Is DS a candidate for an epipen?

[rainbowlight]

My 15mo DS has multiple allergies to egg, milk, soya, beans, lentils, peas, sunflower oil and cats. On Thursday he had his worse reaction to date as he was given accidently peas at nursery - he broke out in hives over his face, neck & chest (as is usual) but his eyes also swelled up which has not happened before. He had to have 2 doses of piriton before the swelling went. He was diagnosed with asthma last month so I am very concerned about the swelling linking with his asthma especially that it was to the same food group as peanuts (legumes).
Has anyone got any experience of the criteria of being prescribed an epipen - I have enquired with the paediatrician at a previous appointment but she dismissed it but this was 2 months ago before the asthma diagnosis - we see her again next month so going to ask her again but would just like to hear of other peoples experiences.

[strawberrycornetto]

Hi. I am in a similar position with DS. His position is slightly less severe (allergy to milk, soy and eggs only (!)). He is 12 months old and at our first appointment he was't given an epipen but at that stage was only allergic to milk. Now, he has 2 more food allergies and is being treated for asthma, although we don't actually have a diagnosis.

I have an appointment with our allergy paediatrician on Thursday to discuss exactly this issue, so I will post and let you know what he says. We haven't had any swelling but his initial reaction to milk was hives.

Also interested to see if anyone else has any views. I'd like to know how many DCS have epipens and whether they have had anaphylatic reactions prior to the prescrition.

[rainbowlight]

Thanks strawberry - I would really appreciate knowing the outcome of your appointment as my paediatrician seemed very reluctant to prescribe due to his age and that over dosing would be very possible so it would be interesting to know the views of your paediatrician. Hope your appoitment goes well.

[strawberrycornetto]

We are lucky to have a good paed. Last time, he was torn and thought on balance better not so I think perhaps this might tip the balance for him. I know asthma is a risk factor for a bad reaction. One of the things he really factored in was where we live and closeness to ambulances/a&e etc. I am in London, with our GPs practice and a chemist within a 2 minute walk of our house and of the nursery and an ambulance station about 5 minutes away. He said he would prefer our nursery to be ringing 999 than using an epipen for every little panic. However, DH travels a lot and the dr said that if we were thinking of going somewhere remote (he said like Thailand?!) he would suggest we revisited the issue. We are off to France with other children in the summer and we are a little way from town, so with the risk of him taking food from the other little ones and the language issues etc, I might push for one then if not before.

I will tell you what I am told on Thursday. I hope your DS is ok and avoids any more reactions, its such a worry

[trixymalixy]

The specialist wouldn't give my Ds an epipen at 18 months, even though his lips and tongue had swelled on eating chickpeas. They didn't go down fully until 48 hours later

The criteria are apparently that they have to be 15kg in weight and have had an anaphlactic reaction (catch 22!!).

Apparently swelling on its own isn't an anaphlactic reaction.

Asthma may make them more likley to prescribe it though as I think that was one of the criteria.

[strawberrycornetto]

That's interesting trixy. My DS will really struggle to meet the weight criteria as he's very small, partly because he's been so unwell with chest problems. He's 0.4th centile so he will take forever to get to 15kgs.

[trixymalixy]

I think they do prescribe them if there has been an anaphlactic reaction even if they don't weigh enough.

It's so worrying isn't it. Especially when you have to entrust them to a nursery.
It would be nice to have the comfort of an epipen nearby.

[nettie]

My DS is allergic to eggs and sesame and has had an epipen since being seen by paediatric allergist at a bout 2. He's never had a anaphalytic reaction, just hives and vomiting. its a junior epipen, though it wasa mentin lastr time we went ( he's 6 now) that after a certain weight he'll need a different one.

[BalloonSlayer]

DS1 was prescribed an epipen at 14months. He was 12kg (I have just checked the red book).

He did not have anaphylaxis, as far as I can make out, as he did not collapse or lose consciousness BUT his throat did close. He could breathe but could not swallow. Presumably that affected the decision though - if he could not swallow then he would be unable to swallow piriton. We were advised to administer the epipen at the drooling/choking (ie oesophagus closed) stage.

