Background: Rates of food allergies in children as well as the rate of families who employ nannies have increased dramatically over the past decade. It is essential that nannies have the knowledge and tools necessary to recognize and treat food allergy reactions.

Objective: To identify gaps in knowledge in the nanny population with regard to food allergy in children.

Methods: A Web-based survey was sent by e-mail to 709 nannies.

Results: A total of 153 nannies (22%) completed the online survey: 26% of respondents had formal educational training at a nanny school; 99% recognized food allergy as a potentially fatal event; 37% reported caring for a child with food allergies. Of these, 71% had food allergy action plans, and 63% had epinephrine available. A total of 71% reported training on administering epinephrine. The nannies' major concerns included accidental ingestion and discomfort in administering epinephrine. A total of 36% were uncomfortable with recognizing a food allergy emergency, whereas 46% were uncomfortable administering epinephrine; 6% thought that a sensitized child could safely eat a small amount of allergenic food, whereas 14% believed that dilution with water might reduce an allergic reaction. A total of 66% desired additional information about recognizing food allergies, and 71% agreed that food allergy training should be required for all nannies.

Conclusion: Nannies demonstrated gaps in knowledge with regard to food allergy in children, which reflects the need for more stringent training and education. Increased communication among parents, nannies, and physicians is needed to protect children with food allergy.

Key words: Food allergy; Nanny; Children; Child care; Epinephrine; Survey