After last week’s mix-up of Dean’s lunch, I had several discussions with Dean’s teachers and the staff about ways to ensure something similar does not happen again.  I’m sure it’s easy to judge and wonder how in the world something like giving a bowl of pasta to a kid who’s allergic to wheat could even happen in the first place.  And I’m sure a lot of people probably also think we’re nuts to even have him in a daycare (or wouldn’t feel comfortable with taking that type of risk) but believe it or not, there is often very good rationale behind why these things happen.  And it’s important to us for Dean to not be the “bubble” kid so we try wherever possible to ensure life is as “normal” as possible for him.

All it takes is a few slight mishaps here and there, and before you know it, a perfect storm is brewing all based on circumstance: we sent Dean’s menu very late Sunday night, kitchen staff didn’t get it in time, kitchen cook knows that Dean has food allergies and checks system, Dean is flagged as the “no dairy” menu since they don’t have a category for “kid who’s allergic to just about everything” menu, kitchen cook preps pasta from the no dairy menu, teachers in room see pasta and think, ‘What? This is pasta.  Dean can’t eat pasta.”, due to a change in morning drop-off schedules, Matt and I forget to drop off his altered menu to his room so they don’t have a menu from us to check against, teacher calls kitchen to confirm, unfamiliar cook says, “Yes, it’s his special pasta.  I checked the system.  He got special pasta”, teachers in the room believe it’s OK (we often bring in safe versions of Dean’s food like gluten-free fish sticks when there are regular fish sticks for lunch so it would be perfectly logical that we brought in safe pasta), and so we end up with a kid who’s anaphylactic to wheat getting a bowl full of wheat pasta.  His teachers feel awful, the kitchen staff feels awful, and given that this is the second mix-up, we all know that something has to change.

So Friday last week, I met with five staff members at Dean’s school: the center director, the head of the kitchen, the head of environmental health & safety (EHS), the head of toddler program, and the group leader of Dean’s teachers.  We put our heads together and decided on the following changes, not only for Dean but some for all the kids at the center who have food allergies:

– We’ve completed his entire altered menu for January-March and in addition to his room and kitchen, EHS has it too.  All substitutions are in red text, and any items brought from home are flagged.

– All food being prepped for a child with an allergy is labeled with a red sticker.

– It does not leave the kitchen until checked by the kitchen head or the assistant manager in her absence.  If he’s not around, the head of EHS will clear it.

– Once in Dean’s room, if any item does not match exactly what’s on the menu Matt and I have provided, they have to clear it with only Matt or me before feeding.

– If there are last-minute menu changes for the entire center that day, we created a list of “safe foods” that the kitchen can serve, mainly plain items like chicken breast or fruit, or any of the items we bring in from home.

– There is one potential area of risk that we don’t really have a foolproof system for and that is the possibility of ingredient or supplier changes that can occur at any time.  Currently, we receive an itemized breakout of every menu item served at the center (they fill a jam-packed 1-inch binder).  We have the OK and not OK sections and these change as Dean’s allergies evolve.  You won’t believe where wheat, eggs, and all the other allergens reside: beef hamburgers, chicken fajita strips, taco seasoning, soup!  Since the center just obtains food from a larger distributor, behind the scenes, they can change who’s supplying that item in a moment’s notice or the same supplier can decide to change the food formulation without notice.  We realize that this is an area of risk as the sausage patties he loves for breakfast today may all of a sudden contain wheat in them next week, and if we don’t continuously pull the ingredient list daily, we won’t know until a reaction ensues.  Quite frankly, we can’t keep up with that kind of checking and oversight, so yes, we are somewhat taking a risk and seeing as there are very few multi-ingredient items he can even eat there, we hope this risk is small.  For now, any supplier changes flagged from the distributor will be passed along to us to confirm safety.  We hope this works.

In other news, Dean is doing much better.  If you hadn’t seen him earlier in the week, you wouldn’t have had any idea he was in the ER a few days prior.

For us, we spent the weekend up in Milwaukee enjoying some much needed time away from work, stress, and the busyness of to do lists and chores.  It was our first time hiring a paid babysitter (not family) and things went extremely well.  Hope everyone enjoyed your own relaxing and safe weekends.