Wednesday, September 26th, 2012
A few days after her Emmy win, I had a chance to chat with actress Julie Bowen but, following a quick congratulations, asked her to switch gears from an exciting moment in her life, to one that was downright scary. When Bowen’s oldest son, Oliver, was a toddler, his face and neck swelled up after eating a bit of peanut butter, and he began having trouble breathing. He was rushed to the emergency room. “My husband and I thought we knew a lot about children and food allergies,” says Bowen. But after his allergic reaction, “we realized how little we knew. That wasn’t even his first exposure to peanuts.” Luckily, Oliver, who is also allergic to bee stings, recovered quickly, but for Bowen, it was a wake-up call.
Now she’s taking part in the Get Schooled in Anaphylaxis initiative, which aims to increase awareness of and preparedness for allergic reactions in school. Bowen says that, in a way, it was helpful that Oliver had such a strong reaction: “We knew right away to take him to the emergency room.” But sometimes symptoms can be more subtle. Your child may experience dizziness, headaches, chest pain, trouble breathing, an itchy throat, nausea, or a rash, among other things.
The best way to cut down on the risk is to avoid allergic triggers, but of course, accidents can happen. So what can you do? First, know the most common causes of anaphylaxis: cow’s milk, eggs, nuts, fish, soybeans, and wheat, as well as non-food triggers such as insect stings, certain medications, and latex. Children who are younger than 3, have a family member with allergies or asthma, or other predisposition are more likely to develop allergies. If your child has one, find out if his school has a prevention and treatment policy, and meet with the school nurse to discuss an action plan in case of anaphylaxis. Even young children can look out for themselves, as well.
“Oliver is his own best advocate,” says Bowen, of her now 5 year old. “He never puts anything he’s never had before in his mouth without asking, and he always asks a grown-up to read him the ingredients label.” When I seemed impressed by his proactive attitude, Bowen told me that, for younger kids, having an allergy can make them feel cool and special. As they get older, they may start to feel like an outsider. That’s why Bowen makes sure her son understands his allergies are just another characteristic, like having red hair or blue eyes. She tells Oliver, “You can’t eat nuts and, if you get stung by a bee, you need to get immediate attention,” then moves on. “I don’t want it to define him, but I do want it to be part of his everyday awareness.”
Today, Oliver keeps a prescription epinephrine auto-injector with him wherever he goes, and Bowen makes sure that, if he’s not with her or her husband, somebody knows how to use it. Aside from that, she says, “We really encourage Oliver to do the things kids love, like taking part in recess and play dates.” (Or perhaps attending awards shows with his mom?) And with a few precautions, there’s no reason he can’t!
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Tuesday, January 10th, 2012
Last week’s horrible story about Ammaria Johnson, the 7-year-old Virginia girl who died at school of an anaphylactic reaction, raises lots of questions. The school reportedly says that Ammaria’s mother didn’t provide the school with an EpiPen (containing epinephrine, which has the potential to stop an allergic reaction). The mother reportedly says she tried to provide one, but was told to keep it at home. It’s confusing all around. We addressed the very serious issue of food allergies in this story in our December issue. Now, the question we parents should be asking ourselves is:
Would I know how to help a child who’s having an allergic reaction?
Say you’re hosting a playdate or a birthday party and you’re with a child who has a food allergy. Would you recognize the signs if he were having a reaction, and would you know how to use an EpiPen if you needed to?
I spoke with Roger Friedman, M.D., a clinical professor of pediatrics and allergy at Nationwide Children’s Hospital and The Ohio State University in Columbus. Dr. Friedman was careful to point out that reactions are “highly variable”—there’s no completely predictable path.
The first sign is often itchy skin. The itchiness may be limited to where the child comes in contact with the food (at least at first). If it’s a bad reaction, he may feel itchy all over. He may break out in hives. “Many times this is a mild symptom, and many times that’s the only symptom,” says Dr. Friedman. At the first sign of itchiness, give an antihistamine like Claritin or Benadryl. “The majority of reactions are managed very safely that way,” he says. But since this won’t prevent a reaction from progressing, you’ll need to watch the child very carefully and have his EpiPen ready. (No EpiPen? Call the child’s parent immediately—or 911.)
If the reaction continues, the child will probably have gastrointestinal issues like an upset stomach, diarrhea, even vomiting. These can come on in a matter of minutes.
Be on high alert for any breathing problems: coughing, difficulty swallowing, wheezing. Any sign that the airways are affected is serious and should be treated immediately. In that case, administer the EpiPen and call 911. (And in that order—give the treatment, then call the paramedics.) If you’re unsure whether the child really needs it, use it anyway. Straight from Dr. Friedman: “The chances of you causing a problem by giving epinephrine is almost zero.”
Nationwide Children’s Hospital has an excellent video that shows exactly how to use an EpiPen. (It even shows a child using one on herself.) Do yourself a favor and watch it here. The most important thing to know: Hold the pen in the middle, as if you’re about to stab someone. Don’t put your thumb on either end, or else you could end up injecting yourself.
Have you used an EpiPen before? Have you seen a child have an allergic reaction? Does your child have a food allergy? What else do you want parents to know? Tell us about your experiences.
Image: Lined primary school paper with “No Peanuts Allowed” written in red via Shutterstock.
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