Fact 1: Over a third of food allergy reactions happen after the first known oral intake of the offending food.
While it is true that an initial sensitizing exposure to an allergen is required before an allergic reaction (symptoms) can occur, the initial exposure to an allergen can happen without eating a peanut, tree nut, or other food.
Initial exposures may occur through the digestive tract when a baby drinks breast milk, or via the skin when the skin’s integrity is compromised by injury or a disease such as eczema. A first exposure can also happen through the respiratory tract, although this is rarer.
Fact 2: The severity of allergic reactions varies from exposure to exposure.
Today’s reaction to an allergen may be less intense than the one six months ago. Several factors influence allergy symptoms, making their severity unpredictable from one onset to the next. These factors include the mix of foods eaten which affect how fast an allergen is absorbed by the gut, and how a food is prepared (e.g., baked, left raw, or roasted).
Factors influencing the unpredictable occurrence of anaphylaxis include the presence of viral infections, underlying disorders (e.g., mastocytosis, asthma, arrhythmia), acute asthma distress, exercise, and medication use.
Fact 3: Hypotension (low blood pressure) and collapse are rare symptoms of anaphylaxis in children.
In infants and children, respiratory distress is the most common symptom of anaphylaxis. Children experiencing anaphylaxis typically demonstrate a persistent cough and wheezing that are sometimes incorrectly addressed with corticosteroids (anti-inflammatory) or salbutamol (a bronchodilator). Adrenaline (epinephrine) is the only effective medication for anaphylaxis.
Fact 3: Carrying an auto-injector is not just for children with a history of anaphylaxis.
Since there is no test that can reliably assess a child’s risk of anaphylaxis, this determination remains a matter of clinical judgment. Auto-injector prescriptions are most always recommended for those with a history of allergic reactions who also have a nut or seafood allergy, are adolescents, have a co-morbid condition (e.g., asthma, arrhythmia), and/or have limited emergency care access. The prescriptions are frequently given to children with multiple food allergies, and those with a history of reacting to very small amounts of an offending food.
Anyone with a food allergy can talk to a doctor or allergist about getting an auto-injector prescription for peace of mind.