An allergic reaction occurs when the immune system mistakenly identifies a harmless substance, as harmful and initiates an attack against it. Symptoms of an allergic reaction vary from baby to baby, and can range from mild to severe.

Be Informed, Be Alert

The reason we place so much importance on allergies in this Course is not to scare you, but to empower you with the right information, so you can be well-informed in case an allergic reaction occurs. Always speak to your doctor for any advice.

Let’s delve more into the types and severity of allergies as well as the signs and symptoms to watch out for in your children.

Types of Allergies

When babies have a food allergy, their body’s IgE (immunoglobulin E) antibodies will identify that specific food as an “invader” and generate symptoms in different areas of the body, such as throat, skin, eyes, nose, stomach, etc.

There are two main types of food allergies.

1) IgE-mediated (immediate onset)

2) FPIES (delayed onset)  

Whether it’s IgE-mediated allergy or FPIES allergy, it’s best to speak to your doctor and if needed an allergist (allergy specialist) who can help you come up with a plan to manage your baby’s allergies.

5 Points To Keep in Mind

1. When major organs are involved (eyes, mouth, throat, skin, stomach, GI tract) and the reaction occurs within the 4-hour window, you’re most likely looking at a food allergy.
2. Some allergies may be such that the child may not even consume the food, but by just smelling or touching it, they could develop a reaction.
3. Many allergies may not present at the first exposure to that food. Your baby may be fine when they eat it the first time around, but they may have an allergic reaction the second or third time they eat the same food. That’s why it’s essential a parent or caregiver is watchful when babies are eating their food.
4. If you have an immediate family member who is “allergic” (asthma, environmental allergies, or eczema), your child is more likely to develop an allergy.
5. If you observe that after a meal, your baby is not in their normal form (this means, their usual personality or nature), it’s a good idea to observe what they ate that has caused this reaction and speak to your doctor about it.

How Severe Is the Allergy?

Usually, these symptoms will vary from baby to baby. Even the range of reactions can vary from mild to severe.

An allergic reaction is considered severe or serious when:

1) the number of symptoms present (allergic reaction is severe if your baby displays more than two symptoms)

2) the severity of each symptom they have (allergic reaction is severe if each of these symptoms are severe, as opposed to mild)

As mentioned earlier, gradual introduction of allergenic foods through repeated, consistent exposure is very important to reduce your child’s risk of developing allergies later on. Once you observe that your baby is accepting and handling that food well, you can slowly increase the quantities and frequency.

Signs of an Allergic Reaction

Allergic reactions can be scary, but noticing symptoms early can help your child get proper treatment. An allergic reaction can occur if a baby touches, ingests, or even breathes/smells a particular allergenic food.

 

Here are some immediate physical signs and symptoms that you can easily observe and hear in a child having an allergic reaction:

• a change in skin color
• some sort of swelling
• vomiting
• hives (small bumps on the skin)
• distress from pain
• persistent coughing or wheezing 

Why do these symptoms occur? When the body encounters an allergen, it goes into defense mode and releases substances known as "histamines," which trigger inflammation within the body. Even a miniscule exposure to the allergenic food can produce an allergic reaction.

Let’s learn more about how allergic reactions vary according to their severity.

If your baby shows two or more SEVERE symptoms, seek medical help immediately. A severe allergic reaction can also trigger “anaphylaxis,” which requires immediate medical attention.

Babies around 6 months will not be able to communicate or convey if they’re experiencing a tingly nose or throat. So how do we know if they’re in distress?

Watch for other behaviors of discomfort in your baby: 

• They may scratch or pull at their tongue
• They put their hands in their mouth (not in a usual way when they’re feeling playful; the discomfort will be evident)
• They may pull at their ears
• Their voice may become hoarse or squeaky (again, in a way that’s not usual)
• They may cry unusually (for bigger babies, their speech may be slurred)

If you observe any of these above symptoms, it’s best to stop feeding that food and speak to your doctor immediately.

