True food allergies in children, as opposed to food intolerances, are relatively rare, affecting somewhere between three and eight per cent of under-threes. However, if your child does have an allergic reaction, it can be extremely frightening, especially the first time that it happens. Knowing what to do in this situation could potentially save your child’s life.

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First aid for allergies

Mild allergic reactions such as coughing, streaming eyes or a runny nose don’t require immediate medical attention. However, they can still be distressing for you and your little one, so it’s important to stay calm, reassure your child and make him as comfortable as possible. You may need to:

  • Remove any tight clothes around his throat or chest
  • Give him some fresh air if he’s coughing
  • Sit him upright on your lap to ease his breathing
  • Cuddle him and reassure him by talking or singing to him
  • Apply a soothing cream such as calamine lotion to an itchy rash

You should also see a doctor as soon as possible, who will be able to recommend the most appropriate course of action. Medication, such as antihistamines or analgesics like paracetamol, should only be given on the advice of a medical professional.

Coping with anaphylaxis

Anaphylaxis – a sudden and extreme allergic reaction, typically causing wheezing and breathing difficulties – should always be treated as a medical emergency. Call 999 immediately and take the trigger food away from your child. While you’re waiting for an ambulance, it may help to loosen your child’s clothing and keep them sitting upright so he can breathe more easily. If your child loses consciousness, check his mouth for any obstructions and check his breathing. Then put him in the recovery position.

Seeking medical help

If you think that your child may have had an allergic reaction to a particular food, you should see a doctor at the first opportunity. He may ask you to keep a food diary to see what the potential trigger might be. When an allergy is suspected, skin prick testing is usually recommended. A skin prick test introduces a tiny amount of an allergen into the skin to see if there is a reaction.

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Another approach is to follow a food elimination diet. This is designed to find out exactly which food is causing your child’s allergic reaction. It involves withdrawing potential trigger foods, usually for two to three weeks, and then reintroducing them one at a time, to see which, if any, are causing the symptoms. A food elimination diet should always be carried out under medical supervision.

Look out for a secondary reaction

A recent study has shown that if the first allergic reaction is severe, there is a strong possibility this will be followed by a second one. "We found that 75 percent of the secondary reactions occurred within six hours of the first," said Waleed Alqurashi, MD, lead author of the study. "A more severe first reaction was associated with a stronger possibility of a second reaction. Children aged six to nine, children who needed more than one dose of epinephrine and children who do not get immediate epinephrine treatment were among the most likely to develop secondary reactions."

Living with a food allergy

If your child has a confirmed food allergy, you’ll need to keep your child away from the trigger food. Familiarise yourself with products that he can safely eat: all UK food packaging has to have a full list of ingredients, but be aware that ingredients may be listed under different names – for example, milk could be described as whey or milk protein. You can also get regularly updated ‘free from’ lists by contacting supermarket head offices and the customer services departments of major food manufacturers.

There is no need to keep your child away from other children, or stop taking him to nursery or groups. You should, however, make sure that everyone who looks after your child, including the parents of any friends he might visit, knows about his allergies. You may want to take your own snacks to toddler groups, parties and play dates so you know he has something he can safely eat.

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If your child is prescribed medication for his allergies, make sure you carry it at all times, and ensure that anyone else who looks after him knows how to use it. This is especially important if he’s given an Epipen (emergency adrenaline injector) for anaphylaxis.

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