What do nannies know about food allergies?


Published Online: September 30, 2014

As more families have two working parents, the need for reliable, trustworthy childcare is becoming increasingly important. Despite the cost, many parents are turning to in-home childcare for these needs. At the same time, the rates of food allergies in children are also rising with severe, potentially life threatening food allergies affecting 1 in 13 children. With more children affected by food allergies, it is important that caregivers are knowledgeable and prepared should an allergic reaction occur. Despite their growing presence in the home, there are limited data in the medical literature regarding nannies’ understanding of food allergies.

In an article recently published in The Journal of Allergy and Clinical Immunology: In Practice, Greiwe et al. sought to understand nannies’ knowledge about preventing and treating food allergic reactions and to identify areas for improvement. The authors used a 46-item online questionnaire that was sent to six nanny organizations who agreed to participate. A total of 153 nannies responded to the survey, which included questions about identifying allergenic foods, determining when an allergic reaction is occurring, and understanding what medications may be used to treat a reaction. Overall, nannies did well at recognizing the most common food allergens and had a good sense of the potential severity of this condition.

The survey did identify potential concerns. Of the nannies with formal educational training at a nanny school, only around 40% had received any food allergy specific training. Just 51% felt comfortable recognizing a food allergy emergency, while 58% felt comfortable preparing a safe meal for a child with food allergy. Only 58% of nannies who cared for children with food allergies had self-injectable epinephrine with them at all times, and 46% felt uncomfortable using epinephrine in an emergency. In addition, 19% of nannies did not always wash their hands after touching food allergens. A small but significant number of nannies adhered to potentially dangerous practices including 30% who felt that removing allergens from finished meals is acceptable, and 14% who felt that providing water can help suppress an allergic reaction. 66% of nannies believed that they needed additional information about recognizing and treating food allergies. Most felt that the child’s physician was the most useful source of information about food allergies.

Ultimately, this paper should serve as a catalyst for future educational efforts in the childcare industry as well as inspire increased dialogue among nanny organizations, nannies, families, and physicians so that the best possible care is provided to children, especially those at increased risk for severe food allergy reactions.


The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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