Reactions May Vary Due to Skin Color 

Do remember that it’s possible your baby can get a red rash in an isolated incident due to some other reason. Not all red rashes mean your baby is having an allergic reaction. Some babies may have sensitive skin. 

On darker skinned babies, the red rashes or flushed skin symptoms may not be physically evident. So, it’s important to view the symptom in relation to all the other symptoms outlined above and not in isolation.

What to Do When a Baby Has Their First Allergic Reaction

• Stop feeding the suspected allergic food.
• Contact your healthcare provider or doctor immediately.
• If your child displays severe symptoms like breathlessness or loss of consciousness, please head to a hospital or emergency room at once.
• Don’t give the allergenic food again without the recommendation or advice from your doctor or allergist.
• Maintain a food journal if you know your child is at a higher risk for allergies (they have asthma, eczema, or an immediate family member has allergies) or your child has their first allergic reaction. Documenting this can help at a later stage as well.

Allergy FAQs

1) How do I know if my baby is a high-risk baby?

Certain babies may be at a higher risk of developing allergies. This includes babies who have an immediate family member (parent or sibling) with a food allergy and those who have asthma, hay fever, or severe eczema (non-food allergy).

2) Is it food intolerance or allergy?

There is a way to differentiate between a reaction arising from food intolerance (your baby’s body cannot digest that food) and one arising from an allergy.

Symptoms arising from food intolerance will:

• be mostly gastrointestinal (GI) related, such as vomiting, diarrhea, gas, etc.
• there will be no skin rashes, watery eyes, or any respiratory symptoms.

Symptoms arising from an allergic reaction will:

• show up on major organs  like the throat, skin, eyes, mouth as well as stomach (GI based symptoms), and
• they occur within the 4-hour window of ingestion or contact

3) Is it eczema or allergy?

It’s natural for parents to confuse eczema with an allergic reaction. Eczema causes your baby’s skin to be very sensitive. If your baby has eczema, the consumption of certain foods may cause that eczema to flare up even more, and this can be scary for parents. 

However, it is not the same as an allergic reaction. An allergic reaction will cause hives or swelling in addition to redness of the skin.

If your baby has eczema, it can be managed without restricting or eliminating any food from their diet. Your doctor will prescribe creams or ointments for the eczema.

4) Is it acidic food or an allergy?

Sometimes, redness around the lips/mouth can occur when your baby consumes acidic or citric foods like lemon, oranges, tomatoes, or strawberries. If babies have sensitive skin, eating these foods can cause skin irritation near the mouth. 

If your baby simply has redness around the lips but they are not in any discomfort or not exhibiting other symptoms, they most likely are not having an allergic reaction. Redness around the lips can also occur due to excessive drooling. Your doctor can prescribe something to apply that will give your baby relief.

5) Should you keep an epipen?

Many parents with children who have allergies keep an “Epipen” or epinephrine at hand, which can be used to control an allergic reaction. Please consult your doctor and follow the treatment protocol they prescribe for your little one. 

Note: Epipens cannot be used to control or manage FPIES symptoms.

6) Should you eliminate or restrict any food?

It’s very natural for parents to get overwhelmed or anxious when their baby has an allergic reaction to a certain food. Parents may instinctively stop or eliminate all other “potentially allergenic foods” out of fear. For example, if your baby has a reaction to peanuts, you may remove eggs, soya, wheat, dairy, and fish from their diet completely. 

However, we do not recommend this as this can lead to nutritional deficiencies. Babies need a balanced diet which includes a variety of foods, flavors, and textures. It’s best to speak to your doctor for a proper plan of action, before eliminating any food on your own.

A delay in the introduction of allergenic foods (without proper cause) can also increase your baby’s chances of allergy development.

Reading about allergens and allergic reactions can be scary. The best thing you can do as a parent is to supervise your baby’s mealtimes. Being present and mindful of what your baby’s eating and if that’s causing any discomfort is a good practice. 

Allergies tend to occur in babies and children, and the majority of these cases are manageable with a proper plan of action with help from a doctor/allergist.