Au Pair Child Allergies and Meds: Get It All in Writing

Claire thought she had covered it. On her au pair's second day, standing at the kitchen counter, she had gone through it all: Leo has a peanut allergy, it's serious, the EpiPen is in the blue pouch, Mia takes her asthma inhaler before football. Nadia nodded at everything, wrote nothing down, and said, "Yes, of course." It was a good conversation.

Three weeks later, Nadia took both children to a birthday party two streets away. A parent handed round a tray of cookies. Nadia knew about the peanut allergy — she remembered that clearly — and she checked: no peanuts in the ingredients. What she didn't know was that Leo's allergy was to tree nuts as well, that "may contain traces" was an automatic no in this family, and that the blue pouch had been moved to the school bag the week before.

Leo's lip started tingling in the car. Nadia phoned Claire, who was in a meeting and didn't pick up. She phoned again. By the time Claire called back four minutes later, Nadia had done the only thing she was sure of: she had driven home to look for the pouch.

It ended fine. It very nearly didn't. And nothing about it was Nadia's fault — she was a careful, conscientious caregiver working from a five-minute verbal briefing given three weeks earlier in her second language, about a medical condition she had never encountered before.

This is the gap that this article closes. Not "tell your au pair about the allergies" — you almost certainly already did that. The point is to get your child's allergies, medications, dosing times, and the exact if-then plan out of your head and onto a page your au pair can hold in their hand at 4 p.m. on a Saturday, when you are not answering your phone.

This article is general guidance, not medical advice. Your child's paediatrician or allergist should give you a written action plan, and that plan always overrides anything you read here. Use this article to help you document, share, and rehearse the plan — not to write it yourself.

Why a Verbal Health Briefing Almost Always Fails

Every host family briefs their au pair on child health. Very few do it in a form that survives contact with a real emergency. The failure is structural, not personal, and it comes from three predictable directions.

Memory decays, and it decays unevenly

The kitchen-counter conversation is dense: allergens, brand names, doses, symptoms, contacts, all in one go, on day two, alongside the wifi password and how the dishwasher works. What survives a month later is the headline — peanut allergy, serious — while exactly the details that matter in the moment quietly fall away.

• The headline survives. Your au pair will remember that a child has an allergy or takes a medicine.
• The specifics don't. Which allergens, what dose, how many hours between doses, which symptoms mean call now.
• The updates never land at all. The dose your doctor changed in March exists only in the conversation you had with your partner about it.

Language turns precision into approximation

Your au pair is likely working in their second or third language, and child health runs on exactly the vocabulary that language courses skip: wheezing, hives, swelling, traces of, twice daily with food, cross-contamination. A caregiver can be fluent in everyday English and still be unsure whether "puffy" and "swollen" mean the same level of alarm.

Written information solves this in a way that talking cannot. Text can be re-read, translated, and checked at the moment it matters, by someone who is frightened and does not want to guess.

The plan lives in a person who isn't there

The whole point of an emergency is that it happens when the adult with the knowledge is unreachable. If your health plan depends on a phone call to you, it isn't a plan. It's a hope.

Key takeaway: A verbal briefing transfers awareness. Only a written plan transfers instructions. Your au pair doesn't need to know that your child has an allergy — they need to know what to do in the ninety seconds after they see a rash.

The rest of this article is the four things worth writing down: the allergy record, the medication card, the if-then plan, and where all three live.

The Allergy Record: What "In Writing" Actually Means

"Leo is allergic to nuts" is not a record. It's a label. A usable allergy record answers the questions your au pair will actually have while standing in a supermarket aisle or at someone else's kitchen table.

One entry per allergen

Write a short block for every allergen separately, even when they feel like one group to you. Nut allergies in particular are where families get burned: "nuts" to a parent may mean peanuts and tree nuts and sesame-adjacent caution, while to a new caregiver reading a label it means the word peanut.

For each allergen, capture:

• The exact allergen: "Peanuts and all tree nuts (almond, cashew, walnut, hazelnut, pistachio)" — not "nuts"
• Severity: Life-threatening, moderate, or mild sensitivity, in plain words
• What a reaction looks like: The specific early signs this child shows — Leo's lip tingles, Mia goes blotchy round the neck
• How fast it moves: Whether reactions typically build over an hour or escalate within minutes
• Hidden sources: The products in your own kitchen and neighbourhood that catch people out — pesto, satay, certain breads, that one brand of cereal bar
• The house rule: Is "may contain traces" a hard no? Is a shared serving spoon a problem? Say it explicitly, because your au pair cannot infer your family's risk tolerance

Rate the risk in words, not vibes

Families often signal severity through tone of voice, which does not travel. Put it in a table so the difference between "avoid" and "emergency" is unmistakable.

