Know what you can do when your child has a reaction
It can sneak in and go unnoticed or it can be an in-your-face frightening experience.
We’re not talking about spooky cats or larger-than-life zombies.
Anaphylaxis includes a range of symptoms that can occur in many combinations and be difficult to recognize. Some symptoms are not life-threatening, but the most severe ones restrict breathing and blood circulation.
Many different organs of your body can be affected:
Skin: Itching, hives, redness, swelling
Nose: Sneezing, stuffy nose, runny nose
Mouth: Itching, swelling of lips or tongue
Throat: Itching, tightness, difficulty swallowing, swelling of the back of the throat
Chest: Shortness of breath, cough, wheeze, chest pain, tightness
Heart: Weak pulse, passing out, shock
Gastrointestinal tract: Vomiting, diarrhea, cramps
Nervous system: Dizziness or fainting.
Anaphylaxis caused by an allergic reaction is highly unpredictable. The severity of a given attack does not predict the severity of subsequent attacks. The response will vary depending on several factors, including the following:
- your sensitivity to the allergen.
- How much of the allergen you are exposed to.
- How the allergen entered your body.
An anaphylactic reaction can occur as any of the following:
- a single reaction that occurs immediately after exposure to the allergen and gets better with or without treatment within the first minutes to hours. Symptoms do not recur later in relation to that episode.
- two reactions. The first reaction includes an initial set of symptoms that seem to go away but then reappear. The second reaction most typically occurs eight hours after the first reaction but may occur as much as 72 hours later.
- a single, long-lasting reaction that continues for hours or days following the initial reaction.
An initial allergic reaction to food sends many kids to the emergency room and can scare even the calmest parents.
More than a million children in this country have food allergies, and 39 percent of those children have a history of severe reactions, according to the American Academy of Pediatrics.
“Food allergies in children have definitely increased,” said Lynda Mitchell, president of the Kids with Food Allergies Foundation, based in Doylestown.
One of the biggest concerns when children have an allergic reaction to a food is that the first time can be mild and may only cause itchy lips or make the tongue feel funny, so a young child might not even know he or she is having a reaction, said Jens Hansen, a nurse practitioner at Pocono Medical Center immediate Care, East Stroudsburg.
If the allergic reaction goes unnoticed, it can cause problems because the severity of the reaction can and often does increase every time you are exposed to the allergen, he said.
“Parents, guardians and adults that work closely with children should know how to recognize an allergic reaction in a child and how to respond,” said Hansen, who is board-certified in family medicine.
Three major food allergies are peanuts, tree nuts and shell fish, Hansen said, adding that medicines can also cause a severe reaction, such as anaphylactic shock.
Hansen said anaphylaxis happens when two or more body systems are involved and is managed by administering epinephrine, along with steroids and antihistamines.
“If you have hives and vomiting or swelling around the eyes and trouble breathing, that involves two body systems, so it would be anaphylaxis,” he said.
Mary Palmieri of Saylorsburg knows all about anaphylaxis and severe allergies in children.
When her 4-year-old twins, Ashley and Briana, were 2 years old, Ashley had an allergic reaction to walnuts, which caused anaphylactic shock, Palmieri said.
“I had made a salad that had feta cheese and walnuts in it, and Ashley had a reaction to the walnuts in the salad,” she said.
She didn’t even eat the walnut. she spit it out. but it was still enough to cause anaphylaxis, Palmieri said.
Noticing that her daughter’s lips and face had started swelling almost immediately, she called 911. Ashley was rushed to the hospital, where she was treated with epinephrine and steroids.
An allergic reaction usually responds to the drugs quickly, but the reaction can last a long time, Hansen said.
Once a child has had a severe reaction to a food or drug, they are usually kept on steroids or antihistamines for a period of time to prevent the allergic reaction from returning, once the initial dose of the drug is out of their system, he said.
When Ashley was given her allergy test, there was an immediate reaction to tree nuts, Palmieri said, adding that they didn’t even have to wait the usual time to see if there was a reaction — it happened immediately.
Contrary to what Palmieri always thought, she learned that although her daughter had a severe reaction to walnuts, classified as a tree nut, her allergy did not include peanuts.
“Peanuts are different from tree nuts — they grow in the ground and not on a tree,” she said.
Children need to be tested to see what other things they are allergic to, Mitchell said.
“You can take your child to an allergist or a dermatologist to have your child tested for any allergies and any sensitivities they might have,” Hansen said.
“Once parents know what caused their child’s allergic reaction, they need to always be prepared in case it happens again. if you are not prepared, it could end in your child’s death,” Mitchell said.
Being proactive means reading all labels on packaged and canned foods for ingredients, Mitchell said, adding, “If you don’t know what is in it, call the company that manufactures the food.”
And it is not only about the food.
“When a child is brought to the emergency room with a severe allergic reaction that results in anaphylactic shock, the doctors usually send an Epipen (a pre-measured dose of epinephrine in injection form) and antihistamines home with the parents in case the allergic reaction returns after a time,” Hansen said.
Parents need to keep an Epipen with them at all times, give one to the child’s school and any other place where the child spends time, Hansen said.
Palmieri remembers how frightening her daughter’s allergic reaction was and how helpless she felt watching her child experience the reaction and not being able to help her.
“We keep an Epipen on us at all times, one at their grandparents’ house and one at the their nursery school,” Palmieri said.
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