Caring for a child with serious allergies can be stressful and scary, but arming yourself with knowledge and preparation can help you and your child take control. Pediatric allergy specialist Jennifer Shih, MD, FAAP, discusses the most common questions she hears from children and their parents about avoiding anaphylaxis and living with serious allergies. 1. Q: What is anaphylaxis? A: In simple terms, anaphylaxis is the term for an extreme allergic reaction. Not all allergies lead to anaphylaxis, but the most common severe allergies are allergies to food, venom, medication and latex. Basically, your body is exposed to something that it percieves as harmful, even if it’s really not, such as a peanut. Your immune system overreacts to the peanut by releasing chemicals that cause allergy symptoms. Some allergic reactions are mild, but some can lead to anaphylaxis, which is really serious and requires a shot of epinephrine and medical care. 2. Q: How can I recognize anaphylaxis? A: In anaphylaxis, you can have symptoms in four different organ systems: your skin, your respiratory system, your gastrointestinal system, and your cardiovascular system. We call it anaphylaxis if you have symptoms in two or more of those systems at the same time. With your skin, you might experience itchiness or hives, and your skin includes your mouth, too, so your mouth could be itchy and your tongue could swell. In your respiratory tract, you may have trouble breathing or start wheezing. Anaphylaxis affects your gastrointestinal tract by causing nausea, vomiting, or diarrhea. And symptoms affecting your cardiovascular system are the most serious, because you can get very low blood pressure and go into shock, which could potentially lead to death. It’s important for people with severe allergies (and their loved ones) to recognize symptoms of anaphylaxis so they can act quickly to treat it. 3. Q: What’s the first thing you tell parents after they learn their child has a serious allergy? A: Usually, parents are pretty scared, so I immediately tell them this is something we can be prepared for–we can potentially prevent anaphylaxis from occurring. Then, I educate them about how to do that. I tell them that no one plans for accidents, so to be safe, they should be prepared. Everything they need to know can be on one sheet called their anaphylaxis action plan. I tell them to keep copies of the anaphylaxis action plan everywhere, because in the moment anaphylaxis is happening, they’re not going to want to think--they’ll just want to know what to do and do it. The anaphylaxis action plan lists the allergens that must be avoided. I always recommend that patients get tested for allergies by a board-certified allergist, even after they’ve experienced anaphylaxis, because we want to know all we can to prevent it from happening again. The anaphylaxis action plan also lists the symptoms of anaphylaxis to be aware of, how to use the epinephrine auto-injector, emergency contact information, their allergy specialist’s contact information, and what medications they’re taking. 4. Q: What tips do you have for patients and parents about epinephrine auto-injectors? A: Epinephrine is actually pretty amazing. It can affect different parts of the body to help relieve all the symptoms of anaphylaxis. It’s incredibly important that people with serious allergies have not just one, but two epinephrine auto-injectors with them at all times. Studies have shown that sometimes, one dose isn’t enough, so it’s always better to have two available. I tell my patients that extreme temperatures can make epinephrine less effective, so they shouldn’t store auto-injectors in the fridge or the glove compartment. Epinephrine auto-injectors should always be room temperature and with you at all times. 5. Q: How do you advise parents to explain serious allergies to their children? A: Honestly, often children are better and less anxious about their allergies than their parents. Kids tend to do a good job explaining their allergies to others and they know to stand up for themselves. For food allergies, I advise parents to involve their child in avoiding the allergen. When you’re at the grocery store, point out foods that are “safe” and “unsafe.” Ask your child to point out foods, too; you can make it a game. Look at ingredients on food labels together so your child knows what to look for. Most importantly, emphasize how crucial it is that your child has an epinephrine auto-injector and anaphylaxis action plan with him or her at all times. The most important thing for parents to do is educate their children calmly. I tell them to make it clear to their children that the allergy is serious, but by following some rules and avoiding certain things, they can prevent a reaction from happening.