Signs of anaphylaxis in children and what to do

Written by: Professor Adam Fox
Published: | Updated: 25/07/2023
Edited by: Emma McLeod

Anaphylaxis can be life-threatening, but there are precautions and quick treatments available to lessen the risk. Professor Adam Fox is a paediatric allergist with expert advice about knowing the signs of anaphylaxis and what do to if you or someone you know suffers this dangerous allergic reaction.

A young girl of about five years old is looking directly into the camera with a slight smile.


What is anaphylaxis and is it common?

Anaphylaxis is a severe and potentially life-threatening allergic reaction but fortunately, it’s quite rare. It's incredibly important that the signs and symptoms of allergic reactions are picked up on rapidly because prompt treatment can greatly decrease risks to the child or adult and make a real difference regarding the outcome of the reaction.


What are the signs and symptoms?

Anaphylaxis typically involves symptoms in one of two different body systems. One of these being the respiratory system and the other being the cardiovascular system. However, most anaphylactic reactions will start with skin symptoms. These can be itchinesshives (urticaria) and swelling (angioedema). In the case of children with food allergies, swelling from a reaction will typically be focused around the mouth. Following skin symptoms, you can often see developments of a runny nose and sneezing.


Issues regarding the respiratory system are more worrying because they cause difficulty in breathing, such as coughing, bronchospasms and wheezing. Cardiovascular symptoms generally involve a drop in blood pressure. This would usually manifest itself as dizziness, confusion and collapse.


What to do if a child has these signs

If there's even the slightest chance that a child has anaphylaxis, it’s advised to get them a dose of intramuscular adrenaline as soon as possible. I always advise patients, and parents of younger patients, to use adrenaline even in the case that they’re not sure if the symptoms are severe enough to warrant an injection. Many patients, if old enough, who suffer from severe allergies will be carrying adrenaline injectors such as an EpiPen, Jext or Emerade.


If a reaction occurs and the sufferer is on their own, the most important priority is to use their adrenaline injector first and then call for help second. If there is someone else present, they can call for help while the sufferer uses their injector.


Professor Adam Fox is one of the founding consultants of the children's allergy service at the world-renowned Guy's and St Thomas' Hospitals. Visit his profile to read more about children's allergies and to book a consultation.

By Professor Adam Fox
Allergy & immunology

Professor Adam Fox is an expert consultant adult and paediatric allergist and immunologist and one of the founding consultants of the children's allergy service at the world-renowned Guy's and St Thomas' Hospitals, home to the UK's largest paediatric allergy centre. Professor Fox is one of only a handful of UK doctors with recognised higher specialist training in paediatric allergy. His specialist interests include the management of food allergies, eczema, asthma, rhinitis (including hay fever), conjunctivitis, and drug and insect sting allergy. From 2018 to 2021, he held the position of president of the British Society for Allergy and Clinical Immunology, having become the first paediatrician to be elected into this role. Professor Fox remains a trustee of the organisation. In July 2022, he became the chair of the National Allergy Strategy Group, which involves working closely with the Department of Health and Social Care.  

Professor Fox completed his clinical training at University College London, having read Medicine and Neuroscience at Cambridge University. He went on to complete specialist training in paediatric allergy in 2006, before spending nine years as clinical lead of allergy at Guy's and St Thomas' Hospitals, London; one of Europe's largest specialist allergy services, recognised as a Centre of Excellence by both the World Allergy Organisation and GALEN (European Asthma and Allergy Network). Following three years as clinical director for specialist ambulatory medicine, he began as commercial medical director for Guy's and St Thomas' Hospitals NHS Foundation Trust. In 2021, with two of his colleagues, he established The Food Allergy Immunotherapy Centre at Great Ormond St Hospital. It was here, where Professor Fox administered the first patient outside of the US Palforzia, the first licenced food allergy desensitisation product.  

In addition to his clinical work, Professor Fox has conducted extensive research and is actively involved in cutting-edge research in allergy desensitisation, asthma prevention, and food allergy, in setting up the largest allergen desensitisation programme in the UK. He has also published extensively and is the senior author of the Milk Allergy in Primary Care guideline, which has been adopted around the world and received the Allergy UK Innovation Award in 2018. Professor Fox is a professor of paediatric allergy at King’s College London, the founding director of the KCL Allergy Academy, an advisor to the National Institute of Healthcare and Clinical Excellence (NICE), and chaired a clinical guideline development group for food allergy in children. Professor Fox has lectured internationally, been involved in the production of various documentaries, and has frequently appeared in TV and print media, notably as a regular contributor to ITV’s ‘This Morning’. 
As a result of his extensive experience and expert care, Dr Fox was included in The Times' Magazine ‘Britain's 100 Best Children's Doctors’, with the Tatler 2013 Guide listing him as one of the UK's top 250 specialists. In 2007, he was recognised as 'Paediatric Allergist of the Year' by Allergy UK. He also received the Raymond Horton-Smith award from Cambridge University for his research in 2012 and a national Clinical Excellence Award from the Department of Health in 2016 and 2020. In 2016 he was awarded the William Frankland Award from the British Society for Allergy & Clinical Immunology for his contribution to the speciality. In 2018, he earned an Excellent Patient Experience from Doctify and was one of the 29 specialists to be honoured with a ‘Top Doctors Award’ from Top Doctor, voted for by other specialists.   

Allergy London, Professor Fox’s private practice, was awarded Best Allergy Clinic in London in the Global Health & Pharma Private Healthcare Awards (2019) and Best Allergy Testing Specialists in the Private Healthcare Awards (2020). On Trustpilot, the practice has a 4.9/5 rating.  

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