Anaphylaxis

Anaphylaxis in children

As a parent, it’s important to be prepared if your child has an anaphylactic reaction. Knowing the symptoms of anaphylaxis can help you know what to look for so you can act quickly to get your child the treatment they need. 

What is anaphylaxis? 

Anaphylaxis is a serious and severe allergic reaction that can affect children of any age. 

This type of allergic reaction can worsen rapidly. Anaphylaxis in children (and adults) is life-threatening, so should always be treated as an emergency. 

What causes anaphylaxis in children?

Allergic reactions happen when a child’s immune system responds to a food or substance as a threat. A number of things can cause anaphylaxis including certain foods, medications and insect stings. 

Below are some of the most common allergens to be aware of.

Foods:

  • Peanuts
  • Milk 
  • Eggs 
  • Soy
  • Wheat
  • Sesame
  • Tree nuts, like walnuts, pistachios, pecans and cashews
  • Shellfish 
  • Fish

Insect stings and bites:

  • Bees
  • Wasps
  • Hornets
  • Ticks
  • Fire ants

Medications:

  • Penicillin
  • Antibiotics
  • Anti-seizure medications
  • Insulin 
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen

In very rare cases, anaphylactic reactions to certain foods can be triggered by exercise. 

In children and young adults, food allergy is the most common cause of anaphylaxis,  whereas in older adults, drug allergies more commonly result in anaphylaxis. Persistent food allergies (those that are not outgrown) such as nuts, sesame seeds, fish, shellfish are more likely to cause anaphylaxis, but in children, cow’s milk allergy (if not outgrown) can also cause severe allergic reactions. .

What are the symptoms of anaphylaxis in children?

Anaphylaxis tends to come on in a few minutes, but allergic reactions to drugs and insect stings usually come on more quickly than to allergic reactions to foods.

Signs and symptoms your child is having an anaphylactic reaction are:

  • Difficulty breathing – shortness of breath, wheezing or persistently coughing
  • Swelling of their tongue or throat
  • Difficulty swallowing or speaking
  • Hoarse voice
  • Skin going pale or blue
  • Feeling persistently dizzy 
  • Collapsing or falling unconscious

If your child is an infant, they may also: 

  • Suddenly start drooling more than usual
  • Be unusually sleepy or floppy

It can be frightening to see your child having a severe reaction. It’s important to stay as calm as you can and get them medical treatment as quickly as possible.

How common is paediatric anaphylaxis?

It’s not clear how many infants and children experience anaphylaxis, but research shows that cases of severe allergic reactions are on the rise.

Any child can have anaphylaxis, but the risk is greater for your child if they have:

  • Allergies
  • Asthma
  • A family history of anaphylaxis
  • Had anaphylaxis in the past

How to treat paediatric anaphylaxis

Severe allergic reactions can be very distressing for both you and your child, but knowing how to treat anaphylaxis can help you to be prepared in case this happens.

Treatment of a known allergy

If your child has had an anaphylactic reaction in the past, they will have been prescribed an adrenaline auto-injector. If your child has symptoms of anaphylaxis, administer the injection into your child’s upper outer thigh immediately and then call 999 straight away.

When the emergency services arrive, give them the auto-injector so they know which medication your child has been given. 

Treatment of an unknown allergy

If your child is having an anaphylactic reaction for the first time, call 999 immediately. 

While you wait for paramedics:

  • Stay calm and reassure your child
  • Lie your child on their back and raise their legs to help prevent shock 
  • Check your child’s airway is open. If your child has stopped breathing start performing CPR with rescue breaths
  • If they’re having a reaction to an insect sting, scrape the stinger off with a stiff object. Do not pull the stinger out as this will release more venom

When the paramedics arrive, they’ll give your child medication to counteract the allergic reaction and reduce symptoms.

If your child is struggling to breathe, the paramedics will give oxygen, or put a tube through their nose or mouth into their airway.

Your child will be monitored in hospital for several hours to make sure their symptoms are under control before you can take them home. 

If a child has had an anaphylactic reaction, it’s vital that they be given an adrenaline auto-injector to treat any future reaction that might happen. 

How to prevent anaphylaxis

If your child has experienced anaphylaxis, it is vital to avoid the allergen that caused it to prevent future reactions. Allergy testing can help you identify the allergen that’s causing the reaction if you’re unsure. 

Once you know what your child’s allergen is, you can work with their care team to avoid them and reduce the risk of anaphylaxis. This may involve measures such as:

  • Reading all food labels before giving anything to your child to eat
  • Alerting your child’s nursery or school and any carers about their food allergies so they can put steps in place to eliminate allergens from your child’s environment 
  • Making sure your child is always wearing shoes when playing outside can help reduce their risk of being stung by an insect
  • Dressing them in long-sleeved tops and trousers to reduce the risk of stings
  • Teaching them to be calm around insects and to move away slowly to avoid being stung
  • If your child has asthma, controlling their asthma well can help reduce their risk of a severe allergic reaction 

If your child has severe allergies, they should be issued with a written emergency treatment plan. This will include medicines such as antihistamines, adrenaline auto-injectors and, for children with asthma, ventolin (blue asthma reliever inhaler) as well as information on how to use these. 

If your child has been prescribed an auto-injector, anyone who takes care of them should  carry the medication at all times and knows how to inject it. 

When your child is old enough, show them when and how to use the auto-injector themselves in case there’s no adult present to help them.

How Children’s Allergy Doctors can help 

At Children’s Allergy Doctors, we know how hard it is to see your child unwell. If your child is experiencing allergic reactions, our expert team can help you discover which allergens are affecting them and how best to treat and prevent anaphylaxis. 

Get in touch to book a consultation with our experienced and knowledgeable paediatricians today.

 

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