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Anaphylaxis in Infants and Children

Anaphylaxis is a severe and potentially life-threatening allergic reaction.  The onset and worsening of symptoms can occur very rapidly and display as a wide range of signs and symptoms.  Symptoms of anaphylaxis often occur within minutes after exposure to an allergic trigger but can sometimes take up to several hours before starting.  It is important to understand that an anaphylactic reaction can happen and allergic exposure at any time, even if previous reactions were mild.  Knowing and recognizing the signs quickly can save lives!  The most common triggers for anaphylaxis in children are food allergies, but reactions to certain medication, stinging insects, and latex are also possible.


Possible anaphylaxis symptoms include (especially if onset is sudden or associated with exposure to a known allergy):

  • Rash or skin redness, especially hives spreading rapidly over the entire body or face
  • Shortness of breath, coughing, wheezing, chest tightness
  • Swelling, especially around the face, lips, mouth, eyes
  • Tightness in the throat, difficulty swallowing, hoarseness, or drooling
  • Dizziness/lightheadedness, fainting
  • Weak pulse, pale or blue color to the skin or lips, fainting
  • Extreme fatigue, confusion, drowsiness, or agitation
  • Vomiting or diarrhea (when combined with other symptoms)
  • Inconsolable agitation, fussiness, or crying in infants

Skin changes such as hives, itchy, flushed, or pale skin are often the first and most obvious signs of an allergic reaction, so if they occur, watch closely for other signs of anaphylaxis.


What to do?  Treat first (if available) and Call 911 or go immediately to the nearest Emergency room.

Treatment for anaphylaxis is to give an epinephrine injection as quickly as possible via an autoinjector such as an Epi-Pen.  If one is available, it should be administered immediately followed by calling 911.

  • If your child is prescribed other medications such as inhalers for asthma or antihistamines for allergies they can also be given, but only after epinephrine and never instead of it.
  • Always stay with and monitor the child while waiting for or seeking emergency care.
  • A repeat dose of epinephrine should be given if symptoms worsen or do not improve within 5 minutes.
  • Never treat at home and assume the emergency is over – always seek immediate medical care even if symptoms appear to completely resolve.  They can return rapidly as medications wear off or the reaction worsens.


References and resources:

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