[BalloonSlayer]

BTW that was Guys allergy clinic if that makes any difference.

Also I have just experienced mild collywobbles as he has gone on to adult epipens now. I found myself worrying about the largeness of a dose for adults on a 4st7 boy. Then I remembered the dose for a 4st6 boy being potentially given to a 14 month old and gave myself a shake!

[Mumfie68]

IME they do prescribe them to children under 15kg if they've had an anaphylactic reaction - DS was floppy/losing consciousness, got sent home from the hospital with an epipen. He must have been about 6 or 8 months old and he was very underweight at that time.

I do think they look for signs of a severe reaction such as floppiness/breathing problems before they'll prescribe, although it looks dramatic hives/swelling even that last a while are only considered a mild/moderate reaction. Remember it's anaphylactic SHOCK, the epipen is to counter the huge drop in blood pressure you get when your body goes into shock by basically giving you a massive adrenaline rush. It's not necessarily a dangerous medicine to give but it's not designed to get rid of hives/swelling, that's what the piriton is for (along with the steroids they pump into you in A&E!)

[alibobins]

Ds has an Epi-pen it was prescribed when he was 8 months after a severe anaphylatic reaction to eggs
Ds was very little for his age but the reaction went to full blown anaphylatic within minutes of eating egg that it wouldn't be worth the risk.
Hospital did discuss a syringe and vile of adrenalin but again they said it wouldn't be fast enough.
We/ambulance have since had to use it 4 times twice for unknown causes.

[trixymalixy]

Alibobins, that must have been terrifying, especially the times it was due to an unknown cause!!

[strawberrycornetto]

We saw the same doctor as babybarrister, which ties in as DS had only a skin reaction and not one as severe as bb describes. As I said, he considered but decided against. For me, the frightening thing is that the severity of the last reaction isn't necessarily indicative of what might come in the future. Alibonins, that sounds really frigtening, especially the not knowing

[trixymalixy]

There's a paediatric allergy clinic at Yorkhill in Glasgow and the specialist there wouldn't prescribe an epipen despite swollen lips and tongue.

[alibobins]

It was really frightening the first time it was a case of in the right place at the time. The gp gave him adrenalin and gave him oxygen and another injection
When we were discharged from hospital I went into see gp to say thankyou and he said he really didn't think he'd see ds again

The unknown reactions were scarey and thats why I'm glad we have got an epi-pen. During one reaction we hesitated and started to drive to the hospital and ds stopped breathing on the way
I have been told his reactions are pretty rare to be that severe. Ds has got brittle asthma so that goes against him too.
We are only under a consultant at our local hospital.

[strawberrycornetto]

Ali, poor you. You have lived through the thing which is keeping me awake at night.

BB, I knew what you meant

[alibobins]

Consultant did say reactions that severe were unusual.
I would just tell them how you feel and ask for one as reassurance.
Hope things improve with ds.

[rainbowlight]

Thanks everyone for your experiences - I think like everyone an epi-pen would bring great peace of mind. I think what is worrying me the most is that my Paed wants us to introduce foods gradually such as eggs in cake to build up his resistance and now his reactions seem to be getting worse I am more reluctant but she says that no exposure is worse in the long term and could make a reaction alot worse if the body hasn't been exposed at all. We did try him on cake before Christmas which I made with 1 egg in and he was ok but 2 weeks ago we tried again and made a cake with 2 eggs and he was violently sick in the car on the way home as we were at my Mum's and covered in hives. I know my Paed will be hard to convince but she may have a different opinion when we see her in March with recent events (she says hopefully!!). It is horrible to see my DS in distress when he has a reaction, so to expose him to his risk group foods is not what I want to do but the Paed's advice is to expose so it is hard to know what to do for the best.

[trixymalixy]

That is the total opposite to the advice I have had which is that total avoidance is better as they are more likely to grow out of the allergies.

My Ds' reactions seem to get more severe with every exposure.

Are you sure this paed is experienced with allergies?