Anaphylaxis

About anaphylaxis

Anaphylaxis is a severe, life-threatening allergic reaction.

Anaphylaxis happens when your child comes into contact with something in the environment that he’s allergic to. This thing is called an allergen. For most people it’s something harmless, like food, insect stings and medications.

When your child comes into contact with the allergen, her body reacts as if it’s harmful. And your child’s immune system responds by flooding her body with chemicals.

When these chemicals get released, your child might go into shock – his blood pressure might drop suddenly and he might have trouble breathing. This is anaphylaxis. It’s also called anaphylactic shock.

Not all children and teenagers with an allergy will have an episode of anaphylaxis. Mild to moderate allergic reactions are more common.

Anaphylaxis is a life-threatening allergic reaction and requires urgent medical attention. If your child is having an anaphylactic reaction, first lay him flat to help keep his blood pressure stable. 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, he might have one or more of the following signs or symptoms:

difficult or noisy breathing
swelling of the tongue
swelling or tightness in the throat
trouble talking and/or a hoarse voice
a wheeze or persistent cough
persistent dizziness or fainting
low blood pressure.

If your child has an allergy to insect stings, she might also have abdominal pain and vomiting – but only after an insect sting.

Young children might go pale and floppy.

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 he has an allergic reaction.

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

Testing for anaphylaxis

If you think your child is at risk of anaphylaxis, getting a proper diagnosis is important. This means a doctor will need to identify what allergens might be 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 or wheat outgrow their allergies by the time they’re five years old. This is true even if your child has had a previous severe allergic reaction to these allergens. Peanut, treenut, fish and shellfish allergies are more likely to be lifelong.

Treatment for anaphylaxis

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

If your child is at risk of anaphylaxis, she’s likely to be prescribed an adrenaline auto-injector – for example, EpiPen®. She’ll probably also have an ASCIA (Australasian Society of Clinical Immunology and Allergy) action plan.

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 his 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.

Avoid using antihistamines for a severe allergic reaction – these will not prevent or treat anaphylaxis.

If you think your child is having a severe allergic reaction, it’s safer to give the adrenaline auto-injector rather than waiting to 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 cure for allergies, but many children grow out of them. But 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’. But by law the 10 most common allergens need to be plainly stated on food labels – for example, cow’s milk, soy, egg, wheat, peanuts and tree nuts.
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.

And 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 key 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 her allergy.

Allergen immunotherapy
You can talk with your allergist or immunologist about allergen immunotherapy, also called desensitisation.

This therapy involves a specialist regularly giving your child increasing doses of the allergen. This helps your child to tolerate the allergen better and reduces his symptoms. This form of treatment takes 3-5 years to work but is usually very effective.

Immunotherapy isn’t currently available for food allergies, but it can be used to treat a severe allergy to insect stings.

For more information on allergies and allergy testing, treatment and management, see our articles on allergies, non-food allergies and food allergies and intolerance: symptoms and management.