An allergic reaction occurs when the body's immune system senses an "invader," or allergen, and attacks it. Allergies can be triggered by any number of things, and the incidence of them is on the rise. Food allergies alone affect about three million kids in the United States, according to the Food Allergy and Anaphylaxis Network, with 90 percent of them caused by:
cow's milk eggs wheat soy peanuts tree nuts (walnuts, pecans, cashews, etc.) fish shellfish
If you suspect your child has an allergy, it's important to talk with your doctor and visit an allergist. But how do you spot an allergic reaction?
What to look for: Hives—or urticaria—is an itchy, welt-like rash that often resembles mosquito bites. They appear in clusters on various parts of your child's body: In the case of a contact allergy, the hives will appear on the part of the body that came in contact with the allergen; in the case of a food allergy, the hives may appear on the stomach, hands, face, back, or inside of the thighs. If your baby can't yet verbalize the itchiness, you may notice scratching or rolling to relieve the itch or simply inconsolable crying.
What to do: When they're the only symptom, hives are usually considered harmless and can clear up on their own, but they can also be treated with an antihistamine, such as Benadryl. (Use this Benadryl dosage chart.) But because hives indicate an allergic reaction, it is important to figure out what allergen caused it. Shellfish, nuts, and berries are common culprits, so it is helpful to think about any new foods your child might have eaten in the past 24 hours and look carefully at food labels.
What to look for: Conjunctivitis, also called pinkeye, is not only a daycare-spread condition: it can be caused by allergies as well. Though both common pinkeye and allergic conjunctivitis may include watery, red eyes, to tell the difference between them you'll want to look for any itchiness of the eyes and possible dark circles around them—called allergic shiners.
What to do: Allergic conjunctivitis is not contagious, but you'll want your baby to see your doctor as quickly as possible so he can make an accurate diagnosis and prescribe medication, such as antihistamines or eye drops, to treat it. Since the condition is often caused by airborne allergens, avoidance is the best remedy, although a cold compress to the eyes may help relieve the itching and combat swelling.
What to look for: A runny nose can often be just be a sign of a cold, but if you notice your child has a persistent, thin, watery discharge, it may be due to allergies. Your child may even develop a crease across the top of her nose—called the "allergic salute"—from constantly wiping upward using her finger or whole hand. You may also notice that your child is breathing out of her mouth because of constant congestion or is sneezing excessively.
What to do: Stock up on tissues ... you'll be doing a lot of nose wiping. You can also flush your child's nose two or three times a day with nasal saline spray to help relieve congestion. Pinpointing the allergen affecting your child will allow you to implement tactics to reduce your child's exposure to it. See your doctor if you're suspicious of allergens.
What to look for: While eczema—also known as atopic dermatitis—is not an allergy, acute allergic reactions can worsen eczema. And because severe causes of eczema are common for infants, eczema is considered to be an early sign of an allergic predisposition. According to Dr. Miles Weinberger, MD, of the University of Iowa Children's Hospital, it is also believed there is a genetic component to children developing eczema. The condition can be caused by allergen exposure to the skin and is characterized as a red, scaly, sometimes oozing rash that appears on the face, scalp, buttocks, thighs, and upper body on infants. (See what eczema may look like here.)
What to do: Your doctor will be able to prescribe mild to mid-potency topical corticosteroids to help clear up eczema. Scratching only makes eczema worse, so do what you can to make sure your child doesn't itch. Oral antihistamines can help with that. You'll also want to keep your child's skin well moisturized.
What to look for: One of the most common allergic reactions for infants is swelling, generally around the eyes, lips, and overall face. It's important to monitor your child's breathing if you notice swelling, as swelling of the throat can be life threatening and a sign of anaphylactic shock (more on that in few slides).
What to do: Swelling is not taken lightly in terms of allergic reactions. Keep an eye on all swollen areas. You child will likely need to be seen by a doctor as some allergic reactions can start with mild swelling and progressively get more severe. You can use an ice pack to help keep swelling down, but call your pediatrician at the first sign of it.
What to look for: In the case of wheezing, it's what you listen for that counts. It may start as a dry, hacking cough but progress to a high-pitched whistling noise when your child exhales. You'll notice it is noisier when your child breathes out than in.
There are many other symptoms of infant allergies including:
a bloated stomach vomiting diarrhea increased gas problems eating and sleeping sudden irritability and crankiness
According to Barbara Rosenstein, director of communications for the Food Allergy Initiative, symptoms may appear within seconds of being exposed to the allergen or up to a few hours later.
It's important to remember that many symptoms of allergies are symptoms of other illnesses. If your child does have an allergy (or allergies), you will likely see several symptoms occur at the same time, and they will likely last longer than eight to 10 days (unlike a common cold).
What to look for: Although rare, anaphylaxis—or anaphylactic shock—is a severe, life- threatening allergic reaction. According to Dr. Michael Pistiner, MD, of Allergy and Asthma Consultants of Rockland and Bergen, each child may demonstrate different symptoms when experiencing anaphylaxis.
"The most common symptoms may include difficulty swallowing and/or speaking, change in voice, tightness or swelling of the throat; sneezing, coughing, wheezing, or shortness of breath; severe itching of the skin, rapidly progressing hives; nausea, vomiting, stomach pain or diarrhea; dizziness, lightheadedness, fainting, loss of consciousness, or anxiety; irregular heartbeats, weak pulse, blueness, paleness, or lowered blood pressure."
In the case of food allergies, you may see a young child scratching at his tongue (or complaining of his tongue itching or a funny feeling in his mouth if he is old enough to verbalize his discomfort).
What to do: Call 911 right away, says Dr. Pistiner. And, he adds, be sure to tell them you believe your child is having anaphylaxis. That way they will send the first available emergency responder armed with epinephrine, the drug of choice for treating an anaphylactic reaction, which needs to be administered as soon as possible. It is available by prescription only— EpiPen® and Twinject® are the available forms of self-injectable epinephrine in the US.
If your child has had an allergic reaction, it is important to make a plan for next time. Seeing an allergist to have your child tested is essential to helping identify what your child is allergic to.
Although allergy testing can be performed at any age there may be false negatives in young children, especially those less than six months of age, so work with your allergist to determine the best method of testing. Once you identify the allergen(s), you'll be able to develop an avoidance strategy to help prevent future reactions. Use these additional allergy resources: