Anaphylaxis

About anaphylaxis

Anaphylaxis is a severe, life-threatening allergic reaction.

Anaphylaxis happens when your child reacts to something in the environment called an allergen. Allergens might be something like food, insect stings or medication.

Allergens cause your child’s immune system to release histamine and other substances into his body. This leads to anaphylaxis symptoms.

Not all children and teenagers with allergies will have anaphylaxis. Mild to moderate allergic reactions are much more common than anaphylaxis.

Anaphylaxis requires urgent medical attention. If your child is having an anaphylactic reaction, first lay him flat or keep him sitting. Don’t let him stand or walk around. Next use an adrenaline auto-injector like EpiPen® if one is available. Then call an ambulance – phone 000.

Symptoms of anaphylaxis

If your child is having a severe allergic reaction, she might have one or more of the following signs or symptoms:

difficult or noisy breathing
swelling of the tongue
tightness in the throat
difficulty talking and/or a hoarse voice or cry
a wheeze or persistent cough
persistent dizziness or fainting
paleness and floppiness (in young children).

If your child has anaphylaxis caused by insect stings, he might also have stomach pain and vomiting.

Sometimes, an anaphylactic reaction might seem like a mild reaction at first but will quickly get worse. So if your child has allergies, it’s important to watch your child closely whenever she has an allergic reaction.

Anaphylaxis usually happens within minutes of your child being exposed to the allergen. But sometimes it can happen up to 1-2 hours later.

Testing for anaphylaxis

If you think your child is at risk of anaphylaxis, getting a diagnosis is important. This means a doctor will need to identify what’s causing your child to have an allergic reaction.

To start the process of allergy diagnosis, you can talk to your family GP, who can refer your child to an allergy and immunology specialist for allergy testing.

When your child has a confirmed diagnosis of allergies, you can prepare yourself to handle all kinds of allergic reactions, including anaphylaxis.

Most children with allergies to egg, cow’s milk, wheat or soy bean outgrow their allergies by the time they’re 5-10 years old. This is true even if your child has had a previous severe allergic reaction to these allergens. Peanut, tree nut, fish and shellfish allergies are more likely to be lifelong.

Treatment for anaphylaxis

Adrenaline is used to treat anaphylaxis. It works very quickly to reverse the symptoms of anaphylaxis.

If your child is at risk of anaphylaxis, he’s likely to be prescribed an adrenaline auto-injector – for example, EpiPen®.

If your child is prescribed an adrenaline auto-injector, it’s important that both you and your child learn how and when to use it. Your child’s ability to use it will depend on her age and development. You and/or your child should carry the adrenaline auto-injector at all times. You can also teach others – family, friends, teachers and carers – how to use it.

Your doctor should also give your child an ASCIA (Australasian Society of Clinical Immunology and Allergy) action plan.

If you think your child is having a severe allergic reaction, it’s safer to give the adrenaline auto-injector than to wait and see whether your child’s symptoms get worse. Not giving the adrenaline auto-injector can be more harmful than giving it, even if it’s not needed.

Managing anaphylaxis

There’s no effective cure for allergies yet, but many children grow out of them. And you can take some steps to make it easier for you and your child to live with anaphylaxis.

Avoid the allergen
It’s very important for your child to avoid the allergen that causes anaphylaxis. This can be challenging, but there are important things you can do to help your child.

Here’s what you can do if your child has a food allergy:

Read labels on all foods. Be aware that some allergenic foods have different names – for example, cow’s milk protein might be called ‘whey’ or ‘casein’. By law the 10 most common allergens need to be plainly stated on food labels – cow’s milk, soy, egg, wheat, peanuts, tree nuts, sesame, fish, shellfish and lupin.
Be careful when you eat out. Ask what ingredients each dish includes, how it was prepared, whether it has touched any other foods, and whether there’s any risk of cross-contamination. Most restaurants will be happy to tell you, but they might not know about the ingredients in some foods like sauces.
Avoid any foods or cutlery that could have been in contact with the allergen. This includes buffets and bain-maries (food warmers). Even tiny amounts of the allergen can cause your child to have a severe reaction.
Teach your child not to share food. This might depend on your child’s age and ability to understand.

Here’s what to do if your child has an allergy to insect stings:

Don’t let your child walk barefoot on grass.
Avoid dressing your child in bright colours.
Dress your child in long-sleeved shirts and pants when you can.
Teach your child not to drink from open soft drink cans outdoors.

If your child has an allergy to a medication, let your doctor, pharmacist or dentist know before your child has any treatments or takes any medications.

Let people know
It’s important that key people – like family, carers, babysitters and your child’s school – know that your child has a severe allergy. It’s a good idea for them to know how and when to use your child’s EpiPen®.

Wear a medical bracelet
This lets people know about your child’s particular allergy. This can be really important if your child has a severe allergic reaction without any friends or family around who know about his allergy.

Discuss allergen immunotherapy with an allergist
You can talk with your allergist or immunologist about immunotherapy, also called desensitisation. Immunotherapy isn’t currently available for food allergies, but it can be used to treat a severe allergy to insect stings.

Allergen immunotherapy involves a specialist regularly giving your child increasing doses of the allergen. This helps your child to tolerate the allergen better and reduces her symptoms. This form of treatment takes 3-5 years to complete but is usually very effective. For more information on allergies and allergy testing, treatment and management, see our articles on allergies, non-food allergies and food allergies.