Survey: Nannies Lack Knowledge, Training to Care for Children with Severe Food Allergies

Research indicates that many nannies know dangerously little about how to prevent, recognize, or treat severe allergic reactions such as anaphylaxis.

The authors of the study, which appeared in The Journal of Allergy and Clinical Immunology: In Practice, sent a 46-item questionnaire to 6 agencies and received responses from 153 nannies. All of the responses came from women, many of them quite experienced. The average survey participant had worked as a nanny for 13 years.

“Although the nannies who took the survey had a good grasp of basic food allergy concepts and answered the majority of questions correctly, the percentages of nannies who answered incorrectly were high enough to merit concern, given the potential for inducing or incorrectly treating an allergic reaction,” the researchers wrote.

“The combination of confidence with incomplete and/or incorrect knowledge could be dangerous because nannies may have a false sense of security when preparing a meal.”

Most of nannies recognized the most common food allergens and demonstrated an understanding of the potential severity of anaphylaxis and other reactions. Just 58% of them, however, reported that they’d feel comfortable preparing meals for children with allergies, and just 51% of them believed they would promptly recognize a food-related emergency.

Even the nannies who were caring for children with diagnosed food allergies when they completed the survey — 37% of the total group — struggled with basic concepts. Only 58% of them said they carried epinephrine autoinjectors at all times, and only 46% of them reported that they were confident they could use such a device properly in an emergency.

Significant minorities of the survey population reported that they regularly engaged in various dangerous food-handling practices or that they held erroneous beliefs about treating allergic reactions.

For example, 19% of the nannies who answered the survey made no point of washing their hands every time they touched a known allergen and 30% thought they could safely prevent reactions by removing allergens from a finished meal. Another 14% of them believed that they could help suppress a reaction with drinking water.

Formal training at an accredited nanny school was no guarantee of fundamental knowledge. Among nannies who had been to such a school, only 40% said they had received any instruction about food-related allergies.

Overall, 66% of the nannies who completed the survey believed they needed additional information to make them better prepared to deal with anaphylaxis. They were particularly eager to learn more about safeguarding the children under their care at restaurants and other venues outside the home.

The majority of them felt that the best place to get such information was from whatever doctors were treating the children they watched, but the majority of them got most of their information from the Internet, especially the site foodallergy.org.

The authors noted several limitations in their study, including the possibility that the nannies who participated were not a representative sample. Indeed, the very high percentage of responders who said they were caring for a child with diagnosed allergies suggests that to be the case.

Still, the authors noted, this appears to be the first study of nanny preparedness and, thus, provides valuable information at a time when serious food allergies are becoming more common among children.