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May 12, 2023
By Katie Chatfield, MPH, RDN, LD, Nutrition Manager

As we enter spring, we’re reminded of the annoyance outdoor allergies can bring. But for people with food allergies, the annoyance becomes a potentially life-threatening concern that must be focused on every day, all year long. For child care providers specifically, food allergies are a consideration that require constant consideration.
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What is a Food Allergy?
A food allergy happens when the immune system reacts to a specific protein in a food, triggering an immune response. The immune response causes the allergic reaction.

According to, a food allergy is a serious and potentially life-threatening medical condition affecting one in every 13 children. That’s about 2 in every U.S. classroom. In the United States, the most common food allergens are milk, egg, peanut, tree nuts, soy, wheat, sesame, fish and shellfish.

While allergies can be a serious medical condition, infants and children with food allergies can still participate in the Child and Adult Care Food Program (CACFP). In fact, when a child’s diet is restricted due to a disability, federal law and USDA regulations require reasonable modifications to be made, at no extra charge. If you care for a child with allergies to wheat, you may start menu planning with rice, corn, or other gluten-free grains. If the child is allergic to both cow and soy milk, however, you may need to serve a milk substitute that does not meet the meal pattern requirements.

Managing Special Diets as a Provider
If you are alerted that a child in your care has a food allergy or special dietary need, there are steps you can take to keep children safe and meet Food Program requirements.

If the dietary accommodation is related to a medical need, obtain a signed Special Diet Statement from a recognized medical authority (such as a physician, physician’s assistant or nurse practitioner). Make sure it specifies the food(s) to be omitted and appropriate foods to be substituted.
Assign specific shelves in the pantry and refrigerator for non-allergenic foods, and store all foods in sealed containers.
Use separate cooking utensils, bowls and dishes for handling safe and unsafe foods. It may be appropriate to assign a child with food allergies a specific chair/seat to reduce the risk of cross-contamination.
For more information on food safety and food allergies in child care settings, visit the Institute of Child Nutrition.

PCI Resources
To support your business and make sure all food is safe for the children in your care, Providers Choice has developed specific resources to help you with common allergens and special diets among children. Our resources cover egg allergies, milk allergies, lactose intolerance, gluten-free diets, specialty infant formulas, approved fluid milk substitutes and vegetarian/vegan diets. Each handout includes information on signs and symptoms of a food allergy, tips for reading food labels, information on required Food Program documentation and Special Diet Statements, and sample menus. Check out all of the resources here, available for free to download and share!