Anaphylaxis is a severe, potentially life-threatening allergic reaction that can affect multiple body systems rapidly. It is a serious medical emergency requiring immediate attention. Infants can also experience anaphylactic reactions, so recognizing the signs and acting quickly are important.
Recognizing Anaphylaxis in Babies
Anaphylaxis in infants can present differently than in older individuals. Skin reactions are frequently observed, including widespread hives, redness, itching, and swelling, particularly around the face, lips, and eyes. These skin changes can be first signs.
Respiratory symptoms may include wheezing, difficulty breathing, fast or noisy breathing, or nasal flaring. Infants might also exhibit belly breathing or chest/neck tugging as they struggle to get air. A hoarse voice or cry can be a sign.
Gastrointestinal issues are common, such as vomiting, diarrhea, and abdominal pain. Cardiovascular signs, while less common than skin or gut issues, include pale or bluish skin, lethargy, floppiness, sudden drowsiness, or loss of consciousness, indicating shock.
Behavioral changes can also signal a reaction in infants who cannot verbalize their symptoms. This can manifest as sudden irritability, fussiness, inconsolable crying, or unusual quietness and sleepiness. Anaphylaxis usually involves symptoms across multiple body systems, and these symptoms can progress quickly.
Common Triggers in Infancy
Various substances can trigger anaphylaxis in infants, with food allergies being the most common cause in young children. Cow’s milk, eggs, and peanuts are frequent culprits, alongside tree nuts, soy, wheat, fish, and shellfish. Even a tiny amount of an allergen can provoke a severe reaction.
Insect stings can also lead to anaphylaxis. While less common, certain medications are known triggers. Antibiotics and antiseizure medicines are among the medications that can cause anaphylactic reactions in infants. Less common triggers include latex, and in rare instances, exercise-induced anaphylaxis can occur, sometimes in combination with certain foods.
Immediate Action and Emergency Response
Administering epinephrine is the first and most important step when anaphylaxis is suspected in an infant. Epinephrine works quickly to reverse severe symptoms and is the only proven treatment. An epinephrine auto-injector, such as an EpiPen Jr., is the preferred method of delivery for infants.
To use an auto-injector, firmly hold the baby’s leg in place, remove the safety release, and press the orange tip against the middle of the outer thigh until a click is heard. Hold it firmly in place for three seconds before removing it and massaging the injection site for ten seconds. Call emergency services immediately after administering epinephrine, even if the baby’s symptoms appear to improve.
While awaiting medical help, position the baby on their back. If the baby is vomiting or experiencing breathing difficulties, place them on their side or in an upright position to help with breathing. Do not wait to see if symptoms improve on their own, and do not rely on antihistamines as the primary treatment for anaphylaxis. A second dose of epinephrine may be needed if symptoms worsen or do not improve within 5 to 15 minutes.
Diagnosis and Ongoing Care
Diagnosing anaphylaxis typically relies on the clinical presentation of symptoms and a history of recent allergen exposure. After an acute event, allergy testing, such as skin prick tests or specific IgE blood tests, can help identify the exact trigger. However, these tests are usually performed after the immediate danger has passed.
Working with an allergist to develop a comprehensive Anaphylaxis Action Plan is a crucial step in ongoing care. This plan outlines specific symptoms to watch for and clear instructions on how and when to administer epinephrine. It also emphasizes the importance of always having at least two epinephrine auto-injectors available, as a second dose might be necessary.
Long-term management involves strict allergen avoidance strategies, which include carefully reading food labels and informing all caregivers about the baby’s allergies. Regular follow-up appointments with an allergist are important for re-evaluating the action plan and ensuring continued safety. Educating family members and other caregivers on recognizing symptoms and using the auto-injector is an important aspect of preventing future reactions.