How to Treat an Allergic Reaction to Food

By Karen DeMuth, M.D., M.P.H., Pediatric Allergy/Immunology Specialist

I’ve seen it time and time again. A child will eat something, which will prompt an allergic reaction. Once the symptoms start, there’s a very small window of opportunity to treat it, and for far too many, that window comes and goes because they weren’t prepared. For many, this may mean a few hours of discomfort. But for some, the result could be death.

It’s all too common that my patients will tell me they don’t carry an epinephrine autoinjector with them. In fact, only about 60 percent of children with a food allergy in the clinic have their epinephrine autoinjectors with them. The reasons are varied, but they all mean the same thing: I’m careful to avoid the food I’m allergic to and I won’t get exposed. Sure, it’s very important to be careful about what you’re eating, but you can’t control what other people are doing. It’s not a substitute for being ready for an accident. You don’t wait to put your seatbelt on until after you’ve been hit; you wear it during the ride in case you get hit because you can’t control the other drivers. The same principle applies to your child carrying an epinephrine autoinjector with them everywhere they go. And if your child is too young to be able to use the epinephrine autoinjector, it’s up to you and the child’s caregivers to always have one nearby.

Keep two epinephrine autoinjectors on hand in case one is defective.

While having the epinephrine autoinjector is an all-too-important first step, it may not be enough to save your child’s life. Each and every caregiver should be trained to handle the situation if the need arises. That includes teachers, bus drivers, family members, neighbors and coaches. These tips will help educate those close to your child:

Always be ready. An allergic reaction can come on at any time and in any place, no matter how careful your child is about what he eats or comes into contact with.
Have a food allergy action plan. Your plan should include:
- How to give the injection
- When to call 911
- What to tell the paramedics
- Who to call as an emergency contact
Keep equipment ready. I can’t stress enough how important it is for your child to carry an epinephrine autoinjector with them at all times. In fact, he should carry two since 20 percent of children require a second dose of epinephrine and also in case one autoinjector is defective. Your child’s school may have one on hand, but don’t count on it.
Know what to look for. Allergic reactions can affect many of the body’s systems, including the skin (rashes and swelling), breathing (coughing, wheezing, labored breaths), the stomach and intestines (nausea, vomiting, diarrhea) and the heart (fast heart rate, dizziness, low blood pressure). Familiarize yourself and others with the symptoms of anaphylaxis and know that not all reactions will be the same. They will differ from person to person.
Know how to handle it. It’s normal for a certain amount of nerves to pop up in a serious situation like this, but if you feel any of your child’s caregivers can’t handle the situation, then they should not be responsible for your child. They need to put their nerves aside, and follow the plan you’ve put in place. It’s also important to review these steps every so often, so it’s fresh in your mind when you need to act quickly. Being prepared and calm in the face of an emergency is the key to a good, safe outcome.
Dr. DeMuth is an allergy/immunology specialist at Hughes Spalding.