Food Allergy & Anaphylaxis in Schools: The Nutrition Expert Witness Perspective
- Rick Miller
- 13 hours ago
- 2 min read
Food Allergy is not rare and on the rise
Food allergy isn’t rare anymore. In UK classrooms, around 1 in 13 children has a diagnosed allergy, and severe reactions can be fatal if mishandled.
As a Consultant Dietitian and expert witness, I’ve worked on cases where allergy care in schools and childcare settings has been called into question. The difference between safe management and negligence can be life or death.
Food Allergy Anaphylaxis in Children: The Scale of the Problem
UK prevalence: 7–8% of children affected.
Common allergens: milk, egg, peanuts, tree nuts, sesame, wheat, soya, fish, shellfish.
Food Allergy Anaphylaxis: Severe, rapid-onset allergic reaction → airway swelling, collapse, death without adrenaline.
Standards of Care in Schools
Care plans: Every child with a diagnosed allergy should have an Individual Health Care Plan.
Training: Staff must be trained to recognise and treat anaphylaxis.
Adrenaline auto-injectors (AAIs): Must be accessible and staff trained in use.
Food provision: Clear allergen labelling and communication with parents.
NICE and Department for Education guidance outline these responsibilities.
Medico-Legal Context
Negligence cases often arise when:
No care plan was in place.
Staff weren’t trained in allergy recognition or AAI use.
Cross-contamination occurred due to poor food handling.
Delays in adrenaline administration worsened outcome.
Case Example
A child with a known nut allergy was served a dessert containing traces of peanuts at a school lunch. No staff member recognised the signs of anaphylaxis early enough, and adrenaline was delayed. The child survived but with significant trauma. In legal proceedings, failure to follow allergy management protocols was central to the negligence claim.
Role of the Dietitian Expert Witness
Reviewing medical and dietary history.
Assessing school food policies and staff training.
Comparing actions against national guidance.
Advising on whether harm was preventable.
FAQs
Are schools legally obliged to keep AAIs? Yes — since 2017, UK schools can purchase spare AAIs without prescription.
Can food allergy management be grounds for negligence? Yes — when harm results from clear failure to follow accepted care standards.
What role does the dietitian play? Dietitians advise on safe food provision, cross-contamination, and nutritional adequacy in exclusion diets.
Closing Thought
Food allergy management in schools isn’t optional — it’s essential. Failures put children at risk and leave schools open to legal action. Dietetic expertise helps courts understand whether care was reasonable or negligent.
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