If there is a history of allergies in your family, even seasonal allergies, some studies suggest that it may raise the chances of your child having a food allergy by as much as 25%. Even a clear family history is not a guarantee of an allergy free child, so consider starting foods, especially those most likely to cause a reaction, earlier in the day and during the business week, so that your doctor is available in case of a reaction. If you have a family history of severe allergic reactions, consult with your doctor about whether they believe it best to introduce the food at the regular time as the longer an exposer is delayed, the more likely a reaction, or if they believe in delaying the exposure. Both schools of thought exist.
As a preventative measure, consider asking your doctor how he or she advises handling an allergic reaction and keep Benadryl on hand. Also, if Benadryl is needed, ask the doctor for dosing instructions, as the bottle does not list dosing instructions for children under two.
Some basic guidelines for an allergic reaction are to stay calm and try to keep your child calm. Make sure that your child is not having problems getting air and that there is no swelling around his mouth, including lips and tongue, as these and others may be signs of anaphylaxis, which requires immediate medical attention.
If you only see a rash, continue to watch for signs of anaphylaxis, remove the offending food and anything that has touched it. Wash your child in cold water, using a gentle soap, but do not rub too hard, as it will further irritate the skin. I am a big fan of the hose in the summer, as my son thinks that it is great to play in the hose naked and gets so distracted that he stops scratching, which allows me to determine the severity of the reaction, but the shower will do the same trick, as the water is removing the trigger and not a washcloth.
If there is no improvement after removing the offending food or you have been instructed to do as such by your pediatrician, give your child Benadryl or a cortisone cream only as instructed. Always remember to be cautious when medicating a small child as using oral and topical Benadryl simultaneously may result in an overdose. Once the situation is under control, call your pediatrician, who may order tests to confirm the allergy.
Both blood and skin tests are used to confirm an allergy, but frequently your pediatrician will order the blood tests first. The results of the blood test may reveal an allergy to every food that you have ever fed your child, but do not throw out the present contents of your pantry until meeting with an allergist, who has far more experience with allergies than your general pediatrician.
The skin test is no big deal, but take a snack and entertainment, as you will be there for a while, but you should leave feeling relieved. The skin test will reveal whether or not your child actually reacts to a certain thing, which is the important information to have.
You will probably receive an epi-junior pen as a precaution, and you should be prepared to keep one with you and leave another at school or daycare. At my son’s school is a pouch, where I have his epi-pen, Benadryl, and cortisone along with a measuring cup with the dosage line drawn in in permanent marker. All contact info is written on the bag and instructions for his care are in the bag and on a piece of paper hanging on the wall under his picture. Your school may have other procedures, but the above is pretty common.
TIP: Epi-pens are generally good for a year, but when you fill the prescription, check the date on the pens you are given to ensure that the date is a year out and has not been on the shelf for a prolonged period.
Many children outgrow allergies, so a food challenge test may be recommended. This should only be done while in the care of the doctor and not attempted at home.
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