Allergies

When we talk about Injury Prevention, we normally think about traumatic events like running with scissors, running by the poolside, or running into glass patio doors.* We don't necessarily associate allergies with injuries. Still, an allergic reaction can be really scary for children (and the adults looking after them). It's actually quite common for allergies to be missed for quite a long time in children, as they often look like just a boring runny nose or a little bit of a poorly tummy.

*Now that I write all that out, it seems like running is the problem. That's it, I'm officially giving up running. For safety.

Allergies are often passed down from parent to child, but just because you have an allergy doesn't mean your child will have the same one(s) as you or even any at all. And just because you don't have any allergies (that you know of) doesn't mean your kid is guaranteed to be allergy-free.

Also remember that reactions to allergies are often progressive, so they can build up and get worse over time, so your child could 'develop' allergies as they get older. Really they were allergic all along, you just didn't notice (which is unsurprisingly much more likely if you or your partner work in the medical profession, but we don't talk about those statistics).

Allergic reactions can vary massively from life-threatening to slightly inconvenient, and there's a lot of VERY INTERESTING science behind how the different reaction mechanisms work in the human body, that I absolutely do not understand (and thankfully, I don't need to, that's what our lovely doctors and nurses are for). The only thing we need to understand is what these reactions could look like, and the kinds of things that can cause them (and how to prevent them).

Allergy Classes

Unofficially, there are three 'levels' of allergic reaction, mild, moderate, and severe. A mild reaction is a bit of a bother. A moderate reaction is really quite unpleasant. A severe reaction is life threatening. Repeat after me: allergies are real, and the can be life threatening.

Mild

An example of a mild reaction is something like a rash or swelling in the specific area where the allergen has interacted with the body. My brother has a mild allergy to mosquito bites, and his arm will swell up and get red and hot wherever he's bitten, but it doesn't affect him beyond the immediate area of the mosquito bite.

Depending on the allergy, the symptoms can look different. You might not even look at it and think it's an ALLERGY, just that your child is having a bit of a reaction. What's important is that the symptoms are manageable at home with anti-histamines, lotions, or other over-the-counter medications and that the reactions go away within a couple of hours once the allergen is removed. For environmental allergies like hay fever or animal allergies, the symptoms might last for a little while, but the reaction itself shouldn't get worse, and it definitely shouldn't be dramatic or exciting.

A Mild Allergic Reaction Might look like:

Coughing

Runny Nose

Sneezing

Congestion

Watery Eyes

Localised Itching

Rash

Tummy Problems

Moderate

A moderate allergy is the broadest category, because it's really any reaction that is OBVIOUSLY an allergic reaction, but not a CALL AN AMBULANCE kind of reaction. This is the kind of allergy that affects the whole body. If my brother got bitten by a mosquito on his arm and his face swelled up, had a rash all over his body, and felt like his throat was getting itchy, that would be a moderate allergy.

A Moderate Allergic Reaction Might look like:

Facial Swelling

Swollen Lips

Swollen Tongue

Rash or Itchy Skin
Over a Large Area of the Body

Hives

Coughing

Wheezing or
Tightness in Throat

Nausea or Vomiting

Excess Saliva, Spitting, or Drooling

What I mean is, he probably wouldn't die from getting a mosquito bite, but it would definitely ruin his day.

A moderate allergic reaction might take a couple of hours to pass, or it might take a couple of days. These reactions might respond to the same medications you would give for a mild allergy, but there's so much variation in cause and symptoms that I can't give much other advice here without writing a full essay. It's really important that you remove the cause of the allergy as much as possible, and monitor closely to make sure the symptoms don't get worse. It's probably a good idea to call your GP or 111 for advice, and the more notes (and photos) you can take about the reaction the better. Things like when and where the reaction started, any treatment you gave, and how the reaction has changed or progressed are really helpful for medical professionals to give you the most help possible.

Severe

A severe allergic reaction can be quite scary, not just for the person having it but for the people around them too. Not all severe allergic reactions are anaphylaxis, but any reaction can develop into anaphylaxis, which is very dangerous and can cause death in less than 15 minutes.

The only way to reverse the symptoms of anaphylaxis is with an epinephrine injector or nasal spray.

A severe allergic reaction is very dramatic. It's the kind of thing you see in the movies. If my brother had a severe allergy to mosquitos, he would probably swell up like a balloon, have difficulty swallowing, get wheezy and struggle to breathe, and generally look VERY unwell. It would also be quite fast from when he was bitten to when he needed help. In anaphylaxis the body releases a flood of chemicals as soon as it registers the allergen so it can happen in a matter of seconds or minutes.

