Food Allergy Education and Management in Early Learning and Childcare Centres: A Scoping Review on Current Practices and Gaps

Mae Jhelene L Santos^{1

2}, Kaitlyn A Merrill^{2

3}, Moshe Ben-Shoshan⁴, Jennifer D Gerdts⁵, Don Giesbrecht⁶, Elana Lavine^{7

8}, Susan Prentice⁹, Julia Upton^{7

10}, Jennifer L P Protudjer^{1

2

11

12

13}

Affiliations

¹ Department of Food and Human Nutritional Sciences, Faculty of Agriculture, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
² The Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada.
³ Department of Biochemistry, Faculty of Science, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada.
⁴ Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Center, Montreal, QC H4A 3J1, Canada.
⁵ Food Allergy Canada, Toronto, ON M2J 4A2, Canada.
⁶ Canadian Child Care Federation, Ottawa, ON K1G 0Y9, Canada.
⁷ Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1X8, Canada.
⁸ Vaughn Pediatric Clinic, Woodbridge, Vaughan, ON L4L 8E2, Canada.
⁹ Department of Sociology, Faculty of Arts, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
¹⁰ Division of Immunology and Allergy, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
¹¹ Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3A 1S1, Canada.
¹² George and Fay Yee Centre for Healthcare Innovation, Winnipeg, MB R3E 0T6, Canada.
¹³ Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.

PMID: 37508672
PMCID: PMC10377763
DOI: 10.3390/children10071175

Food Allergy Education and Management in Early Learning and Childcare Centres: A Scoping Review on Current Practices and Gaps

Mae Jhelene L Santos et al. Children (Basel). 2023.

. 2023 Jul 6;10(7):1175.

doi: 10.3390/children10071175.

Authors

Affiliations

¹ Department of Food and Human Nutritional Sciences, Faculty of Agriculture, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
² The Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada.
³ Department of Biochemistry, Faculty of Science, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada.
⁴ Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Center, Montreal, QC H4A 3J1, Canada.
⁵ Food Allergy Canada, Toronto, ON M2J 4A2, Canada.
⁶ Canadian Child Care Federation, Ottawa, ON K1G 0Y9, Canada.
⁷ Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1X8, Canada.
⁸ Vaughn Pediatric Clinic, Woodbridge, Vaughan, ON L4L 8E2, Canada.
⁹ Department of Sociology, Faculty of Arts, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
¹⁰ Division of Immunology and Allergy, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
¹¹ Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3A 1S1, Canada.
¹² George and Fay Yee Centre for Healthcare Innovation, Winnipeg, MB R3E 0T6, Canada.
¹³ Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.

PMID: 37508672
PMCID: PMC10377763
DOI: 10.3390/children10071175

Abstract

Anaphylaxis has occurred in preschools/schools yet there are no consistent food allergy (FA) management practices in early learning and childcare centres (ELCC) across jurisdictions. Presently, there are no reviews that have synthesized FA-related knowledge and management practices within ELCC. We aimed to perform a scoping review of FA management in ELCC, and report on perceived gaps or barriers. A PRISMA-ScR-guided search was conducted for North American, European and Australian articles in English/French in the OVID-MedLine, Scopus, and PsycInfo databases. Two independent reviewers screened the titles/abstracts of 2010 articles and full-text screened 77 articles; 15 of which were specifically related to ELCC. If the two reviewers could not agree to the relevance of a given study, a third reviewer provided guidance. This third reviewer also screened French articles. Thematic and descriptive reports of the studies were presented. We reported solely on pre-Coronavirus Disease pandemic ELCC studies. We included ten articles in this review, which provide evidence that ELCC staff have variable baseline knowledge, comprehension, experience, and practices in place to manage FA. ELCC staff also have limited FA-related training and experience regarding administration of epinephrine auto-injectors (EAI). Emergency Anaphylaxis Plans (EAP) were described in four studies. One study reported the parental influence on the site's food purchasing and FA management. Three studies provided educational interventions, which demonstrated increased and sustained FA-related knowledge and confidence post-intervention. Participants deemed the training beneficial and desired annual training and more FA resources to be available. Across jurisdictions, ELCC staff have provided care and administered EAI in emergencies, but training remained variable. Communication and care planning amongst ELCC staff, and parents, is crucial. Annual education, available EAI and EAPs are tools necessary for effectively managing emergencies.

