What is an allergic reaction to a food?
An allergic reaction occurs when a person’s immune system treats a protein (an allergen) in a food as harmful. Children with food allergy are at risk of having a severe allergic reaction, called anaphylaxis (an-nah-fil-axe-is). Anaphylaxis often happens quickly and can cause death if not treated.
If you are not sure whether your child is at risk of a severe allergic reaction, ask your child’s health care provider. Children and teens at risk of a severe allergic reaction should also see an allergist. If your child is at risk, ask your child’s health care provider to write an Anaphylaxis Emergency Plan that explains what to do in case of an allergic reaction. To get a blank copy of an Anaphylaxis Emergency Plan, visit Food Allergy Canada: https://foodallergycanada.ca/wp-content/uploads/Anaphylaxis-Emergency-Plan-Form.pdf (PDF, 749KB).
What are the symptoms of a severe allergic reaction (anaphylaxis)?
Symptoms of a severe allergic reaction typically start within minutes of eating or being exposed to an allergen. In rare cases, the reaction can take up to several hours to start. Symptoms can vary from person to person and can look different each time they have an allergic reaction. Symptoms generally include 2 or more of the following:
- Skin: hives, swelling (face, lips, tongue), itching, warmth, redness, rash
- Respiratory (breathing): coughing, wheezing, shortness of breath, chest pain or tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny, itchy nose, sneezing and watery or itchy eyes), trouble swallowing
- Gastrointestinal (stomach): nausea, pain or cramps, vomiting, diarrhea
- Cardiovascular (heart): paler than normal skin colour or blue colour, weak pulse, passing out, dizziness or light-headedness, shock
- Other: anxiety, sense of doom (the feeling that something bad is about to happen), headache, uterine cramps, a metallic taste
Responding to a severe allergic reaction
Anaphylaxis can be life threatening, so it is important to respond quickly and follow these emergency steps:
- Give epinephrine (for example, EpiPen®, EpiPen Jr® or neffy®) at the first sign of a known or suspected severe allergic reaction. Epinephrine is the only drug that can reverse symptoms of anaphylaxis and is a life-saving medication. This medication is safe, so if you are unsure, the safest option is to give the epinephrine
- Call 9-1-1 or your local emergency service. Tell them someone is having a severe allergic reaction
- Give a second dose of epinephrine as early as 5 minutes after the first dose if there is no improvement in symptoms
- Go to the nearest hospital immediately (by an ambulance if possible), even if symptoms are mild or have stopped. The reaction could get worse or come back, even after proper treatment. Stay in the hospital for observation for as long as the doctor suggests (generally about 4 to 6 hours)
- Call your emergency contact person (for example, a parent or a guardian)
Other important information about epinephrine devices
Epinephrine devices expire on the last day of the month indicated on the product packaging. For example, if the product is marked as expiring in January, it remains valid (not expired) until January 31.
- You are advised to have more than one device in case two doses are needed
- If you are experiencing an anaphylactic reaction and only have an expired device, use the expired product and immediately contact 9-1-1
- Whether the product is expired or not, go to the nearest hospital as soon as possible after using the product, as instructed in the product labelling
What can I do to help my child with a severe food allergy stay safe?
Consider having your child wear medical identification jewelry, such as MedicAlert.
Always keep your child’s epinephrine device with them. Carry it with you when you and your child are away from home.
Help your child avoid their food allergens. Eating even a very small amount can trigger a severe allergic reaction.
- Learn how to recognize your child’s food allergens on food labels. For information, visit Canadian Food Inspection Agency https://inspection.canada.ca/en/food-labels/labelling/consumers/food-allergies
- Encourage everyone to wash their hands before and after eating. Help young children to wash their hands
- Wash kitchen equipment and surfaces before preparing foods. Use clean dishes and utensils each time you serve a different food and clean all eating surfaces well after meals and snacks
How can I prepare my child for school or child care?
- Give child care staff a copy of your child's Anaphylaxis Emergency Plan
- Provide written consent for staff to give your child epinephrine when needed. Do not sign anything that releases the facility of responsibility if epinephrine is not given
- Give staff an epinephrine device for your child. Ask that it be kept in a secure, unlocked place that is easy to access. Provide a new one before the expiry date
- Epinephrine devices are prescribed based on body weight. As your child grows, check with your child’s health care provider to ensure you have the correct epinephrine device for their weight.
- Update staff on your child’s Anaphylaxis Emergency Plan as food allergies change
As your child matures, they can learn to take some responsibility for their safety. When your child is ready, teach them:
- To carry their own epinephrine device in a fanny pack or other carrier. Most can do this by 6 or 7 years of age. It should not be kept in a school locker
- How to self-administer the epinephrine
- How to avoid their food allergens. When your child is very young you can teach them to talk to you before accepting food from others. As your child matures you can teach them to know their food allergies and check with an adult before accepting food from others
- To avoid sharing food, utensils and napkins
- To avoid putting objects, such as pencils, in their mouth
- To tell someone if they think they are having an allergic reaction
- To tell their friends about their food allergy and where they keep their epinephrine device
For more information
If you have questions about food allergies, call 8-1-1 to speak with a registered dietitian.
The B.C. Government provides safety planning resources for severe allergic reactions in schools. To learn about promoting awareness, developing policies and creating safety plans in schools, visit Anaphylaxis.
