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A Guide for Parents on Handling Severe Allergic Reactions in Infants & Toddlers

While rare, severe allergic reactions can happen with infants and toddlers. Severe allergic reactions in infants and toddlers can be tricky to identify because some of the symptoms can look a lot like normal behavior for a baby or toddler. Also, unlike older children and adults, infants and toddlers struggle to verbalize what they are feeling and what’s happening. This can make children very anxious and possibly hysterical because they have never experienced it before and are uncomfortable.

As a parent, it’s important to remain calm, be prepared and know the signs of a severe allergic reaction so that you can help and keep your child safe. With some help from the American Academy of Pediatrics (AAP), we’ve put together some information and tips for staying informed and creating an allergy and anaphylaxis emergency care plan for your child.

Causes of a severe allergic reaction

There are a lot of things that can cause a severe allergic reaction (also known as anaphylaxis). Common allergens include:

  • Foods
    • Peanuts
    • Milk
    • Eggs
    • Tree nuts (cashews, pecans, pistachios, walnuts)
    • Fish
    • Shellfish
  • Insect bites or stings
  • Medicines
  • Latex
  • Eating certain foods followed by exercise

Symptoms of a severe allergic reaction

How can you spot signs of an allergic reaction? Anaphylaxis symptoms come in a wide range, and they can start within minutes or several hours after exposure. Be aware of the following symptoms, especially if they happen immediately:

  • Shortness of breath, wheezing, coughing or tightness in the chest
  • Trouble breathing, swallowing, change in voice
  • Skin changes like rash, redness or hives and/or pale or bluish color
  • Swelling of the lips or tongue
  • Weak pulse, symptoms of shock
  • Vomiting, diarrhea (if combined with other symptoms)
  • Dizziness or fainting
  • Sudden drooling
  • Unusual sleepiness
  • Inconsolable crying

What to do if your child is having a severe allergic reaction

  • Carefully administer epinephrine (EpiPen) if available and prescribed by the primary medical doctor. Inject into the outer thigh muscle.
  • Call 911 or take your child to the nearest emergency department.
  • Take note of when you give the first injection.
  • Calm and reassure your child and have them lie down.
  • Check your child’s airway and breathing. Strained breathing or talking, a hoarse voice or high-pitched breathing sounds are all signs that your child’s throat is swollen.
  • Do not give any medication by mouth if your child’s throat may be swollen.
  • If symptoms don’t improve within 5 minutes of the injection, try a second dose.
  • Keep your child lying on his/her back unless he is vomiting or having trouble breathing in which it’s better to have him lay on his side.
  • You may administer a prescribed inhaler to your child along with epinephrine but NEVER use another medicine in place of it.

If the child has had a severe allergic reaction before, it’s important to inform whoever else helps to take care of him/her on what to do if a reaction occurs and how to properly use an EpiPen if your child needs it (and a medical professional advises you to use it).

Additional Resources

Epinephrine Auto-Injector – For more information on how to use an EpiPen, click here.

Allergy and Anaphylaxis Emergency Plan – For tips on how to create your own, click here.

It’s important to know what to do when an infant or young child has a serious allergic reaction. Prepare by setting up an emergency plan and carrying an EpiPen to use only if/when a medical professional advises you to use it in an emergency situation. You may also find our blogs on preventing allergies and seasonal allergies in children helpful.

Information in this article is not intended to be used as medical advice, but instead for thought and consideration. For more information, please consult your provider or your child’s pediatrician regarding more information about severe allergic reactions in infants and toddlers.

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