Fear and Allergies in the Lunchroom

Nonetheless, others are making major efforts to guard against allergic reactions. Eighteen percent of schools now ban peanuts entirely, up from 13 percent in 2005. At Mercer Elementary, where Caleigh Leiken and 11 other students have severe food allergies, teachers and bus drivers have been trained to use an EpiPen, and teachers explain allergies to all their students, not just the ones who suffer from them. In Connecticut, that's the law—the state's guidelines for schools require teachers to educate kids about allergies, so they won't harass classmates who can't indulge in, say, grilled cheese sandwiches. Massachusetts, Vermont and Tennessee also have statewide allergy guidelines for schools, and this year New York and New Jersey began to formulate their own. Proposed federal legislation would take things even further, giving schools up to $50,000 each to voluntarily implement uniform guidelines so that when children graduate from a school or cross state lines, parents won't have to start the education process all over again.

As awareness grows, some people wonder: are food allergies exaggerated? The numbers of children with allergies are substantial, but fewer than 1 percent of kids under 5 suffer from peanut allergies and severe reactions kill between 100 and 200 people a year. Parents—conditioned by overcautious pediatricians who've told them to keep their young kids away from nuts and eggs—may panic unnecessarily. Not every rash or stomachache after lunch is an allergy. If you are lactose intolerant, for example, your body is unable to digest lactose, the major sugar found in milk, and you may feel crampy or gassy. If you're allergic to milk, on the other hand, your immune system sees milk proteins as dangerous and revolts against them. Allergists say a fair number of kids are being told to avoid foods they aren't allergic to. "Studies have shown that up to 25 percent of parents think their children may have a food allergy," says Dr. David Fleischer, of National Jewish Medical and Research Center in Denver, "but they've only been confirmed in about 8 percent."

An accurate diagnosis takes time, skill and patience. Skin tests for allergies are exceedingly sensitive, which means they overpredict the number of people who would have a reaction about 60 percent of the time. Blood tests, combined with a carefully documented history of symptoms, are more helpful, allowing doctors to make predictions about a child's risk for allergies based on how many antibodies to a specific food allergen show up in their blood. The only way to diagnose an allergy for sure, however, is to do a food challenge: give a patient small and increasing amounts of the suspect egg or wheat or seafood under a doctor's watchful eye, then monitor reactions. Knowing one way or the other can lift the burden for parents and children alike. "If you don't need to avoid a food," says Fleischer, "it's such a relief to the family that their lives can go back to normal."

Normal could one day be a reality for allergic kids if the science pans out. Last year researchers at National Jewish announced they'd identified a gene that protects mice against developing severe allergic skin reactions. At Mount Sinai, researchers have blocked the allergic response in mice for six months—a quarter of their life span—with an herbal preparation; now they want to test it in humans. One day, Sampson predicts, it might be possible to screen a child's genes, determine if he's at risk, then intervene before the itching and wheezing begins.

But that's pie in the sky for now. Bryan Bunning's hopes are far less grand. He just wants to outgrow his egg allergy so he can finally indulge in "any sweet thing" he can find. High on his list: birthday cake. Having his cake and eating it too—a well deserved reward.

With Karen Springen, Joan Raymond in Shaker Heights And Mary Carmichael

© 2007