Cover the situations, not just the foods

An allergy record that only lists ingredients leaves your au pair to improvise the hard parts. Add the scenarios that actually come up:

• Birthday parties and playdates: Does your au pair bring a safe alternative? Do they speak to the host parent? Do they call you first?
• Restaurants and bakeries: Are they allowed at all? What do they say at the counter?
• School and camp: Who at school holds the medication, and does your au pair need to hand anything over at drop-off?
• Other children's food: Sharing at the park, a sibling's snack, the neighbour's dog treats within a toddler's reach

Key takeaway: Write your risk tolerance down, not just your allergen list. "Traces are a no, parties need a call to me first, restaurants are fine if they tell staff" is worth more than a perfectly detailed ingredient table with no rules attached.

Much of this belongs alongside the core information every au pair needs about your kids — the allergy record is the safety-critical layer of that same profile, and it deserves to be the most precise part of it.

Medications: The Dosing Detail Nobody Writes Down

Medication is where written instructions stop being useful and start being essential. A dose is a number, a time, and a maximum, and none of those three survive a conversation.

The medication card

For every medicine your child takes — regular, seasonal, or as-needed — record the same eight fields. Consistency matters more than elegance here: your au pair should be able to scan any card and find the dose in the same place.

• Name and strength: The exact product, including concentration for liquids (children's ibuprofen 100mg/5ml)
• What it's for: In plain language, so your au pair understands why and doesn't confuse two similar bottles
• Dose: The precise amount and measuring device (5ml using the syringe, not the kitchen spoon)
• When: Fixed times for routine meds; the specific trigger for as-needed ones
• With or without food: And whether it can be mixed into a drink
• Maximum in 24 hours: The single most important line on the card, and the one most often left off
• Where it's kept: Exact location, including the spare and the one that lives in the school bag
• Expiry date: With a reminder to check it, because expired adrenaline is a plan that fails silently

Routine meds and rescue meds are different jobs

Separate the two clearly, because they demand opposite instincts. Routine medication is about consistency; rescue medication is about speed.

The logging half of routine medication is worth solving properly. "Did she already have her tablet?" is a question two caregivers will get wrong at least once, and the answer needs to exist somewhere other than in one person's memory. Setting the dose as a recurring task in a shared tool like AuPairSync — with the amount and the maximum written into the task itself — turns it into something both of you can see was ticked off at 8 a.m., rather than something you both assume the other did.

Say who is allowed to give what

Be explicit about permissions, and don't assume they're obvious.

1. Name what your au pair may give. Only the medications on the cards, only at the doses written, only for the reasons listed.
2. Name what they may never give. Anything not on the list. No paracetamol from their own bag, no remedy a friend recommends, nothing from the neighbour's cupboard — however harmless it seems.
3. Check your agency's rules. Many programmes ask for written host-family permission before an au pair administers any medication. Sort the paperwork before you need it.
4. Make the exception unmistakable. Rescue medication in a genuine emergency is never something to hesitate over. Say that out loud: if you think Leo needs the auto-injector, use it — you will never be in trouble for using it.

Key takeaway: The two lines that prevent the most harm are the daily maximum and the explicit permission to use rescue medication without asking first. Write both, in bold, on the plan.

The "What To Do If" Plan

An allergy record tells your au pair what to avoid. A medication card tells them what to give. Neither tells them what to do when something is already happening — and that is the document that actually gets used.

Write it as if-then, not as prose

Under stress, nobody reads paragraphs. Write the plan as a short chain of conditions and actions, in the order they happen, with one instruction per line. Your allergist's action plan will usually be structured exactly this way; copy its structure rather than rewriting it.

The shape that works:

1. If you see [specific mild symptoms] → give [named medication, exact dose] → stay with the child → message me
2. If you see [specific severe symptoms] → give [rescue medication] immediately → call emergency services → then call me
3. If you are unsure which it is → treat it as severe

That last line does more work than the rest combined. The most common failure in a real reaction is not the wrong drug — it's a caregiver waiting to see whether it gets worse.

The symptoms that mean don't wait

Spell these out in the child's own terms, not in medical vocabulary. Your au pair should be able to match what they're seeing to what's on the page.

• Breathing: Any wheeze, coughing that won't stop, a voice that's gone hoarse, obvious struggle
• Swelling: Lips, tongue, throat, or face — particularly if it's changing quickly
• Skin: Hives spreading beyond the contact point, widespread flushing
• Behaviour: Sudden pale floppiness, a child saying they feel "funny" or "like something's wrong", drowsiness that came out of nowhere
• Two systems at once: Skin and stomach, or skin and breathing, is the classic escalation pattern

Emergency numbers and what to say

🌍 Country-specific section. Emergency numbers and dispatch practice differ. Write the right ones for where you live on the plan itself — don't assume a caregiver from another country knows them.

