Nuts and kinders

I’ve explained in a previous post that I have a severe allergy to tree nuts. My husband has  a milder allergy to tree nuts as well. Thus, we are being very careful with our little daughter. Genetics being what they are, I presume that there’s a chance she may develop the same allergy. I mean to find a “nut-free” kindergarten for her.

In light of that, it’s stories like this one which strike a chill into my heart. The Baptist family’s four year old son Alex was attending a supposedly “nut-free” kindergarten. It appears that perhaps some nuts made their way into the kinder; at any rate, Alex seems to have suffered a severe anaphylactic shock and died. One staff member accidentally stabbed herself in the finger with the Epipen (adrenalin injection), the other couldn’t get the lid off the spare Epipen. Epipens save the lives of those who suffer from anaphylaxis.

The coroner was not prepared to find that Alex’s death was as a result of anaphylaxis. Nor was she prepared to find that the kindergarten staff had been wanting, or that a parent might have brought a peanut butter sandwich to the kindergarten for her toddler (despite “evasive” evidence from the parent).

I have some sympathy for the kindergarten staff. If they have not been trained in the administration of Epipens, and were thrown into a crisis situation, then it’s understandable that they would panic, and that accidents will occur. I do not think that they should be personally blamed, but I do think that it should be recognised that kindergarten and school staff require training in the administration of Epipens, and also training as to how to respond when an anaphylactic reaction is suffered by a child.

On the other hand, my heart aches for the Baptists. I can understand how they must feel furious and devastated. Your child is so precious, and to lose your son in such a way… They must wonder what would have happened if the Epipens had been administered properly.

I think it’s also a matter of educating the broader community. It appears that there was some evidence that another person brought a peanut butter sandwich to the kindergarten, although the coroner was not prepared to conclude that this in fact occurred. Parents need to be told that they should not bring in food with allergens if there is a child with an allergy in the class. It’s not a matter of a child not liking peanuts, or breaking out in a rash – it’s a matter of life and death. Again, I don’t feel that the person who may have brought peanut butter into the kindergarten should be singled out – there’s a lot of ignorance out there.

As I have said in my earlier post, I think that there is a general lack of understanding in the community as to the severity of some allergies – it’s not just “being picky” or being a hypochondriac. I can die if I eat the wrong thing and don’t administer my Epipen in time. Of course, the question I always get asked is: “Have you had to do it before yourself?” The answer is, “Yes.” When people say, “How could you bear to do it?” I say, “Better than dying.”

So, to the Baptists – I am so so sorry about the loss of their son, and I wish them all the best in their campaign to raise awareness of this issue.

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6 Comments

Filed under allergies, nuts, society

6 responses to “Nuts and kinders

  1. The staff most definitely should be trained on how to use an Epipen.

    Every place I ever worked with kids, although in a different capacity, we had to learn how to use Epipens and we had to learn CPR.

    Having kids is worrisome enough.

  2. lostinsuburbia

    There are a growing number of schools (primary) and most daycare centres across NSW that have nut free policies. Some however, make the mistake of not informing parents of the policy. (The school my kids are currently at have only just made the announcement that due to some allergies the school is a nut free zone) The big problem with this is most parents are fairly ignorant to the fact that muesli bars and nutella contain nuts that can set the allergic reactions off also, not just peanut butter. And that for some severe cases, they don’t even have to ingest the allergen to have a reaction.

    It may be a pain in the butt for parents who kids aren’t allergic to conform to this rule, (I have a kid who lives on peanut butter) but he can have the PB at home on weekends. I would much rather listen to my kid whinge about another vegemite sandwich (because that’s the only other sandwich he will eat) than be the cause of someone else’s child possibly dying.

    And with the rising incidence of allergies (and diabetes comes to mind too), staff of schools need more adequate training. (The staff here almost freaked when they found out they may have to put my sons eye back in if it fell out. Because he can’t quite do it himself yet.)
    I hope your daughter is spared the tree nut allergy, for peace of mind. I have a friend who homeschools one of her three children for this very reason.

  3. There is more to the Baptists’ story than the death of their child: I believe there has been significant personal vilification of the kinder staff involved by the family, and threats and alienation directed at the mother who said she might have inadvertently sent part of a peanut butter sandwich to kinder.

    It must be terrifying, knowing that your child could drop dead suddenly from anaphylactic shock. But the reality is, more children die of asthma attacks. In both cases, it is important to determine where the balance of responsibility lies between parents and carers. Did the parents check sufficiently that the carers knew how to use an epipen? Apparently this particular pen had a well-known design flaw and several doctors had injected themselves accidentally as well with the same model.

