Managing allergic reactions in children

Allergic reactions are common in childhood and can range from mild skin symptoms to more serious, rapid-onset reactions. Understanding how to recognise and manage an allergic reaction when it occurs is essential for parents and carers.

In this article, consultant paediatrician Professor Nick Makwana provides clear guidance on identifying allergic symptoms, what to do during a reaction, and when to seek urgent medical help.

What is an allergic reaction?

An allergic reaction happens when the immune system overreacts to a normally harmless substance, such as certain foods, pollen, insect stings, or medications. Symptoms can develop within minutes or over several hours, depending on the trigger and the individual child.

Recognising the signs of an allergic reaction

Most allergic reactions in children are mild and can be managed at home. Symptoms may include itchy skin, hives, swelling of the lips, eyes, or face, a runny or blocked nose, mild stomach discomfort, or a flare-up of eczema. Although these reactions are uncomfortable, they are rarely dangerous.

Severe allergic reactions (anaphylaxis)

Anaphylaxis is a life-threatening allergic reaction and requires immediate action. Signs include difficulty breathing, wheezing, swelling of the tongue or throat, hoarseness, dizziness, collapse, or extreme drowsiness. Infants and younger children may appear pale or floppy.

What to do during an allergic reaction

Knowing how to respond quickly and calmly can significantly reduce the severity of an allergic reaction.

Remove the trigger

If possible, stop exposure to the allergen, for example by removing the food or moving the child away from environmental triggers like pollen or insect stings.

Give the appropriate medication

For mild to moderate reactions, antihistamines can help reduce itching, hives, and swelling. Children with asthma symptoms may require their inhaler. Adrenaline auto-injectors (AAIs) must be administered immediately if there are signs of anaphylaxis—do not delay.

Monitor closely

Even after symptoms improve, continue observing your child. Some reactions can worsen or recur over time.

When to seek urgent medical help

Seek emergency help immediately if adrenaline has been used, if the child is having difficulty breathing, collapses, becomes unresponsive, or symptoms progress rapidly. Children treated for anaphylaxis should always be reviewed in a hospital, even if they seem better.

Being prepared for future reactions

Children with known allergies should have a personalised allergy action plan. This should include clear guidance on recognising symptoms, treatment instructions, and checking the expiry dates of adrenaline auto-injectors. Schools, nurseries, and carers should also be informed and trained in managing reactions.

Managing allergic reactions effectively comes down to recognition, prompt treatment, and preparation. Specialist assessment can further reduce risk and improve quality of life for children with ongoing or severe allergies.