Give your au pair a script, because "what's your address?" is a surprisingly hard question in a second language under adrenaline. Write your full address, the nearest cross street, and the door code on the plan, and add the sentence to open with: "A child is having a severe allergic reaction. I have given adrenaline. The address is..."

Practise the auto-injector before you need it

If your child carries an adrenaline auto-injector, reading about it is not enough. Ask your pharmacy or allergist for a trainer device — they're free and contain no needle — and have your au pair physically practise.

• Where: Outer thigh, and it works through clothing
• How long: Hold in place for the number of seconds this specific device's instructions state; brands differ
• Then what: Call emergency services every single time, even if the child looks better — reactions can rebound hours later
• Position: Follow the action plan; lying flat with legs raised is common guidance, but a child struggling to breathe is usually more comfortable sitting up
• Never leave them alone, and note the time the dose was given so you can tell the paramedics

Key takeaway: Rehearse the auto-injector with a trainer device in the first week, then again a few months in. A caregiver who has held the device in their hand acts in seconds; one who has only been shown a photograph hesitates, and hesitation is the whole risk.

Make It Findable in the Ninety Seconds That Matter

A perfect plan that lives in an email from March is not a plan. The last piece of the work is deciding where it lives and making sure it's there when the phone is in someone else's hand.

Two copies, always

• A physical copy somewhere permanent and obvious — inside a kitchen cupboard door, not on the fridge under six layers of artwork. One page, large type, per child.
• A digital copy on your au pair's phone, because that's the copy that goes to the park, the party, and the school run.

The digital half is where most families quietly fail: the plan gets sent as a photo in a chat, then buried under three weeks of messages about dinner. Keeping the signed action plan, the allergy record, and the medication cards in shared document storage means your au pair searches one place instead of scrolling — and when your allergist changes a dose, you replace one file rather than hoping the newest photo is the one they find.

The handover pack

Your au pair will regularly hand your child to another adult. Prepare a short version they can pass on without having to explain the whole medical history.

• School and camp: A copy of the action plan, the in-date medication, and a note of who holds it
• Playdates and parties: A three-line summary — allergen, what a reaction looks like, where the medication is
• Babysitters and grandparents: The same one-pager your au pair uses, so the instructions never change shape between caregivers

Keep it current

Child health information goes stale faster than anything else in the household. Set explicit review triggers rather than a vague intention:

• Every prescription change — update the card the same day
• Every birthday or growth spurt — many paediatric doses are weight-based
• Every school year — new teacher, new nurse, new copy needed
• Every three months — a two-minute expiry check on the auto-injector, inhalers, and liquids

This kind of periodic review sits naturally in the weekly check-in rhythm you already have. One question — anything change with the kids' health this week? — catches most of it.

The Health Documentation Checklist

If you do nothing else, do these eight things. They take an evening and they hold for the whole year.

1. Get the written action plan from your paediatrician or allergist. Ask for it explicitly; don't reconstruct it from memory.
2. Write one allergy record per allergen, including severity, early signs, hidden sources, and your family's traces rule.
3. Write one medication card per medicine, with dose, timing, daily maximum, storage location, and expiry.
4. Write the if-then emergency plan, including the when in doubt, treat it as severe line.
5. Add the address script and local emergency number to the plan itself.
6. Practise the auto-injector or inhaler with a trainer device, hands-on, in the first week.
7. Put a copy in two places — inside a cupboard door and on your au pair's phone.
8. Give explicit permission, in writing, to use rescue medication without calling you first.

Fold this into the wider onboarding conversation rather than treating it as a separate ordeal. If you're building an au pair family handbook, the health plan is its most important chapter, and it belongs in the first week alongside the emergency contact list rather than in month three.

Regulations and medical guidance change. The information here reflects general good practice at the publish date. Your child's own action plan, your local emergency guidance, and your agency's medication rules take precedence over any general advice.

The Bigger Picture

There's an uncomfortable truth underneath all this documentation: you are asking a twenty-two-year-old, often far from home and in a second language, to hold your child's safety in their hands on an ordinary Tuesday afternoon. That's a real weight, and most au pairs feel it long before anything goes wrong.

Writing it all down isn't a sign that you don't trust them. It's the opposite. A caregiver with a clear plan in their pocket is a caregiver who can relax into the job — who can take your child to a birthday party without a low hum of dread, because they know exactly what to check, exactly what to do, and exactly when to stop asking permission and act. The paperwork isn't there to control them. It's there so they can be confident.

And the version of Claire's story that ends well isn't the one where Nadia remembers harder. It's the one where she opens a page on her phone in the car, reads three lines, and knows.

Getting your child's health information out of your head and into one shared place? Download AuPairSync to keep allergy records, medication schedules, and emergency plans somewhere your au pair can reach them in seconds.