Table 2 Qualitative themes, summary statement, codes and supporting quotations related to Theme 1: Each classroom is a “case-by-case” basis

Theme description: This theme describes the minimal standardization and inconsistent enforcement of food allergy policies between school divisions, schools within the same division, and classrooms within same school. This theme also captures the individual decisions made by teachers (and administrators) to manage food allergy in their classrooms and schools, both to adhere to school and/or school division-enforced policies, and policies that teachers have enforced individually (i.e., peanut/ tree nut bans and adding additional bans depending on students’ allergies).

Codes

Supporting Quotes

Ways to manage food allergy in the classroom

I’m always checking in on those kids, even if it’s something that I know they’ve eaten a hundred times without nuts. If it doesn’t come from their home, I’m constantly going to them… “How you feel? Feeling good? Do you need water? Oh, I noticed you coughed just then. Are you okay? Oh, you just swallowed the wrong way. I’m sorry I’ll leave you alone now.”… Sort of hyper focus on those kids. (T12)

Mealtime at school

So we used to eat in a large lunch room [pre-pandemic]. All of the grade 3/4/5 students would eat in one room. We just have a blanket policy for allergies; peanuts and nuts are always a no-go. But if we had a child with a seafood allergy or something, we just wouldn’t allow it in that lunchroom. (T7)

The lunch program is a blanket no nuts policy […] if [lunch supervisors] find nuts in someone’s food, they will ask the student to eat in the hallway or in the office. (T12)

Implementation of policies related to food allergy management

There’s no discussion about [food allergy management] ‘cause everyone has a different opinion [laughs] It just changes every two seconds, to be honest with you. So I think we just make up our own lines. Some err on the side of caution, some are more like, “Okay well if [student] is not ingesting [allergen], they’re fine”. (T16)

I’ve seen different environments where allergies are not as high of a concern, and then schools where the classroom rules are very stringent. (T9)

In each classroom, [food restrictions] are a case-by-case basis. (T11)

Special events

I would give the student with the allergy something else [instead of classroom treat] so they’re not completely left out. But, again, I would have to I think use my judgement with the kind of food it was and if there’s no indication at all, about like, “may contain” then I maybe send the [treat] home with the kid who brought the [treat]. (T11)

It definitely make me feel a lot more anxious when we’re having celebrations where food is involved [.] I always feel a sense of anxiety, and I’m always checking in on those kids, even if it’s something that I know they’ve eaten a hundred times without nuts. (T12)

[On planning field trips and managing risk], it’s balancing how can I be proactive and try to determine where the highest risk might be, and also mitigate that, but also, not single out the child too much […] there’s always some level of risk […] and you know it’s not helpful to put them into a bubble and not let them experience life because of that. (T14)

Responding to food allergy emergencies

The [students with food allergy] both carry an [EAI] on their person so that’s obviously accessible […] I am trained on how to use the [epinephrine auto-injector], but I would probably be a little bit overwhelmed in the [emergency] situation. I would like somebody else who is also trained in it to make sure that I’m doing it correctly, or if I’m not able to, that they are able to do it. […] It’s just a lot to deal with that - in that situation. Like I don’t want the kid in that situation– it just makes me anxious to think about it but when the time comes, I might be completely fine or I might pass out [laughs]. (T11)

I haven’t really had incidents happening. So you can go through the whole year and be like, “Oh yeah. That was great, I had my training. I was prepared if something happens. But nothing happens.” So maybe that’s why I felt fine. If something were to happen mid-year, would I still feel comfortable remember how to use an [auto-injector]? (T20)

[A student was] having a pretty severe reaction, I would say, but still able to know what […] he needed to do. He was a little bit older. This was a grade three student. He had eaten something in the classroom. I guess um, it had come into contact with something he was allergic to. I believe it was peanuts. He was able to let me know that something was wrong, and we got his [auto-injector] as he was carrying it on him, in a little pouch, and he administered his medicine. And I took him to the office, and he stayed there for further care. […] Even if it’s scary, you kind of have to put that to the side for a second and just refocus, um, and then you can freak out later when everything’s okay. […] Sometimes you might be the only adult like, around, and um, it – that just undermines the importance of um, trying to keep yourself calm and not letting your –your emotions, or whatever it is - fear, or the stress of the situation take over. (T9)