If your child has a food allergy, the epinephrine auto-injector in their backpack may not be the only one at school, and new research suggests that backup matters a lot. A national survey of school nurses presented at the American College of Allergy, Asthma and Immunology (ACAAI) 2026 Annual Scientific Meeting found that schools without stock epinephrine were more than 4 times as likely to report having no epinephrine available during an allergic emergency.
A second study at the same meeting found that many babies still miss the recommended window for eating peanut, especially in families who don’t speak English at home. Here’s what both studies mean for your family, and the questions to ask your child’s school and pediatrician.
What Is Stock Epinephrine?
Stock epinephrine is an “undesignated” supply of epinephrine auto-injectors a school keeps on hand for anyone who has a severe allergic reaction (anaphylaxis), not just students with a prescription on file. All 50 states and Washington, D.C., permit schools to stock it, but according to ACAAI only 10 states require it, as reported by Contemporary Pediatrics.
That gap matters because food allergies are common and reactions can be unpredictable. About 7.6% of U.S. children have a food allergy, and 42.3% of children with food allergy report at least one severe reaction, according to research cited in the study. ACAAI notes that food allergy is the leading cause of anaphylaxis outside the hospital in the United States.
What the School Nurse Stock Epinephrine Survey Found
The survey, led by Mahi Singh, MD, a member of ACAAI, was sent to 1,847 U.S. school nurses between August and December 2025. A total of 349 nurses, each representing one school, responded. Key findings:
- 87% of schools kept stock epinephrine on hand.
- 74% still required students with known food allergies to bring their own device.
- 10% of nurses reported that epinephrine was unavailable during an actual emergency.
- Schools without stock epinephrine were more than 4 times as likely to report that no epinephrine was available in an allergic emergency.
- 72% of schools said no student needed epinephrine in the past year, a reminder that emergencies are rare but high-stakes when they happen.
“Our findings show that having stock epinephrine available at school clearly improves student safety,” Singh said. She also pointed out that requiring families to supply a separate device for school “can be expensive for families and limit accessibility outside school hours compared to backpack storage.”
The study has limits. Only about 19% of nurses responded, the data are self-reported, and the work was presented as a meeting abstract that has not yet been peer reviewed.
Peanut Introduction: Language Barriers Leave Some Babies Behind
The second study looked at a different piece of the food allergy puzzle: how early babies start eating peanut. Since the landmark LEAP trial, experts have known that feeding peanut early can dramatically lower the chance of a peanut allergy. In that trial, among high-risk infants, peanut allergy at age 5 was 1.9% in children who ate peanut regularly versus 13.7% in those who avoided it.
A 2021 consensus from U.S. and Canadian allergy groups recommends introducing peanut around 6 months of age, and not before 4 months, for all infants regardless of risk, with no required prior testing. And it seems to be working: a 2025 analysis in Pediatrics found peanut allergy diagnoses in children under 3 fell 43% after the guidance came out, according to Contemporary Pediatrics.
But not every family is getting the message. Researchers led by James Senter, MD, MPH, of Chicago reviewed the records of 3,170 children seen for 6- and 9-month well-child visits at two primary care sites of a large academic children’s hospital from 2021 to 2026.
- Overall, only 27.5% of babies had documented peanut introduction by 6 months, rising to 68.3% by 9 months.
- Babies in families who spoke a language other than English at home had about 79% lower odds of peanut introduction by 6 months (odds ratio 0.21), and about half the odds by 9 months, even after adjusting for income, financial stress, neighborhood and medical factors.
- These families did not meaningfully catch up between the two visits.
“Our findings suggest that language, on its own, is a barrier,” Senter said, stressing that the gap “isn’t about families not caring about their child’s health.” The researchers recommend professional interpreters and translated materials that explain how to introduce peanut and keep it in the diet.
Food Allergy Checklist for Parents
Whether your child already has a food allergy or you’re about to start solids, here’s what to do:
- Ask your school about stock epinephrine. Does it keep undesignated auto-injectors? Where are they stored, and who is trained to use them?
- Keep a written emergency action plan on file. ACAAI advises that it travel with your child on field trips and to sporting events.
- Carry two doses. ACAAI recommends having two doses available because a severe reaction can return in about 20% of people.
- Talk to your pediatrician about peanut at the 4- and 6-month visits. Ask how to introduce it safely (thinned peanut butter or peanut puffs, never whole peanuts) and how often to keep serving it.
- Ask for an interpreter or translated handouts if English isn’t your family’s first language. You have a right to understand the advice.
- Re-check old diagnoses. As we reported this week, more than 1 in 3 babies who test positive for peanut allergy may tolerate peanut in a supervised food challenge.
For more on keeping kids healthy this season, see our parent guide to flu, COVID and RSV vaccines for 2026-27.
This article is for informational purposes only and is not medical advice. Talk with your child’s pediatrician or allergist about your child’s specific needs.