    Anaphylaxis is actually relatively well-managed and responded to – every child care centre I’ve been to has been nut free, for example, and all have special procedures for calling an anaphylaxis emergency. I gather there’s a push for legislated anaphylaxis planning at the State government level.

    I gather in this case, the coroner was unable to determine if it was anaphylaxis, mainly because the child also had a pre-existing heart condition. The kinder teachers have maintained that they were ill-informed about treating the child, and part of the concern was not to aggravate the heart condition.

    I feel for kinder teachers and carers, and also for parents. It is all round a dreadful situation – parents feel unable to return to work or put their child in much-needed kindergarten, and carers feel that they are being asked to act as pseudo-paramedics and diagnosticians.

    Whilst giving this family’s behaviour a very wide area for discretion – they have lost their beloved baby boy, I can’t imagine how they must be feeling – as a policy response, it is important to address all issues. This may include taking into account some of the increasing evidence about the causes of anaphylaxis, and indeed all allergies and auto-immune disorders. This includes supporting breastfeeding for over 12 months (ie extending maternity leave, shock!), giving children plenty of exposure to whole foods, and to plenty of normal bacteria (yes, like letting them sit in shopping trolleys without inserting disinfected covers!), and reducing exposure to chlorine-based cleaning products and bleaches. We’re all so terrified by germs and addicted to white bread, we’re destroying our own immune systems.

    These are measures that are difficult to push in a consumption and advertising-dominated world. But that world is starting to have real effects on our children’s health.

  4. Cherry, absolutely, vilification and threats from the bereaved parents are out of line. I can understand that they feel devastated, but that’s no excuse for getting nasty with individuals who may not have been properly trained or panicked (staff) or made an honest mistake (other mother). Still, I do feel the coroner went the other way a bit and totally exonerated both individuals and the kinder itself, when she should have made comments about general staff training and community awareness of this issue.

    As someone who has had to use an Epipen myself, I think the chance of stabbing yourself was somewhat overstated by the coroner. The instructions are pretty clear, so that I could administer it to myself without training. Take off the grey cap at the back, hit the black end against your thigh. I’ve done it while in anaphylaxis. Still, I think more training is essential.

    My understanding of the evidence about breastfeeding is that the evidence is equivocal as to whether it prevents allergies. Certainly my own family history shows this clearly. I was not breastfed on account being very premature. My sister was breastfed, but still has allergies, although not as severe as mine. My husband was breastfed but suffers from severe allergies, asthma and eczema. His brothers (twins) were not breastfed but do not have any of these problems (lucky bastards). You know what the common factor between my husband and I is? Auburn hair and freckles… Whereas our less allergic siblings do not have this colouring. I’m sure there’s a theory here somewhere.

    My concern with pushing breastfeeding as the solution to allergies is that (a) mothers will feel very guilty if they can’t breastfeed for some reason and (b) it might lead people to believe that their child won’t have a problem because she was breastfed, when it’s not as simple as that.

    Further, my mother scrupulously fed me hand-prepared fresh stuff made from scratch…still allergy city here.

    Certainly I think that it’s good to expose your child to some germs. I don’t let my daughter eat off the toilet, but I certainly don’t put disinfecting covers on shopping trolleys or any rubbish like that. If she eats a stick from the garden – meh! – presumably cave babies did things like that all the time. I’m afraid I don’t have the time or inclination to be a clean freak.

    As for whether she develops allergies? It will be interesting to see. I’ve followed all the guidelines (breastfed over 12 months, exposed her to dirt, fed her non-processed foods, kept her away from allergenic foods) but I suspect that genetics has the greatest influence, so I’m going to be careful. I hope and pray that she is safe.

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  6. Beethoven

    I just came across your article.
    There is no doubt this a tragic case. I can only begin to think what it must be like to send your child to kinder and not have them come home.
    However, there has been a great deal of misinformation about this case. The coroner’s report is published on the Anaphylaxis Australia website here.
    I suggest everyone with an interest in this issue should read it.
    It is unfortunate that the family knows the full circumstances in which the teacher jabbed herself with the epipen (at significant health risk to herself) but have chosen to misrepresent it as her panicing. The teacher had been fully trained in the administration of an epipen and did not panic.
    There is much more that could be said and maybe one day it will.
    For now it is important to remember that a child died and we need to learn everything we can about how and why he died.

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