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Published on August 03, 2018

Back to SchoolBack to School: Immunizations, Food Allergies & Independence

In this Fox 8 House Call series, Cone Health experts explore back to school topics, including:

Immunizations & Physicals

Summer is almost over and it’s almost time to start on your child’s back-to-school checklist. For many parents, scheduling your student’s annual physical exam is at the top of that list. Public schools require all children entering school for the first time or moving from another state to have a school physical. While they encourage kids to get their physical before the school year begins, they usually allow parents a 30-day grace period after school starts. The form that providers complete to document the physical is the North Carolina Health Assessment Transmittal Form. This form can be completed by a nurse practitioner, physician’s assistant or a physician.

School physicals are designed to help providers and parents know if there is a physical limitation that may impact a child’s learning. During a school physical, the provider will assess their hearing, vision, skin, heart and lungs. The form also lists a child’s allergies (food- or medication-related), medications, special diet instructions, and any health-related recommendations that can support or enhance the child’s performance at school. Further, this form allows providers to document any recommendations for the school, and whether or not follow-up is needed throughout the year. If a child has a chronic disease, such as asthma or diabetes, the provider can also attach an “asthma action plan” or “diabetes care plan.” During the health assessment, the provider should also ensure the child’s immunizations are up to date.

Before all children begin public school or transfer from another state, their immunizations must be up to date. If a parent is unsure whether or not their child’s immunizations are current, the provider should be able to access the North Carolina Immunization Registry or NCIR to check. If the child is transferring from another state, the provider will request a copy of the child’s immunizations from the previous provider. If a parent is unsure or thinks their child may have missed their immunization, providers are able to use a “catch-up” immunization schedule and then update their profile on the registry. Examples of immunizations that must be up to date include varicella, MMR (measles, mumps and rubella) and hepatitis vaccines, to name a few. Additionally, if a child’s immunizations are not up to date, schools may also offer parents a grace period to allow them to get caught up.

Christie Leath, NP, is a board-certified family nurse practitioner at InstaCare in Greensboro.

Food Allergies

For parents of children with food allergies, education and communication are key to a successful and safe school year. Creating a partnership between parents, physicians, teachers, the school nurse, coaches and other school staff is important for food allergy management, as all of them play a role in keeping the classroom and food-allergic children safe. Parents should also think about volunteers in the school – especially chaperones during field trips. Kids spend upwards of eight to 10 hours at school away from their parents; therefore, it truly requires a team effort to ensure that this environment is safe for them.

The most common food allergies are peanuts, milk, eggs, soy, tree nuts, wheat, shellfish and fish.

When it comes to food allergies, education is extremely important. In general, understanding the signs of an extreme allergic reaction, or anaphylaxis, can help you recognize the symptoms and call for help. Possible symptoms include hives, wheezing, throat swelling, stomach pain, vomiting or passing out. No matter the allergy, parents can work with their child’s allergist to create an emergency anaphylaxis plan. This plan should list all of the child’s known allergies, the child’s medication dosage and what to do if the child has an allergic reaction. Once they’ve put this plan together, it can be a tool to educate and share with teachers and caretakers.

While avoidance of the allergenic food is paramount in preventing reactions, there are now potentially curative treatments available. The Allergy and Asthma Center of NC is now offering oral immunotherapy (OIT) to patients with peanut allergies. Through OIT, patients consume small amounts of their allergenic food twice daily. The first dose and every increase of dosage is done in the office, with the allergist monitoring the patient. Over time, the patient may develop a tolerance to the food so that they can consume small amounts safely. If there are no reactions during the escalation phase, your child could be eating a full serving of the allergenic food in four to five months. They plan to offer OIT to patients with egg and milk allergies later this year.

EpiPens are common tools used to treat severe allergic reactions, and children with severe allergies may benefit from having one nearby. If your child needs to have one on hand, it’s important that their teachers and caregivers are aware of and know how to use one. EpiPens do expire and need to be replaced yearly.

Joel Gallagher, MD, is an allergy and immunology specialist at the Allergy and Asthma Center of NC and a member of Cone Health Medical Group.

Preparing Kids to be on their Own

Starting college and moving out of their parents’ home is a transitional landmark in every teen’s life. It is normal, even expected, that there will be stress during times of transition like this – but not all changes are bad or permanent. Allow your college students space to figure things out in their new environment.

To help your new college student start out on the right foot, encourage them to maintain or create a routine where possible. No matter what the routine is, some semblance of structure is helpful to ground them in times of change. Waking up around the same time, finding a study location, setting up regular social interactions and more can all help them settle into a new normal. Getting plugged into local clubs or interest groups can be a good way to meet people, as well as attending sporting events, concerts and interacting with fellow students from class. If they currently see a therapist or psychiatrist, make sure they keep up with regular appointments or help them find a local provider early on to keep things consistent if they move away.

As your teen gets acclimated it’s fine to check in on them to make sure they’re doing okay. Ask how they are doing and give them space to share what’s going on or if they need to talk things out. It is never “wrong” or a bad idea to seek help when someone is struggling during a transition. There doesn’t need to be a serious issue before seeking support.

In Greensboro, the Cone Health Partial Hospitalization Program was created to give college students and young adults the tools and the space to work through life’s struggles as they learn to be on their own. If your college student in the Greensboro area experiences extreme struggle with this transition or an exacerbation of their mental health symptoms, the Partial Hospitalization Program could be helpful.

Jenny Edminson, LCSW, is a licensed clinical social worker and counselor at Cone Health’s Behavioral Health Partial Hospitalization Program.

Fox 8 House Call

Fox 8 House Call

Cone Health experts appear Monday, Wednesday and Friday at 8:30 a.m. on the Fox 8 morning news.