Health Issues

Anaphylaxis in Infants & Children

Anaphylaxis is a rapid and severe allergic reaction. It is also a life-threatening emergency.

Research shows a rising number of children being treated in emergency departments for anaphylaxis in recent years. Allergic reactions are unpredictable in terms of when they occur, what types of symptoms develop, and the severity of those symptoms; they can happen to children at any age, including infants.

Being prepared and knowing the signs of an allergic reaction can save a child's life. At any age, anaphylaxis can be deadly without immediate medical help. Read on.

Anaphylaxis includes a wide range of symptoms that can start quickly—within minutes or several hours after exposure to an allergy trigger.

Be aware of any of the following symptoms, especially if they appear suddenly:

shortness of breath, wheezing, coughing or tightness in chest
trouble breathing or swallowing
skin changes like rash, redness or hives, and/or pale or bluish color
swelling of the lips or tongue
sneezing, stuffy nose, runny nose
tight throat, difficulty swallowing, hoarseness
weak pulse, symptoms of shock
vomiting, diarrhea (if severe or combined with other symptoms)
dizziness or fainting
feeling of "doom," confusion, drowsiness or agitation

Infants may also experience other symptoms such as:

irritability, fussiness, or inconsolable crying  
sudden drooling 
unusual sleepiness

Epinephrine is the recommended emergency treatment for symptoms of anaphylaxis.

Epinephrine helps quickly reverse the life-threatening symptoms of anaphylaxis. If it is available, epinephrine should be given immediately to anyone experiencing symptoms of anaphylaxis, followed by a call to 911, and a trip to the emergency department.

The medicine comes in auto-injector syringes to make this easier. The best place to inject it is in the muscles of the outer part of the thigh.

Epinephrine autoinjectors should be prescribed for anyone who has ever had an anaphylactic attack and for infants and children at high risk for anaphylaxis. Because a second dose may be needed if symptoms don't ease quickly, children at risk for anaphylaxis should carry at least two autoinjectors with them at all times.

Children who are old enough can be taught how to give themselves epinephrine, if needed. Epinephrine autoinjectors should be readily available in school or child care settings and trained staff should be available to act quickly in case of a reaction. Keep in mind, schools may require detailed instructions from your child's doctor about how and when to use it. See Administrating at School: Tips for Parents.

What to do after giving an infant or child epinephrine:

Note what time the epinephrine was given and call 911. Ask for an ambulance with epinephrine. Tell rescue squad when epinephrine was last given when they arrive.
Stay with child and give a second dose of epinephrine if: symptoms get worse, continue, or do not get better in 5 minutes.
Keep child lying on his or her back. If the child vomits or has trouble breathing, keep child lying on his or her side.
Give other prescription medicine (such as the child's inhaler/bronchodilator or an antihistamine prescribed by the doctor), but never use other medicine in place of epinephrine.

Lots of things can cause a severe allergic reaction.

Common Allergens that Can Trigger Anaphylaxis
Foods	Peanuts are one of the most common U.S. food allergies. The American Academy of Pediatrics advises parents to introduce peanut-containing foods after their baby has tried low allergy risk foods as an allergen prevention strategy for high-risk infants" Milk Eggs Tree nuts such as walnuts, pistachios, pecans and cashews Shellfish (such as shrimp, lobster) Fish such as tuna, salmon, cod (although, like with peanuts, there is some evidence that consuming fish early in life may help prevent allergic diseases such as asthma and eczema).
Insect stings	Bees Wasps Hornets Yellow jackets Fire ants
Medicines	Antibiotics and antiseizure medicines are some of the more common medicines that cause anaphylaxis. However, any medicine, even aspirin and other nonsteroidal anti-inflammatory drugs, have the potential to cause severe reactions.
Other	In rare cases, anaphylaxis may be related to a certain food followed by exercise.

Be prepared: have an allergy and anaphylaxis emergency care plan.

Anyone caring for an infant or child with a life-threatening allergy must be able to recognize anaphylaxis and know when and how to give the lifesaving treatment (epinephrine).

If your child is at high risk for allergies, or has had a previous severe allergy reaction, the American Academy of Pediatrics recommends you have an Allergy and Anaphylaxis Emergency Plan. Your pediatrician can help you and your family use this plan with anyone who cares for your child. It's also clearly written and easy to understand. See for yourself!

Additional Information:

Last Updated: 9/30/2019

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.