Spotting Food Allergy Symptoms in Children & Anaphylaxis

For parents, understanding food allergy symptoms in children is incredibly important. While many allergic reactions are mild, some can be severe and life-threatening, known as anaphylaxis. Pharmacist Zeinab Ardeshir from PillSorted shares vital information on recognising these serious symptoms and how to act quickly in an emergency. This guide will walk you through the key signs to look out for and the essential steps to take.

What is Anaphylaxis?

Anaphylaxis is a severe, life-threatening allergic reaction that can occur rapidly, often within minutes of exposure to an allergen. While many people associate anaphylaxis with food, it can also be triggered by insect stings, certain medications, or other substances. The underlying cause is an overreaction of your immune system to something it mistakenly identifies as harmful.

When anaphylaxis occurs, the body releases a flood of chemicals that can cause a sudden drop in blood pressure and narrowing of the airways, making breathing extremely difficult. If not treated quickly, it can lead to loss of consciousness and can be fatal. This is why understanding and acting swiftly on food allergy symptoms in children and other allergic reactions are so vital.

Recognising Severe Food Allergy Symptoms in Children

Rapid recognition of anaphylaxis symptoms is critical. These symptoms can progress very quickly, so knowing what to look for can save a life. Here are the key food allergy symptoms in children and other severe allergic reactions that demand immediate attention:

• Lightheadedness or Dizziness: This can be a sign of dropping blood pressure.
• Difficulty Breathing: Look for wheezing, a tight chest, noisy breathing, or a harsh cough. Airways can narrow significantly, making it very hard to breathe.
• Swelling and Hives: Swelling of the lips, face, or throat is a serious sign. Hives (itchy red welts) or skin rashes can appear rapidly.
• Nausea, Vomiting, or Abdominal Pain: Gastrointestinal symptoms can also indicate a severe reaction.
• Feelings of Confusion or Anxiety: The person might seem disoriented or distressed.
• Collapsing or Loss of Consciousness: This is an emergency and requires immediate intervention.

If you observe any of these symptoms, especially a combination of them, act fast. Speed is of the essence in treating anaphylaxis.

Emergency Treatment: Adrenaline Auto-Injectors (EpiPen)

The primary treatment for anaphylaxis is an injection of adrenaline (epinephrine). Adrenaline works by reversing the effects of the allergic reaction: it helps to open up constricted airways, narrows blood vessels to raise blood pressure, and reduces swelling. The primary device for administering adrenaline is the EpiPen auto-injector. A newer, needle-free option, the EURneffy nasal spray, is currently undergoing regulatory review and may become available in the future.

EpiPen Auto-Injectors

EpiPens come in two strengths to cater for different weights, which is particularly important when considering food allergy symptoms in children:

• 0.3mg: For children over 30kg and adults.
• 0.15mg (EpiPen Jr): For children weighing between 15kg and 30kg.

How to use an EpiPen:

1. Hold correctly: Hold the EpiPen in your dominant hand with the blue safety cap pointing upwards and the orange tip (where the needle comes out) pointing downwards.
2. Remove safety cap: Pull off the blue safety cap.
3. Position for injection: Place the orange tip against the outer thigh, at a 90-degree angle to the leg. It can be injected through clothing.
4. Plunge firmly: Push down firmly until you hear a click, indicating the injection has started.
5. Hold for 10 seconds: Keep the auto-injector in place for 10 seconds to ensure the full dose is delivered.
6. Remove and massage: Remove the EpiPen and gently massage the injection site for 10 seconds.

Important Safety Note: Never put your thumb or fingers over the orange tip or the blue safety cap when removing it, as this could lead to accidental injection into your fingers. Always hold it firmly in the middle part of the device.

Introducing the EURnephy Nasal Spray

A new, needle-free option for emergency adrenaline treatment has been approved by the MHRA since July 2024: the EURnephy nasal spray. This device provides a 2mg dose of adrenaline via nasal administration, offering an alternative for those who may prefer a needle-free option or as a supplementary treatment.

How to use EURnephy nasal spray:

1. Hold correctly: Place your thumb under the plunger part and your two fingers at the top, on either side of the nozzle.
2. Insert into nostril: Insert the nozzle into one nostril as far as comfortable, ensuring it is held straight and not angled towards the septum or side wall.
3. Press firmly: Once in position, press the plunger firmly to deliver the single dose.

Important Note: Do not test plunge the device. It contains only one shot. The nasal spray is effective even if the nose is blocked, such as during a cold.

Crucial Steps After an Adrenaline Dose

Administering adrenaline is the first critical step, but it’s not the only one. After giving an EpiPen or EURnephy, follow these essential steps:

• Call 999 Immediately: Even if the person feels better, call emergency services straight away. A secondary reaction can occur hours later, and medical observation is essential.
• Help the Person Lie Down: Instruct the person to lie flat. If breathing is difficult in this position, you can help them into a semi-sitting position. Do not let them stand up or walk around.
• Observe and Monitor: Stay with the person and continue to monitor their symptoms until medical help arrives.
• Prepare a Second Dose: Have another EpiPen or EURnephy ready. If symptoms do not improve or worsen within 5 minutes of the first dose, it is perfectly safe to administer a second dose. There is minimal risk of overdoing adrenaline compared to the risk of not giving enough in time.

Key Takeaways for Managing Food Allergy Symptoms in Children

Anaphylaxis is a serious allergic reaction that requires immediate attention. For parents, being prepared to recognise and respond to severe food allergy symptoms in children are paramount. Remember these key points:

• Speed is Vital: Delaying treatment is the biggest risk factor for fatal anaphylaxis. If you suspect a severe reaction, administer adrenaline without hesitation, even if you are unsure.
• Know the Symptoms: Be familiar with the signs of anaphylaxis, especially those affecting breathing, circulation, and skin.
• Carry Two Doses: Always ensure you have two adrenaline auto-injectors or nasal sprays readily available.
• Check Expiry Dates: Regularly check the expiry dates on your adrenaline devices and replace them as soon as possible if they are expired or have been used.
• Seek Medical Attention: Always call 999 immediately after administering adrenaline, even if symptoms improve.

Being prepared and knowing how to act can make all the difference in an anaphylactic emergency. For more information on general health topics, please visit our General Health section.

Disclaimer: This blog post is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making changes to your health routine.