If you think someone is having a severe allergic reaction, you should definitely call 999. If you are unsure if it's a moderate reaction or a severe reaction, call 999. It is much, much better to overreact and feel silly for calling for help, than to regret not having asked for help when you need it. Not that you should ever feel silly for calling for help, but you know what I mean.

A Severe Allergic Reaction Might look like:

Facial Swelling

Swollen Lips

Swollen Tongue

Rash or Itchy Skin Over a Large Area of the Body

Hives

Coughing

Wheezing or Tightness in Throat

Nausea or Vomiting

Excess Saliva, Spitting, or Drooling

Rule One: Don't Panic

If you find yourself in the unfortunate position of dealing with an allergic reaction, the first and most important thing to remember is to stay calm. The faster the heart pumps, the faster histamine (the chemical messenger that tells the body to react) is thrown around the whole body. A child will judge the situation based on your reaction, so even if you are ABSOLUTELY FREAKING OUT, don't let it show, as any extra panic will just make everything worse.

If the child is having an anaphylactic reaction and has an Adrenaline Auto-Injector (often called an Epipen or an AAI), you should give them a dose directly in the upper thigh. Different AAI's have different instructions, so if you're spending time with someone who carries one around, it's a good idea to get a quick lesson from someone who knows (a responsible adult or for older children, the child themselves) ahead of time, just to make sure you know what to do. You can click this link here to learn more about how different brands of injector pens work.

It is VERY IMPORTANT that you DO NOT put your thumb on the end of any auto-injector. You do not need to press with your thumb, it will inject automatically. In the best case scenario, you gain nothing. In the worse case scenario, you accidentally inject your own thumb with a life saving dose of adrenaline (which is BAD if you don't need it), and there is no adrenaline left for the person who needs it.

NO NO NO

YES YES YES

Once you've solved the immediate problem, you should 100% call 999 and tell them that the person is having anaphylaxis. Take note of the time that you used the first AAI in case a second dose is needed - this is important information for medical responders.

If the reaction is mild or moderate you can give your child an age-appropriate dose of an anti-histamine (like Piriton, Piriteze, or Benedryl), and call 111 for further information, or if the symptoms get worse, call 999.

After a reaction has occurred, it might be worth organising a visit to your GP to see if they think you should see an allergy specialist.

Common Allergens

You can be allergic to anything, and you can also develop allergies to anything, pretty much at any time of your life. I have a friend who used to get her nails done with UV gel for YEARS, but then one time it didn't get cured properly so the wet gel sat on her nails for a couple of weeks underneath the top coat, and now if she touches uncured gel nail polish at all her fingers swell up like she's wearing cartoon gloves.

Obviously, I'm not saying that you should never let your kid eat, touch, or breathe near anything for their whole lives, but just be aware that they might not be lying about suddenly being allergic to brussel sprouts and green peppers. They probably are. But they might not be.

Allergies normally come from three places - things you put inside your body, things that you touch (or touch you), and things that just exist in the world around you.

Things You Ingest

Mostly, we're talking about food and medicine allergies here. I suppose your kid could decide to eat or drink a traditionally inedible allergen, but that, I fear, is what we refer to as a 'you problem'. Here's a list of some food and drug allergies for you to consider.

Peanuts

Cow's Milk

Crustaceans or Shellfish

Tree Nuts

Wheat

Eggs

Fish

Soybeans

Sesame

Penicillin and related antibiotics

NSAIDS (non-steroidal anti-imflammatory drugs) - aspirin, ibuprofen, neurofen

local or general anaesthetic

chemotherapy drugs

anti-seizure drugs

alcohol

Things You Touch

I know that TECHNICALLY you also touch food, and with severe allergies, you might find that touching food is enough to trigger a reaction even if it's not eaten, but this category of things are things that you're probably not feeding your child. At least not deliberately.

Insect bites and stings - bees, wasps, hornets

Latex

Perfume

chlorhexidine (a common antiseptic and disinfectant)

hair dye

Metals

synthetic fabrics

wool

animals

nail varnish

harsh chemicals

Things In Your Environment

Yes. I am aware that this is a terrible definition of a category. Everything that you eat or touch exists in your environment. But I couldn't think of a better way to describe things that you can't see but you can breathe in or can get on your skin, okay? You're welcome.

