last edited by Mom2277; 04/12/13 07:15 PM.