When your child has severe allergies, there's a lot you can do to help him avoid anaphylaxis, a dangerous allergic reaction. Work with your child and with the friends, family members, and other adults who are part of his life to manage his allergies and, in turn, make anaphylaxis less likely.
How to Help Your Child
Get an early start. The sooner you begin, the better. If you have a 2-year-old with a food allergy, encourage him to check with you about what he puts in his mouth. "Ask him to do this, even if he doesn't get it right every time," says Christine Szychlinski, manager of the Food Allergy Program at Children's Memorial Hospital in Chicago.
"We start teaching children what foods they're allergic to at 3 or 4 years of age," says allergist Paul V. Williams, MD, of Northwest Allergy and Asthma Center in Mount Vernon, WA.
Make it less about discipline and more about learning. Start as soon as your child is diagnosed, Szychlinski says.
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 anyone other than their parents
- To not eat foods they aren't sure about
- Anaphylaxis symptoms
- How and when to call for help
Model a "can-do" attitude. How you react to your child's allergy will set the stage for how he responds, Szychlinski says. Sadness, anger, and frustration are normal, but if that's all your child sees, his allergy may become a burden.
"Kids need to accept this as a normal part of life," Szychlinski says. It may help to bring your child to school meetings where you discuss your child's allergy with teachers, nurses, or administrators. But if you do that, make sure you set a positive tone. Don’t portray the allergy as a problem.
Rehearse and remind. You can also help your child by role-playing. Act out what he should do if he starts to have an allergic reaction.
You’ll probably have to remind your kid about anaphylaxis symptoms from time to time. Don’t scare him, but make sure it’s not "out of sight, out of mind."
Teach him it’s OK to ask for help. Some children are slow to ask an adult for help. Others don’t want to stand out from the crowd. Tell your child what adult at school, or other places, he should go to if he needs help.
Most important, Szychlinski says, is to find a person who won't ask, "What happened? What did you do?" Your child’s support person needs to be someone who will drop everything to help them right away.
Be consistent. Treat the allergy the same way you would anything else in his life, Szychlinski says. For example, if you use positive reinforcement as a parent, do that with allergy management, too.
Adjust as your child ages. Middle school is a time of change. Kids with serious allergies should learn to play a bigger role in their own safety. During this time, encourage your child to:
- Say "no" when people offer food
- Read labels
- Wash his hands often
- Keep his hands out of his mouth
"You want kids to make their mistakes when other people are still watching them," Szychlinski says. "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."
Let him carry his own epinephrine. When is a child ready to carry his own injector? 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:
- Can safely work the device
- Knows when to use it
- Is mature enough not to share it or show it off to friends
"I insist that it is a skill they can do when they go to high school," Szychlinski says.
Older children may be able to give themselves the shot, but they should still have a backup, like a classmate, who knows how to do it, too. "It's like swimming with a buddy," Szychlinski says. The backup must be someone who isn't skittish about needles or injections.
How to Help Others Help Your Child
People need to know your child has an allergy so they can help if he needs it. Here are some key ways to spread the word.
Use a medical alert tag. Make it a routine part of your child's life from an early age. If you wait until he starts school, he’s more likely to resist the idea because he doesn’t want to stand out.
A medical bracelet is safer than a necklace, especially for kids who play sports, Szychlinski says. They can put athletic tape over it and never have to remove the bracelet.
Tell other adults. The grownups who are a part of your child’s life need to know about his allergy and what to do if he goes into anaphylaxis. Who’s on the list?
- Childcare providers
- Babysitters
- The school nurse
- Playground supervisors
- Teachers
- Bus drivers
- Parents of friends
- Relatives
- Coaches
"The more people that know about it, the better," Williams says.
This is especially true if children aren't comfortable going to an adult for help, Szychlinski says. Then, they need to be watched more closely. The bottom line: When a child is out of his parents’ care, a severe allergy becomes a group responsibility, she says.
Share the symptoms. What’s important for people to know? Start with this:
- Your child's allergy triggers
- The symptoms of an anaphylactic reaction
- Where to store an epinephrine auto-injector
- How to give the shot
- When to call 911
Make a plan. Write down your emergency action plan and share it with all involved adults. Everyone should be able to carry out the action plan.
For example, if a young child starts to eat something at a friend's house, an adult who knows about your plan should say, "Let's ask your mom or dad if you can eat that,” Szychlinski says.
Be consistent.
"Try to make the way you treat the food allergy consistent with the rest of your parenting," Szychlinski says. For example, if you use positive reinforcement in other areas of parenting, do that with your child's allergy management, too.
Adjust as your child ages.
Middle school is 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 their hands
- Keep their hands out of their mouth
Start trusting them more. You'll still have adults on hand for backup, but at this age, it's time for your child to start taking more responsibility.
"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 device
- Knows when to use it
- Is mature enough not to share it or show it off to friends
When is a child ready to give themselves an injection? "I insist that it is a skill they can do when they go to high school," Szychlinski says.