Airbourne and environmental allergens can cause hayfever symptoms that can last for days, weeks, or months at a time.

Grass Pollen

Tree Pollen

Mould

Fungi Spores

Dust

Dust Mites (they live in the dust)

animal dander (dead skin) and fur

cigarette smoke

Living With Allergies

Being told your child has allergies can be kind of scary. There's this potentially life-threatening thing out there in the world, and it's now your job to keep your little one away from it.

This doesn't have to mean putting them in a giant inflatable bubble and going overboard with the antiseptic wipes, but it might mean making some pretty significant lifestyle changes. It might range from rehoming a beloved family pet, changing the way you cook, or getting used to carrying around an

Adrenaline Auto-Injector.

There are some great resources out there that go into a lot more detail than we have the space to do here, there will be some links at the bottom of the page here

where you'll be able to learn more.

In the mean time here's some practical advice we've picked up over the years.

Make sure your child knows that they have allergies. One way to make this easier is getting them a med-alert bracelet or necklace to wear, especially if they're younger or have unusual or multiple allergies.

Get comfortable advocating for your little one. There are people out there who genuinely don't believe food allergies exist. Fortunately, they are quite rare, but you might need to be vocal about the dangers. You should never feel pressured to stay in a situation where you fear that your child's allergies are not being taken seriously. I'm not suggesting you start throwing punches or anything, but be confident walking away from anyone or anything that concerns you.

If your child needs an Adrenaline Auto-Injector, have a backup. Then have a backup backup - anaphylactic reactions sometimes need more than one injection. 'Two is one and one is none' is a good motto to live by.

Do not leave home without it.

Make sure you explain how and when to use them to whichever adult will be responsible for using them.

And please make sure they are in date. PLEASE.

If your child has environmental allergies, you can ease symptoms by putting clean sheets on the bed regularly and having baths or showers before sleep. This way, any allergens that have gotten on their skin and hair don't get rubbed into the pillows overnight.

Keep your house clean and well-ventilated. Changing the air by opening the windows every morning (once you're up and dressed) can make a huge difference. Dusting surfaces with a damp cloth removes more dust than using a feather duster, and doing a light vacuum clean every day is more effective than doing a single deep clean once a week.

Stay on top of mould by keeping your spaces warm and dry. If you're renting and you find mould in your home, contact your landlord as they will be able to help you to keep your home a safe and healthy environment.

There are loads of replacement ingredients that you can use in cooking and baking, so having an allergy to common foods like wheat, dairy, or eggs doesn't have to mean that your child can never have treats like birthday cakes. Take time to do your research and you'll find a whole bunch of viable alternatives. Pro-tip, do a trial run of any new bakes BEFORE you serve them up to a roomful of guests. I learned that from personal experience...

Intolerances

Technically an intolerance isn't an allergy as they don't trigger the immune system to react, but they're often confused with each other. Food intolerances can mimic the symptoms of food allergies, so it's not unreasonable to consider an intolerance as a mild allergy. You probably know someone who is lactose intolerant, which might give them a poorly (and very smelly) tummy. Lactose intolerance is the most common food intolerance available on the market, and it could be yours for the low low cost of one cheesy pizza.

Some people are more sensitive to their food intolerances than other people. My dad can have one yoghurt a day without worrying too much, though he wouldn't want to eat a whole cheesy pizza. On the other hand, my old housemate couldn't even put milk in his coffee without getting tummy cramps.

If your child has a food intolerance, they might complain of having tummy pain or feeling sick, and they might have symptoms like diarrhoea, bloating, farting a lot, constipation or acid reflux. Other symptoms to look out for are joint pain, skin rashes, unusual tiredness, or headache.

There's no treatment for a food intolerance, you just need to reduce or remove those foods from your child's day-to-day diet, but you don't need to be as strict as if it were an allergy. Your child will not die from a food intolerance, and though it won't be fun (for anyone involved) a bite or two of the wrong food isn't something you need to worry about too much.

Lactose Intolerance

Lactose intolerance is the most common food intolerance around the world. It's so common, that it gets its own subcategory on this page. Lactose is a naturally occurring sugar that can be found in cows' milk, and the products that are derived from it. Most people who are lactose intolerant can handle a few grams of lactose a day, and there a quite a few foods made FROM milk, like cheeses that vary in how much lactose they have, so living lactose-free doesn't have to mean living dairy-free. Some foods that are not 'low-lactose' have small enough serving sizes that the lactose per serving is acceptably low.

