Management of Children With Food-Induced Anaphylaxis: An Overview

Introduction

Anaphylaxis is a potentially fatal response that manifests as an abrupt onset of symptoms affecting several organ systems and needs prompt medical attention. While the number of deaths from anaphylaxis is still rather low, hospitalizations for food-induced anaphylaxis have become more common in recent years. Anaphylaxis symptoms can vary greatly in severity.

The most common symptoms (>90 percent) are related to the skin, mucous membranes, and gastrointestinal tract, followed by symptoms affecting the respiratory and cardiovascular systems (>50 percent). For children and teenagers, food is the most frequent cause of anaphylactic responses. Adrenaline autoinjectors (AAI) are advised for the first care of anaphylaxis, and intramuscular adrenaline is the preferred therapy for food-related anaphylactic events.

Which Foods Often Cause Anaphylaxis?

The following eight foods are thought to be the source of 90 percent of food allergies. These include milk, eggs, wheat, soy, tree nuts, almonds, fish, and shellfish. Eggs, milk, and peanuts most frequently cause children's food allergies. However, they can also be caused by wheat, soy, and tree nuts.

The foods that typically trigger the worst responses include fish, shellfish, peanuts, and tree nuts. Anaphylaxis affects about 5 percent of children under the age of five. Among children under eighteen, the frequency of reported food allergies increased by 18 percent between 1997 and 2007. Most children "outgrow" their allergies. However, allergies to fish, shellfish, peanuts, and tree nuts can last a lifetime.

What Are the Symptoms of Food-Induced Anaphylaxis?

Severe allergic reactions, such as food-induced anaphylaxis, can be fatal if left untreated. After eating the trigger meal, symptoms usually appear minutes to hours later and might affect different body areas.

The following are a few of the most typical symptoms to be aware of:

Skin:

• Hives: These are elevated and itchy welts that can develop anywhere on the body.

• Redness and Swelling: These can affect the lips, eyes, or face, and in extreme situations, they can spread throughout the whole body.

• Itching: This may be broad and quite strong.

Respiratory Symptoms

• Breathlessness: This might be followed by tightness in the chest, wheezing, or trouble breathing.

• Runny or Stuffy Nose: This may indicate inflammation of the airways.

• Coughing: It can be productive (producing mucus) or dry.

• Wheezing: Exhaling produces the high-pitched whistling sound known as wheezing.

Cardiac Symptoms

• Increased Heartbeat: The body attempts to get more blood to the important organs.

• Feeling Lightheaded or Dizzy: This might indicate low blood pressure.

• Losing Consciousness or Fainting: This is a medical emergency that has to be treated right away.

Gastrointestinal Symptoms

• Vomiting and Nausea: This may indicate that the body is attempting to rid itself of the allergen.

• Inflammation: Intestinal inflammation may be indicated by discomfort and abdominal cramping.

• Diarrhea: It may be bloody or watery.

Others:

• Anxiety: This is a typical anaphylactic symptom that may be quite common and upsetting.

• Change in Taste: A metallic taste in the mouth is a less typical symptom that some anaphylaxis sufferers may experience.

How to Manage Food Anaphylaxis in Children?

Food allergies can induce symptoms that range in severity from minor to potentially fatal; each reaction's intensity is unique. Individuals who had previously only had minor symptoms may suddenly develop anaphylaxis. This potentially fatal response can, among other things, make breathing difficult and cause a sharp decrease in blood pressure.

For this reason, allergists dislike labeling someone as "mildly" or "severely" allergic to a food since they cannot predict what will happen with the next reaction. Outside of a hospital, food allergies are the most common cause of anaphylaxis in the United States.

Epinephrine, sometimes called adrenaline, is considered the first line of therapy for anaphylaxis, which happens when an allergy triggers a cascade of chemicals that might cause the body to go into shock. After being exposed to an allergen, anaphylaxis can happen seconds or minutes later, intensify rapidly, and be lethal.

Anyone who has a food allergy has to keep their auto-injector handy at all times. Approximately 20 percent of people may experience a recurrence of the severe response, so make sure to have two doses on hand. If one experiences any severe symptoms, such as shortness of breath, hives, tightness in the throat, weak pulse, repeated coughing, difficulty breathing, difficulty swallowing, or a combination of symptoms from different parts of the body, like hives, rashes, or skin swelling combined with vomiting, diarrhea, or abdominal pain, use epinephrine right away. There may be a need for repeated doses. Once epinephrine has been provided, immediately call for an ambulance (or have someone nearby do so). The patient should be shifted to the emergency department.

Adrenaline side effects that are frequently seen include anxiety, restlessness, and dizziness (feeling unbalanced). Rarely, side effects from the medicine include an irregular heartbeat, a heart attack, sudden elevation of blood pressure, and the accumulation of fluid in the lungs.

Pre-existing diseases like diabetes or heart disease may make children more susceptible to the negative effects of adrenaline. Nevertheless, the most efficient medication for treating severe allergic responses is epinephrine, which is regarded as being quite safe.

How to Prevent Food-Induced Anaphylaxis While Eating Out?

Eating outside might be difficult if the child has one or more food sensitivities. But it is possible to enjoy a fulfilling and healthy meal; all it takes is a little planning and perseverance on the parents' part.

• Be aware of the ingredients in the dishes at the restaurant one wants to dine at. Get a menu from the restaurant beforehand and review the offerings.

• Inform the server of the child's dietary restrictions right away. He or she ought to know the components and methods employed in each dish's preparation. Before ordering, inquire about ingredients and preparation. Ask to talk with the chef or manager if the server appears to need this information.

• Steer clear of family-style or buffet-style serving since this might lead to food cross-contamination from using the same utensils for many dishes.

• Steer clear of fried meals; other dishes may be cooked in the same oil.

• Giving a food allergy card to the management or waitress is another way for those with food allergies to eat out. A food allergy card includes extra information, such as a reminder to make sure all utensils and equipment used to create meals are completely cleansed before use, along with details on the exact products the kid is sensitive to.

Conclusion

Food allergies are the main risk factor for food-induced anaphylaxis, especially in children. The intensity of an allergic response in the past does not always indicate the severity of an allergic reaction in the future. Avoiding allergens and administering an intramuscular epinephrine injection if an anaphylactic episode transpires are the only life-saving treatments for anaphylaxis. An anaphylactic plan outlining allergens and treatment options should be given to all patients at risk for food-induced anaphylaxis, along with self-injectable epinephrine.