What causes anaphylaxis?

Children can react to many substances. But some of the most common allergens are:

• Foods, mainly milk, egg, wheat, soy, peanuts, shellfish, and tree nuts, such as almonds, cashews, and walnuts

• Insect bites and stings

• Medicines, such as antibiotics

• Latex, a type of rubber

Some people have their allergies treated with immunotherapy in the form of allergy shots or tablets. These treatments may cause serious reactions, such as anaphylaxis in some people. This is rare.

What are the symptoms of anaphylaxis?

In an allergic reaction, the immune system mistakes a substance as harmful. It then floods the whole body with strong chemicals. These chemicals can cause symptoms, such as:

• Itching skin and raised bumps on the skin (hives)

• Swelling of the mouth or face

• Wheezing or trouble breathing

• Cough, sneezing, or runny nose

• Trouble swallowing

• Hoarse voice

• Lightheadedness, dizziness, or fainting

• Nausea, vomiting, or diarrhea

• Stomach pain or cramping

• Confusion

• Slurred speech

• Anxiety or feeling of doom

If your child has symptoms of anaphylaxis, act quickly!

If your child's healthcare provider has prescribed epinephrine medicine, such as an autoinjector or nasal spray, use it right away and exactly as directed. Then call 911.

How is anaphylaxis treated?

In the hospital:

• Your child is likely to be given epinephrine (adrenaline). They may also be given antihistamines or steroids to help stop the allergic response.

• The healthcare provider will ask about substances your child may have been exposed to and whether a similar reaction has happened before. Your child may need certain tests.

• Your child will be watched for a few hours or overnight to make sure symptoms don’t come back.

• Your child will be referred to their healthcare provider or an allergist for follow-up care. An allergist is a healthcare provider with special training in treating allergies.

Using injectable epinephrine

To treat a future attack, the healthcare provider may prescribe an epinephrine autoinjector. This is epinephrine in a form you or your child can use. It is a pen with a hidden needle that’s released by a spring. Here is how to use one type of epinephrine autoinjector. Your healthcare provider or pharmacist can tell you about other types. When you pick up the epinephrine autoinjector at the pharmacy, take a moment to open the box and look at it. If you are unsure how to use it, ask your pharmacist to demonstrate it for you.

• Grasp the pen in the middle, not on the end.

• Pull off the safety cap.

• Hold your child tightly.

• Point the orange tip of the pen anywhere on the outside of your child’s thigh. The injector may go through pants. But if you are able to expose the skin, that is even better.

• Push the pen into the thigh. Wait to hear a click. Then hold for 3 to 10 seconds, based on the type of autoinjector used, to release the epinephrine.

• Remove the needle by pulling the pen straight out, away from the leg.

• Massage the injection site for about 10 seconds.

• As soon as you’ve given the shot, call 911.

• Have your child lie down with legs raised or a pillow under the knees until help arrives.

Older children should be taught how and when to use the epinephrine autoinjector themselves.

Preventing anaphylaxis

To help prevent allergic reactions:

• Food allergies. Read package labels carefully and use caution in restaurants. Also explain your child’s allergy to teachers, caregivers, and other parents.

• Bee or wasp allergies. Have your child wear long sleeves, long pants, and shoes outdoors. Don't let your child wear clothing with flowery patterns or bright colors. Strong smells can attract bees. So tell your child not to use perfume, cologne, or highly scented laundry soaps. Be careful in fields, gardens, picnic areas, and around garbage cans. See an allergist to get testing. Venom allergies are treatable with special allergy shots for bee venoms. These shots can protect your child in case of a future sting.

• Tell your child’s healthcare provider, dentist, and pharmacist of any allergies your child has to medicines. Keep a list of alternate medicines handy.

Keeping your child safe in an emergency 

These precautions can help keep your child safe in an emergency:

• Tell key people about your child’s allergy. This includes adults who spend time with your child, such as childcare providers, teachers, and other parents. Let them know the warning signs of an allergic reaction and what to do if it happens. Teach them how to use the epinephrine.

• Make an action plan. Describe how to care for your child in case of an allergic reaction. Give a copy of the plan to the school nurse, food service workers, and people who care for your child.

• Have your child wear a medical alert bracelet. This explains your child’s allergy to anyone who comes to your child’s aid. You can buy the bracelet in most drugstores and on the Internet.

• Always carry 2 epinephrine doses. Some families find it easier to keep multiple doses on hand: a 2-pack at your child’s school or daycare center and a 2-pack in a safe place at home. Also have a 2-pack for you or your child to carry. Be sure to check expiration dates on the medicine. They typically need to be replaced every year. Talk with your child's healthcare provider if the epinephrine is expensive and you have trouble paying for it.