However, anything that is made WITH milk, like custard, rice pudding, milkshakes, or sauces like white pasta sauce or cauliflower cheese will have lactose levels the same as milk, so if a glass of milk is too much, it's best to avoid most of these products too. Ice cream, white and milk chocolate, yoghurt and fermented yoghurt drinks, and milk derivatives like buttermilk and evaporated milk are all products that have a lot of lactose in them and should be avoided.

Medium lactose foods can be eaten in moderation. One portion of these foods shouldn't cause any digestive distress, but eating multiple portions a day may.

Soft cheeses like cream cheese, ricotta, and mascarpone. These are the cheeses often used to make cheesecakes, so as long as it's only a small slice, cheesecake might not be off the menu.

Halloumi is a cheese that technically is very low in lactose, but it's sometimes made from a mixture of goat, sheep, and cow's milk, so that can produce an unpleasant reaction. For this reason, we consider it 'medium' rather than 'low'.
Cream, sour cream, and creme fraiche are quite high in lactose proportionally, but because you tend not to eat much of them at a time, the amount of lactose per serving is actually very low. You shouldn't be serving your child coffee, but if you were going to, a splash of cream has much less lactose than a splash of milk.
Fermented or cultured yoghurts like Greek yoghurt, Skyr, and quark (cheese curd), can be relatively low in lactose, but because the serving sizes are quite large, should only be eaten in moderation.

Low to no lactose foods should be safe for anyone with lactose intolerance to eat regularly.

Hard cheese: cheddar, edam, Swiss, Monterey Jack, Gouda, Wensleydale, Red Leicester, Double Gloucester, and hard (or pizza) mozzarella. Because most of the milk and whey are removed during the cheese-making process, hard cheeses have almost no lactose. If it grates, it's great.

Aged cheese: the longer a cheese is aged, the less lactose it will contain, as the lactose gets converted to lactic acid. Parmesan, camembert, brie, pecorino, gruyere, feta, and Manchego are all cheeses that are low lactose.

Butter. This means that cakes and biscuits shouldn't cause too many problems (depending on the other ingredients and fillings). Birthdays just got a lot easier.
Ghee, or clarified butter is practically lactose-free.

There are loads of variations of products that are processed specifically to remove the lactose, like lactose-free milk, and with plant-based diets becoming more and more popular, dairy alternatives are really easy to find.

With any low or reduced-lactose dairy product, make sure you try a small amount at a time and only increase the quantities if and when you're sure that they can be tolerated. Just because a foodstuff SHOULDN'T cause digestive distress doesn't mean it won't. You've got to do your own research. Keep a notebook. Start a blog. Make it a family activity. This is what people do for fun, right?

...And The Others

You shouldn't be giving children caffeine. At all. It is a psychostimulant (which is why it keeps us awake) and aside from the immediate physical impacts it can have on children, like an increase in heart rate and blood pressure, dehydration, anxiety, headaches, hyperactivity, and difficulty concentrating, in the long term it can also interfere with calcium absorption (meaning weak bones), and decrease tooth enamel (weak teeth). There is evidence to suggest that regular caffeine consumption hampers children's mental development and affects the growth of their brains.

Plus, it makes them REALLY hyperactive and annoying, and then when it wears off it makes them irritable and grumpy and EVEN MORE annoying.

On top of that, caffeine stimulates the gut, even without an active intolerance (IYKYK), AND It's also one of the most common (and least known) food intolerances, so it's just generally not a good idea to caffeinate your kids.

Other common food intolerances include:

Gluten (found in wheat, rye, and barley)

Histamine (found in cheese, pineapples, bananas, avocados, chocolate and some wines. Do not give wine to children.)

Fructose (a sugar compound found in fruits and vegetables, often used as a sugar alternative)

Eggs (specifically egg whites)

Salicylates (found in aspirin)

Amines (produced when proteins start to break down, found in cured meats, processed seafood and poultry, and other aged or fermented products)

Soy (tofu, tempeh)

Yeast

Sugar alternatives (like aspartame or sugar alcohols used in zero calorie drinks)

The most important thing to remember is that intolerances are not caused by an autoimmune reaction, so though they can be unpleasant, and even quite distressing, they are not life-threatening.

Resources

Gluten (found in wheat, rye, and barley)

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