Q: If your infant or toddler has a food allergy, what symptoms of anaphylaxis should you watch for in case there’s an accidental exposure?

Michael Pistiner, MD: As the parent of an infant or toddler with food allergies, you will want to be able to recognize signs and symptoms of an allergic reaction. You will also want to know when an allergic reaction might be anaphylaxis, a severe allergic reaction.

Allergic reactions can vary from person to person. They can even be different from one reaction to the next.

Symptoms to watch for in infants and toddlers include:

  • Itchy hives, a rash and swelling
  • Coughing, wheezing and shortness of breath
  • Drawing in the belly or pulling at spaces between the ribs
  • Belly breathing or breathing through the nose.
  • Vomiting and diarrhea
  • Changes in activity or behavior, such as becoming tired or cranky or not able to hold the head up
  • Changes in skin color, such as turning blue or gray due to lack of oxygen

Some might put an object in their mouth, scratch or pull at their tongue, or even lick objects like a chair.

When your child is diagnosed with a food allergy, your doctor will give you a prescription for epinephrine auto-injectors. Your doctor will also provide an Allergy and Anaphylaxis Emergency Plan. This plan can help you determine if you need to use epinephrine to treat your baby quickly.

Being able to identify symptoms is going to help tell you when and how to treat a food-allergic reaction.

Michael Pistiner, MD, FACAAI, is a board-certified pediatric allergist, Director of Food Allergy Advocacy, Education and Prevention of the Food Allergy Center at MassGeneral Hospital for Children in Boston, and co-creator of the educational website AllergyHome.org.

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