Allergy in childhood is fairly common. It may seem like anything can cause an allergic reaction: pollen, insect bites or stings, pet hair, dust mites, mould, cigarette smoke, medications, foods such as eggs, dairy products, soy, wheat, shellfish and peanuts are all common allergens. But that doesn’t mean you must keep your kids away from these things. If they do turn out to have an allergy or two, the good news is that most tend to be mild allergic reactions.

An allergic reaction occurs when the body’s immune system releases antibodies against an ‘invasive’ substance or material. As part of its attack, the body also releases histamine, which is what causes inflammation, a common symptom of an allergic reaction. (This is why the most common medication for a mild allergy is an anti-histamine.)

Symptoms of an allergic reaction happen almost immediately; this timing is what differentiates an allergy from a mere intolerance. For example, a child who is intolerant to eggs may get a stomach pain, vomiting and diarrhoea a few hours after she has consumed them; a child who is allergic to eggs, will get stomach pains, vomiting and diarrhoea almost immediately after being exposed.

Allergic reactions tend to take parents and kids by surprise because it’s difficult to know if and to what your child is allergic. Some allergies tend to run in families; if you or your spouse have a specific allergy, you may want to consider getting your child tested for it. However, it is not only prohibitively expensive to test for all allergies, it is also impossible to do so. And so, it’s best to be prepared by knowing the symptoms of a reaction and how to respond.

While most will be mild allergic reactions, a severe allergic reaction can cause anaphylaxis, which is a life-threatening condition. It’s important to know the signs and best response for both.

Severe Allergic Reactions

Most severe allergic reactions in children are caused by insect stings or bites, food or medication. Symptoms of anaphylaxis or a severe allergic reaction occur very quickly, usually within 3 to 30 minutes of contact. Symptoms include the following:

• Sudden swelling of the throat, face, lips or tongue
• Severe coughing or wheezing
• Trouble breathing or inability to breathe
• Tightness in the lungs or chest pain
• Low blood pressure
• Weak, rapid pulse
• Dizziness or fainting
• Pale or flushed skin
• Hives, welts and/or sudden, severe itchiness of the skin
• Profuse sweating
• Severe stomach pain, vomiting and/or diarrhoea

How to respond:

Severe allergic reactions are life threatening and need to be treated as medical emergencies. If you have an epinephrine pen, give your child at least one shot. Monitor your child’s breathing and start CPR if his breathing stops. Finally, take your child to the nearest hospital using the quickest mode of transport and route.

Be prepared:

It is impossible to monitor your child at all times, but if you know your child has a severe allergy or one runs in the family, be prepared: Keep at least two epinephrine pens on your child’s person, with you, at home, in the car, your child’s school and any other place that your child frequents regularly. You, all caregivers, and your child (once old enough) should be trained in how to use it. Also, check and restock your store of epinephrine pens regularly, as they do expire.

Mild Allergic Reactions

Common scenarios of mild allergic reactions are listed below, along with symptoms, causes and treatment. A mild allergic reaction can turn into a severe one, so continue to supervise them to make sure they do not get worse.

Scenario 1 and Response

Your daughter comes to you complaining of stomach pain. She then vomits, and that’s when you notice hives (red bumps on the skin) all over her body. This would be a common reaction to an allergy to foods like dairy products, fish, or peanuts. Offer plenty of fluids to prevent dehydration, offer plain or bland food, all her to rest, and see a paediatrician for medication.

Scenario 2 and Response

Your son has had a reoccurring cough for the past six months, as well as wheezing that comes and goes. This would be a common reaction to an allergy to dust mites, mould, or cigarette smoke. Make sure he is exposed to fresh and circulating air and minimise dust and mould by: cleaning regularly, exposing his bed to sunlight, which kills dust mites; thoroughly drying and shaking out sheets before making the bed; avoiding using a vacuum with your child in the room; and not allowing anyone to smoke near your child. Finally, see a pediatrician for a prescription for an anti-histamine or nasal corticosteroid.

Scenario 3 and Response

Your daughter has had a recurring, red, itchy, scaly, dry rash on her elbows (or knees, back of neck, wrists, ankles or buttocks) for a month. This is eczema, a common reaction to soap, artificial clothing fibres, heat and sweat, or food. Switch to laundry products that are free of perfumes and dyes. Give her lukewarm baths or showers before applying moisturizer while her skin is still damp. If it persists, visit a pediatrician for a prescription for an anti-histamine or steroid cream.

Scenario 4 and Response

Your son has watery eyes, itchy skin, a congested nose, dry throat, and sneezing. This is commonly called Hay Fever and is a reaction to pollen and other environmental factors. Keep home and car windows closed, use air filters in your home, give him wraparound sunglasses when outside to protect his eyes, paste a little Vaseline at the opening of his nostrils to trap pollen and prevent him inhaling it, and wash his hair, face and hands and change his clothes after outdoor play. If symptoms persist, visit a pediatrician for advice on nasal drops and an anti-histamine.

Scenario 5 and Response

Your daughter comes to you with itching skin, mild swelling, and a mild case of hives. There is a stinger embedded in one of the hives on her arm. This is typically a sign of an allergy to a sting or bite from an insect like a bee or red/fire ants. First, if the stinger is embedded, scrape it sideways away from the skin and use tweezers to remove it. Then, clean the area with soap and water or rubbing alcohol. Apply a cold compress and keep the area elevated and immobilised as much as possible.

As always, consult your pediatrician before giving any medication to a child, including antihistamines, nasal corticosteroids or drops and steroid creams.