Food allergies have more than doubled in the developed, Western World over the last 50 years and the reasons remain unclear. Yet recent data finds 8% of children in the US with a food allergy with 1/3 of those children at risk for severe or life threatening reactions. A Pediatrics study published today has some sobering news about our ability to protect children from allergic ingestions. When it comes to allergies and deadly reactions 2 things are necessary:
- Avoidance of known triggers/allergens.
- Treatment of anaphylaxis (severe reactions) promptly with epinephrine.
Trouble is, children get exposed to known allergens by mistake and people are often nervous or unsure about how and when to use an Epipen (epinephrine in a pre-measured syringe). All parents/caregivers/teachers/coaches need to practice use of an Epipen & refresh why/when to administer it to an allergic child.
- Researches followed over 500 infants and young children allergic to milk and eggs (and many to peanuts) between 3 and 15 months of age. During the 3 years of the study, the majority of children (72%) had an exposure to an allergen that caused a significant reaction. Of the allergic reactions, 42% were reactions to milk, 21% to egg, and just under 8% to peanut. Reactions were most severe when a child was exposed to peanut, followed by milk, and then egg.
- Over 1/2 of the ingestions occurred after a non-parent adult offered an allergic food.
- 87% of reactions were due to accidental ingestions. Reasons for the mistakes? “Unintentional ingestions (eg, purely accidental such as forgetfulness, reduced supervision, not checking a product,etc), (64.9%); label reading error, (15.8%); cross-contamination, (15.1%); error in preparation, (4.1%); and manufacturer labeling error, (0.1%).”
- 11% percent of the reactions were severe. However, parents and adults caring for the children gave epinephrine only about 30% of the time when indicated. Study participants indicated not being able to recognize reaction, being too scared, not having the Epipen on hand, wanting to wait for more symptoms to develop, and not knowing if it was needed as rationale for not using the epinephrine.
What Parents Can Do To Support Young Children With Food Allergies
- Don’t Be Shy! Now is the time to reiterate your concerns and your care plan for a child with allergies in a daycare, preschool/school setting, or camp. When you drop off your child next, review their allergy history, their care plan, and reasons to use Epinephrine (an EpiPen) with their day time care provider. Don’t be shy.
- The EpiPen app. It’s free. Put it on your smartphone now if you’ve got one. Consider having your adult children, care providers, aunts and uncles or anyone else who cares for an infant or child with allergies download and review it, too. Get out a trainer Epipen or watch an instructional video about using an Epipen.
- Join FAAN and use their network as a support, a sounding board, a resource, and a community. Read their resources online to educate yourself and your family. Then go out and educate those who interact with your child on a daily basis. Don’t be shy about reminding teachers, friends, coaches, and relatives or refreshing what they know. Read labels.
- Know what anaphylaxis is really: It’s a serious allergic reaction with widespread effects on the body. It’s sudden and a potentially life-threatening reaction that involves two or more body parts (skin, gastrointestinal tract, heart, or respiratory tract) after an exposure to an allergen. Most food allergy anaphylaxis cases are ingestions. It is extremely rare for dust or contact/handling of food to cause anaphylaxis but some children can have more serious reactions.With anaphylaxis, there also can be swelling of the airway, serious difficulty with breathing, a drop in blood pressure, loss of consciousness, and in some cases, even death. If anaphylaxis is suspected, use epinephrine and call 911 immediately. If the reaction is worsening or it’s been 15 minutes and/or a child isn’t improving, consider repeating the epinephrine dose.
- If people around your child don’t “get it,” don’t give up. Use the words “life threatening allergy” as necessary when explaining your child’s risk of anaphylaxis to allergy exposure. Pull out your Epipen or Epipen trainer and show others how to use it and why. Prevention of ingestion is still a huge part of diminishing risk so feel free to refresh other’s knowledge quarterly.
What do you think about the study findings? Will you change what you do for your child at their daycare, preschool, or school?