• Regulations permit substitutions for children with special needs
• A statement from a physician supporting a student’s condition and prescribed substitution must be submitted to the Child Nutrition Department as soon as diagnosed.
• A medical statement for milk allergies is required for each school year.

For non-disabled individuals, the supporting statement shall include:

1. An indication that the medical or other special dietary needs restrict the child’s
   diet.
2. The food or foods to be omitted from the child’s diet and the food or choice of
   foods that may be substituted

The medical statement must include

1. Identification of the medical or other dietary need
   which restricts the child’s diet
2. The food or foods to be omitted from the child’s diet,
   and the food or choice of foods to be substituted
3. Signature of a licensed medical
   authority.

NOTE
A medical statement from your child’s physician must be on file annually in order for us to meet
their special dietary requirements.

• Medical Statement for Special Diets
• Medical Statement for Special Diets with Food Restrictions

Food Allergy

Generally students with food allergies or intolerances do not have a disability as defined
under 7 CFR 15b.3 of USDA’s nondiscrimination regulations, and school food authorities
may, but are not required to, make substitutions for them. However, when in the
licensed physician’s assessment, food allergies may result in severe, life-threatening
(anaphylactic) reactions, the child’s condition would meet the definition of “disability,”
and the substitutions prescribed by the licensed physician must be made. See above for
what the physician’s statement should include and use Exhibit 6.3 when requesting this
statement.

To assist with the guidelines, some situations with responses follow:

QUESTIONS AND ANSWERS

Situation 4: 

A child has a life-threatening allergy that causes an anaphylactic (allergic) reaction to peanuts. The slightest contact with peanuts or peanut derivatives, such as peanut oil, could be fatal.

Question:

To what lengths must the food service go to accommodate the child? Is it sufficient for the school food service to merely avoid obvious foods, such as peanut butter, or must school food service staff research every ingredient and additive in processed foods or regularly post all the ingredients used in recipes?

Response

The school has the responsibility to provide a “safe,” non-allergic meal to the child if it is determined that the condition is disabling. To do so, school food service staff must make sure that all food items offered to the allergic child meet prescribed guidelines and are free of foods which are suspected of causing the allergic reaction. The general rule is to exercise caution at all times. Do not serve foods to students at risk for anaphylactic reactions, if you do not know what is in them. It is important to recognize that a child may be provided a meal that is equivalent to the meal served to other students, but not necessarily the same meal.