Reporting levels for allergy is considered higher among the ordinary population than is diagnosed at the GP. In the UK, 'self reported' allergy suggests that potentially, as many as one in five children have allergic rhinitis, one in three have asthma and one in six have eczema.8,9

The pattern of allergy can change as the child grows older, with younger children more likely to have atopic eczema, food allergy, gastrointestinal symptoms, or wheezing. However, the pattern of conditions may change to asthma and allergic rhino-conjunctivitis. The British Society for Allergy & Clinical Immunology (BSACI) points out that the best approach to managing the condition will take into consideration the impact on their lives both at school and at home.9

Since October 2014, the regulations allow schools to obtain and store salbutamol inhalers without a prescription in case a child with asthma cannot access their own inhaler.10

Guidance around this sets out:

·      how to recognise an asthma attack and what to do

·      arrangements for the supply, storage, care and disposal of the inhaler (ideally, there should be two plastic spacers compatible for use with the inhalers)

·      which children can use an inhaler

·      how to respond to asthma symptoms and an asthma attack

·      staff considerations.

The guidance expects all staff to be trained around the general principles involved with asthma, while designated staff take on specific roles. Staff should also watch the inhaler technique videos on the Asthma UK charity's website.11,12

For atopic eczema, emollients are the first line treatment, regardless of severity, and should always be used even when the atopic eczema is clear, NICE has advised. €Leave-on emollients should be prescribed in large quantities (250€“500 g weekly) and easily available to use at nursery, pre-school or school.€13