In plain words
Anaphylaxis is a severe allergic reaction that can start within minutes of contact with an allergen. It can affect the skin, breathing, the throat, the stomach, and blood pressure. Signs can include hives, swelling of the lips or tongue, wheezing, vomiting, pale or limp skin, or a sudden change in alertness. It is an emergency. Call 911 right away. Mild allergic rashes are more common and different, but any breathing trouble or swelling of the face or throat is an emergency. Clinicians recognize it by its signs. If your family has known allergies, ask your provider what a plan for the baby should include.
The deeper version
Anaphylaxis is a rapidly progressive, potentially fatal systemic reaction, typically mediated by IgE-dependent mast cell and basophil degranulation. The World Allergy Organization anaphylaxis guidance (Cardona and colleagues, 2020) defines clinical diagnosis by sudden onset with skin or mucosal involvement plus respiratory compromise or reduced blood pressure. is the first-line treatment in major guidelines. The second NIAID-sponsored symposium on the definition and management of anaphylaxis (Sampson and colleagues, 2006) set much of the clinical framework. Infants may present with vomiting, lethargy, and pallor more than hives. Food-protein-induced enterocolitis and other non-IgE reactions are distinct. The controversy concerns under-recognition in infants and whether delayed epinephrine use drives poorer outcomes.
Where it comes up
- Dairy and other sensitivities in a breastfed babyFeeding Your Baby
- Vaccines: the baby's schedule and who around the babyBaby Basics
- When to call the pediatrician (and when to go in)Baby Basics
What mothers here say about anaphylaxis
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Sources
- Cardona V and colleagues, World Allergy Organization Journal — World Allergy Organization anaphylaxis guidance (2020)
- Sampson HA and colleagues, Journal of Allergy and Clinical Immunology — Second symposium on the definition and management of anaphylaxis (2006)