WebMD Health - Allergies

May 3, 2011 3:41 PM

Protect Your Child From Dangerous Allergies

Are you the parent of a child with life-threatening food allergies? Is your child at risk for anaphylaxis if stung by an insect? If so, you probably feel strongly about keeping your child healthy and safe.

WebMD consulted allergy experts to find out how parents can help their children become their own best health advocates. Here are the tips that allergy experts shared.

Anaphylaxis Tip No. 1: Educate Your Child Early

Even when your child is young -- and mainly your responsibility -- you can start laying the groundwork by educating him. Help your child take ownership by teaching him how to manage serious allergies and avoid anaphylaxis.

"I encourage parents to start sharing the responsibility with the child from the time of diagnosis," says Christine Szychlinski, APN. Szychlinski is a pediatric nurse practitioner and manager of the Food Allergy Program at Children's Memorial Hospital in Chicago.

Sharing responsibility with a child works better than going solo, she says. That's because keeping the child safe becomes less of a disciplinary issue and more of a shared educational process.

The amount of responsibility the child can take on certainly depends upon your child's developmental stage. Even a 2-year-old, says Szychlinski, can be encouraged to check with his parents about what he puts in his mouth. "Ask him to do this, even if he doesn't get it right every time."

Paul V. Williams, MD, board-certified allergist with Northwest Allergy and Asthma Center in Mount Vernon, Wash., and chairman of the Section on Allergy & Immunology of the American Academy of Pediatrics, agrees that parents should share as much as a child is able to understand. "We start teaching children what foods they're allergic to at 3 or 4 years of age," says Williams.

By the time children reach school, Williams says children should know:

  • Their allergy triggers and what they can't eat
  • To not accept food from other kids or adults, other than parents
  • To not eat foods they aren't sure about
  • Anaphylaxis symptoms
  • How and when to call for help

Another practice to start early with kids, says Szychlinski, is wearing a medical alert tag with a list of allergy triggers. If you start early, it becomes a normal part of a child's life. But if you abruptly introduce the idea when school starts, a child is more likely to resist the idea.

A medical bracelet is safer than a necklace, says Szchlinski, especially for kids who play sports. They can put athletic tape over it and never have to remove the bracelet.

Anaphylaxis Tip No. 2: Identify the Team

Williams says that any place a child goes without a parent is a place in which other adults should be informed about your child's risk for anaphylaxis. People to notify about your child's serious allergies may include:

  • Childcare providers
  • Babysitters
  • The school nurse, if your child's school has one
  • Playground supervisors
  • Teachers
  • Bus drivers
  • Parents of school friends
  • Relatives

"The more people that know about it, the better," says Williams. This is especially true if children aren't comfortable going to an adult for help, says Szychlinski. Then, they need to be watched more closely. The bottom line is that, when a child is out of the care of parents, a severe allergy becomes a group responsibility, she says.

What information is important for people to know? To begin, they should know:

  • Your child's allergy triggers
  • The symptoms of an anaphylactic reaction
  • Where to store an epinephrine auto-injection pen such as EpiPen or Twinject auto-injector.
  • How to administer the epinephrine injection
  • When to call 911

Always share a written emergency action plan about these steps with all involved adults. Every adult that is responsible for your child should support him in following the action plan.

For example, if a young child starts to eat something at a friend's house, the adult should say, "Let's ask mom or dad if you can eat that," says Szychlinski.

Even an older child who can administer epinephrine by herselfshould have a backup, which may include a classmate, says Szychlinski. That's because a severe allergic reaction can make your child incapable of thinking clearly, so she needs someone else around who can help. "It's like swimming with a buddy," she says.

But identifying a person who can give the injection isn't always simple, according to Szychlinski. Some people may want to help, but aren't comfortable with needles.

"I've gone to schools and pulled out the epinephrine injection and seen teachers turn pale." If this person passes out around needles, a change of plan is in order. Maybe this person can instead become the one who finds someone else to administer the epinephrine or who calls 911.

Anaphylaxis Tip No. 3: Communicate Well

How you react to your child's severe allergy will set the stage for how your child responds, says Szychlinski. Sadness, anger, and frustration are normal reactions, but if that's all your child sees, then his allergy may become a burden.

"Kids need to accept this as a normal part of life," she says. You can help by modeling good communication. One way to do this is by allowing your child to sit in on part of a school meeting where you discuss your child's allergy with teachers, nurses, or administrators.

You can also help your child by role-playing. Role-play how to respond if she starts to have an allergic reaction or displays symptoms of anaphylaxis. Or choose other methods that are appropriate for your child's personality.

As with other life skills, children may need an occasional reminder. Children may not remember what anaphylaxis symptoms look like - especially if they only had a severe allergic reaction when very young. For this reason, anaphylaxis may simply be "out of sight, out of mind."

Another strategy is to help your child identify someone at the school to communicate with. All too often, says Szychlinski, children are afraid to go to an adult for help.

Maybe your child has been taught to accept adult authority without question. Or perhaps your child is afraid to stand out in front of their peers. It's important to know that these roadblocks can be life-threatening to a child with a serious allergy.

Most important, says Szychlinski, is to find a person who won't ask, "What happened? What did you do?" Your child's support person needs to be an empathetic adult who will take them away from their peers.

Anaphylaxis Tip No. 4: Adapt as Your Child Grows Older

Yes, your child needs life skills that other children may not. But you can teach these skills. And you can adapt as your child's needs change, but be sure to maintain a consistent parenting style, suggests Szychlinski.

"Try to make the way you treat the food allergy consistent with the rest of your parenting," she says. If your approach is to use positive reinforcement, do that. Or if you're the kind of parent that doesn't care whether or not your child is potty trained until later, be sure to set up adequate support for your child until the necessary skills are acquired.

As your child grows older, view middle school as a transition time. For kids with serious allergies, middle school is a period during which they become more responsible for maintaining a safe environment for themselves. During this time, encourage your child to:

  • Consistently say "no" to food offered
  • Read food labels
  • Regularly wash hands
  • Keep hands out of their mouth

"You want kids to make their mistakes when other people are still watching them," says Szychlinski. "If we don't give them the opportunity and we maintain all the protection during middle school, when they get to high school, the outcomes can be more dangerous because there won't be the same monitoring."

When can you give your child the responsibility to carry his or her own epinephrine? Williams says it's a judgment call based less on age and more on skills and knowledge.

"Generally by the time a child reaches middle school, most school systems allow it," he says. "It's a decision usually made in conjunction with the school nurse." A child may be ready when he:

  • Understands how to work the mechanism of the epinephrine
  • Knows when to give epinephrine
  • Resists sharing it or showing it off with friends

After a child starts carrying epinephrine, when might you expect him to administer it? "I insist that it is a skill they can do when they go to high school," says Szychlinski. As is the case in any new situation, your child can begin to rely on the skills and self-confidence you've helped instill from the very beginning.

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