Can you give piriton after eating for unknown allergies?

[Meltinthemiddle]

A parent at my nursery wants us to administer piriton after each meal due to unknown allergies. They come out in a rash so not life threatening. They are waiting for the scratch test. I've noticed on the prescribed bottle it says give as required but not after each meal/food. Has anyone else been advised this by the doctor? Obviously I am going to question the parent as feel it should be given of he has a reaction not as a precaution unless I have it writing.

My little one has a higher dose of paracetamol that the label on the bottle says but the only way this can be given at nursery is because his consultant has documented the dose in a clinic letter. If you give the higher dose and something happens it would just be your word that the parent told you to give it after every meal so I would be asking for written evidence of the dose from the prescriber.

Yeah thank you. Obviously I'd give it if they have an reaction but it doesn't say after eating.

Are they having a reaction after every meal? That answers your question really.

Has the child's doctor suggested/prescribed this?

Some children get quite drowsy on Piriton (it's a known side effect) so it's not a great idea to use it unless necessary.

And another problem with giving AHs like this is that they can mask visible indicators of a reaction which means if it does escalate into something more serious, you don't spot it until it's already escalated, as there's no warning.

Please don't assume that just because so far it has been 'just a rash' that it might stay that way, though, allergic reactions can escalate at any point. Is your allergy training up to date?

Yes I am aware that a more severe reaction can occur but so far they have only had a rash. It is prescribed by the doctor, but it says as required not after each meal/eating. Apparently he can eat something day and be fine and have an reaction the next.

As the piriton is for a food allergy then “as required” would be with each meal. The parent is merely repeating the verbal instructions, so you should follow them.

The “as required” on the package is general because piriton is also used for other allergies like pet allergies and dust mite allergies. So for pet allergies it would be take before exposure to a cat/dog/Guinea pig etc, and for dust mite allergies it would be take at bedtime.

It is an anti-histamine and works best before exposure to an allergen. It’s not that effective if you wait for a reaction.

Prophylactic AHs aren't usually given for suspected food allergies though. it makes more sense to strictly diarise food/drink and monitor for reactions, treating at the first sign of a reaction.

And if it was being given to ward off a food allergy then it would need to be given at least 15-30 minutes before food.

@TrailingLoellia As a parent/carer you can follow the verbal instructions of the prescriber, as a childcare provider you need it in writing from a HCP.

My DS had an undiagnosed food allergy, he had Piriton in nursery in case there was a reaction as we didn’t know what caused it.

His “rash” wasn’t life threatening but you wouldn’t leave him red and itching his face and rubbing his eyes off.

Plus Piriton does not make either of mine drowsy mores the pity as it knocks me on my arse!

I did not know that. So I’d ask the parent to get a doctors note in that case.
I agree they aren’t usually given for food allergies per se. It’s more for known food intolerances. My DD has a food intolerance for raw bananas. Not a food allergy but they would give her a rash and nausea.

Absolutely not. You would be going against the dosing guidance, for which you need written medical evidence.

My little boy has Piriton at nursery. When he was under 1 years, Piriton could only be administered by the nursery if the Piriton had been prescribed by the GP, which showed dosage amounts. The GP only prescribed a dose after a reaction, not every meal.

After he turned 1 years of age, non-prescribed Piriton could be administered by nursery, but only the recommended dosage on the box. If my boy had a second reaction, they would not administer another dose if it was before next dose was due and would call me to collect him.

My boy has only been administered Piriton 4 times at nursery, 1 required a call home and collect, the other 3 times were one off and all on different days.

If a parent wants a dose after every meal, it will need the GP to sign off.

Thank you, I will ask her to get a letter from the GP of she want me to give it after meals.

What exactly does it say on the bottle? You may notice it says max dose in 24hours? So if you work it out, it is usually x2 max in 24h for under 1y.

So if mum wants to use as precaution/ward off any symptoms, she can administer AM before nursery, and PM after tea. Or, as and when needed but no more than dose/24hours. (If you see hives/swelling/urticaria/excessive itching/weepy eyes/sudden cold like symptoms accompanied by irritability/crying, then you administer). Have you asked mum what all baby's signs and symptoms are?

It's says gives as required. Dosage 2mg 4-6 hours between dosage. Then max of 4 in 24 hour period.

Piriton is for symptomatic relief of allergy symptoms. It’s not for “just in case” use. Here’s the leaflet. https://www.medicines.org.uk/emc/files/pil.3928.pdf

Exactly, it's for treating symptoms, not a preventative medicine.