Recognizing and treating serious allergic reactions (anaphylaxis) in infants and toddlers: a plain language review

Plain Language SummaryWhat is this review about?This review gives an overview of research studies that looked at the management of serious allergic reactions in infants and toddlers. An allergic reaction is an overreaction of the immune system (the body’s natural defense system) to generally harmless foreign substances, like food, medications, or insect stings/bites. When the reaction is serious or affects two or more groups of organs, including the cardiovascular system (heart and blood vessels), the gastrointestinal system (stomach and intestines), the skin, and/or the respiratory system (lungs and airway), it is known as anaphylaxis. Life-threatening anaphylaxis is characterized by respiratory and/or cardiovascular involvement and may occur without the involvement of other organs. Serious allergic reactions are treated with epinephrine, the only medication globally approved for them.What were the results?Findings from research studies showed that common signs and symptoms of serious allergic reactions in infants and toddlers include itching, rash, eye swelling, and stomach pain. These findings suggest that modifying the traditional clinical criteria of signs and symptoms in older children and adults to include those unique to infants and toddlers increased the correct identification of serious allergic reactions. Research also showed that epinephrine was not given as often as it should have been for serious allergic reactions in infants and toddlers. However, having an established allergy emergency plan for those with a food allergy increased the chance that epinephrine was given. Finally, parents of infants and toddlers who were trained to give epinephrine for serious allergic reactions during an oral food challenge were more comfortable with using epinephrine.What do the results mean?Some signs and symptoms of serious allergic reactions in infants and toddlers differ from those in older children and adults and are not currently included in the criteria used by healthcare professionals to identify serious allergic reactions. Modifying these criteria in established guidelines may help healthcare professionals better recognize serious allergic reactions in infants and toddlers. Additionally, early evaluation for food allergies and having an allergy emergency plan increases the chance of giving epinephrine to infants and toddlers in a timely manner.