Keywords: anaphylaxis; early learning and childcare centres; food allergy; scoping review.

PubMed Disclaimer

Conflict of interest statement

M.J.L.S., K.A.M. and S.P. declare no competing interest. M.B.-S. is a Member of the Board, the Canadian Society of Allergy and Clinical Immunology, and on the steering committee for Canada’s National Food Allergy Action Plan. J.D.G. is Executive Director of Food Allergy Canada and co-leads Canada’s National Food Allergy Action Plan Food Allergy Canada funding from Pfizer, Kaleo, Bausch Health, Mead, and the American Peanut Council, all unrelated to the submitted work. D.G. is Chief Executive Officer, Canadian Child Care Federation. E.L. is Section Head of Pediatrics, the Canadian Society of Allergy and Clinical Immunology, and reports having accepted advisory board honouraria from ALK-Abello and Aralez. S.P. declares no conflicts of interest. J.U. reports research support/grants from Novartis, Regeneron, ALK Abello, DBV Therapeutics, and CIHR, and fees from AstraZeneca, Pfizer, ALK Abello, Bausch Health, Kaleo, and Food Allergy Canada, all outside the submitted work. J.L.P.P. is Section Head, Allied Health, serves on the Board of Directors for the Canadian Society of Allergy and Clinical Immunology, is a member of the steering committee for Canada’s National Food Allergy Action Plan, and has received consulting fees from Novartis and Nutricia.

Figures

**Figure 1**
PRISMA flow diagram depicting the selection process for articles and reports relevant in the current scoping review.

See this image and copyright information in PMC

References

1. Boyce J., Assa’ad A., Burks A.W., Jones S.M., Sampson H.A., Wood R.A., Plaut M., Cooper S.F., Fenton M.J., Arshad S.H., et al. 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:S1–S58. doi: 10.1016/j.jaci.2010.10.008. - DOI - PMC - PubMed
1. Gupta R.S., Springston E.E., Warrier M.R., Smith B., Kumar R., Pongracic J., Holl J.L. The Prevalence, Severity, and Distribution of Childhood Food Allergy in the United States. Pediatrics. 2011;128:e9–e17. doi: 10.1542/peds.2011-0204. - DOI - PubMed
1. Spolidiro G.C.I., Amera Y.T., Ali M.M., Nyassi S., Lisik D., Ioannidou A., Rovner G., Khaleva E., Venter C., van Ree R., et al. Frequency of food allergy in Europe: An updated systematic review and meta-analysis. Allergy. 2023;78:351–368. doi: 10.1111/all.15560. - DOI - PMC - PubMed
1. Clarke A.E., Elliott S.J., St. Pierre Y., Soller L., La Vielle S., Ben-Shoshan M. Temporal trends in the prevalence of food allergy in Canada. J. Allergy Clin. Immunol. Pract. 2020;8:1428–1430. doi: 10.1016/j.jaip.2019.10.021. - DOI - PubMed
1. Gaspar-Marques J., Carreiro-Martins P., Papoila A.L., Caires I., Pedro C., Araújo-Martins J., Virella D., Rosado-Pinto J., Leiria-Pinto P., Neuparth N. Food Allergy and Anaphylaxis in Infants and Preschool-Age Children. Clin. Pediatr. 2014;53:652–657. doi: 10.1177/0009922814527502. - DOI - PubMed

Publication types

Actions

Grants and funding

J Protudjer Operating Grant/CAPMC/ CIHR/Canada

LinkOut - more resources

Full Text Sources

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Food Allergy Education and Management in Early Learning and Childcare Centres: A Scoping Review on Current Practices and Gaps

Affiliations

Food Allergy Education and Management in Early Learning and Childcare Centres: A Scoping Review on Current Practices and Gaps

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

Grants and funding

LinkOut - more resources

Full Text Sources