Here's why some allergy experts don't think peanut bans are a good idea

The end of summer means the return to packing lunches, and that rings alarm bells for parents of children with severe food allergies. Bans on nuts and peanuts were once a staple of school rules, and while a growing number of institutions have done away with those policies, advocates say the lesson should be to focus on prevention and treatment.

At Parkdale Elementary in St-Laurent, Que., laughter and hugs marked the first day of classes Thursday as children lugging backpacks and lunch bags met their new teachers. Among them was grade two student Izzie Kuan, who is allergic to nuts.  

“We have tomato Alfredo,” said her father, Brian Kuan, displaying the contents of her lunch. “No nuts or peanuts in here.”

But the school dietician, Arianne Seguin, says other students could have those allergens in their lunches. The school board moved away from strict bans prohibiting certain allergens years ago.

“We don’t ban foods anymore for the simple and good reason that we don’t know that it is an effective way of preventing school allergic reactions,” says Seguin. “Instead, we work on prevention.”

Studies, including a literature review by McMaster University published in the Journal of Allergy and Clinical Immunology in 2021, concluded there is no solid evidence to support bans. Some research suggests they create a false sense of security.

Dr. Moshe Ben-Shoshan, an allergy and immunology specialist at the Montreal Children’s Hospital, says bans don’t eliminate allergens and can prompt people to be less careful because they believe the school is peanut-free.

“We know that even when we try to do these bans, they are not peanut-free zones, for example in one of our studies, we have found that there are more accidental reactions in peanut-free zones that have a peanut-free policy, maybe because of that false sense of security,” says Ben-Shoshan.

He says the focus to keep the nearly ten percent of children suffering from food allergies, should be on prevention and ensuring school staff are ready to treat children who suffer from a severe allergic reaction.

“My creed is 'better safe than sorry,'” says the doctor. “So if it crosses your mind that a child might need epinephrine, it is better to give it than to be sorry, because the side-effects are basically non-existent. In general, we say that when a reaction involves more than one organ system it is better to give epinephrine, or when a child does not look good. For instance, if a child presents with hives and coughs, you should inject.”

Some provinces, including Ontario and Alberta, have laws on specific ways for schools to ensure the safety of children with severe allergies. Ontario brought in Sabrina’s Law in 2006. It was named after teenager Sabrina Shannon who had advocated for others with food allergies and suffered a fatal anaphylactic reaction during her first year of high school in 2003. That law requires schools to create individual plans for each student at risk of anaphylaxis.

There are no province-wide rules in Quebec, and advocates say this creates uncertainty for parents. Allergies-Quebec has been pushing for a boost in training for all school staff.

“I think it starts with good training,” says Allergies-Quebec spokesperson Dominique Seigneur. “It is key to know what the triggers are, the signs and symptoms. It is not easy to know what is happening.”

But Seigneur, and other parents, says the focus is also on making sure all children and their parents, even those of children who have no allergies, know they can play a part in keeping everyone safe, and going far beyond keeping peanut-butter sandwiches out of lunch bags.

Jeannine Cafaro’s daughter Nora has severe allergies to foods like nuts, eggs, sesame and avocado. She is starting kindergarten, and her allergies have added to first-day jitters for her mom.

“You can’t control what other kids do, who might put their fingers in her lunch,” she says. “There are also certain paints that have eggs in them, will everyone know that?”

She is trying to balance teaching her daughter how to protect herself, but also not scaring her too much. She agrees bans don’t work.

“My daughter has multiple food allergies, I can’t expect other parents not to send eggs, sesame, avocados. I can’t expect that of them, and I would not ask that of them. But I would love other parents to tell their kids, 'Don’t share your food, wipe your hands after eating.' I think that could go further than just saying, ‘Let’s ban some things.'”

And that is a lesson the school board dietician at Parkdale Elementary says she teaches students and teachers.

“It’s about washing your hands and your desk before and after you eat,” said Seguin. “Overall, it is about respecting other students that might have allergies, not touching their food, not sharing food and utensils.”

She says she understands the stress many parents of children with severe allergies feel.

“It is probably scary, especially for the parents of very young children,” she says. “But at the same time, they are learning to keep themselves safe.”