Learn the Signs of a Peanut Allergy Emergency

If your child has a peanut allergy, you’re always on high alert to keep them safe.

But accidental exposure can still happen. And if it does, knowing what an emergency allergic reaction looks like can help you respond when every moment counts.

“Food allergy reactions are always something to take seriously,” says allergist Jaclyn Bjelac, MD. “Anyone caring for a child with a peanut allergy should know how to spot an allergic reaction and know what to do.”

Give your child their prescribed epinephrine immediately and call 911 or emergency services if they have severe symptoms — including trouble breathing, throat tightness, significant swelling, dizziness or fainting — or if their allergy symptoms are affecting more than one area of their body. Don’t wait to see if symptoms improve.

What does an allergic reaction to peanuts look like?

Allergic reactions to peanuts can range greatly.

A mild allergic reaction typically involves symptoms in just one area of the body. Symptoms may include:

• A few hives or mild itching
• An itchy or runny nose
• Sneezing
• An itchy mouth
• Mild nausea or stomach discomfort

Other times, an allergic reaction to peanuts can be an emergency. And scary as it is, there’s no reliable way to predict how serious your child’s allergic reaction will be.

“Many times, people who’ve had only very mild reactions to peanuts in the past can have a much more severe reaction on their next exposure,” Dr. Bjelac clarifies.

Signs of a severe allergic reaction to peanuts

Anaphylaxis is an emergency-level allergic reaction. It can come on suddenly or start with mild symptoms that get worse.

“A seemingly mild allergic reaction can progress into life-threatening anaphylaxis,” Dr. Bjelac explains. “So, watch your child closely for changes.”

Signs of a peanut allergy emergency include:

• Breathing problems, like shortness of breath, wheezing or repeated coughing
• Throat symptoms, including tightness, hoarseness and trouble breathing or swallowing
• Significant swelling, especially of the lips or tongue
• Widespread skin symptoms, like hives or redness over large parts of the body
• Stomach symptoms, including repeated vomiting or severe diarrhea
• Circulation problems, like pale or bluish skin, dizziness, fainting or a weak pulse
• Changes in behavior or awareness, including confusion, anxiety or a feeling that something very bad is about to happen
• Symptoms in more than one area of the body, like hives, along with vomiting, or an itchy mouth, along with sneezing

Babies and young children having a severe allergic reaction may have these same symptoms. Or they may look a little different. Also look for signs like:

• Hoarse-sounding cries
• Noisy breathing
• Rubbing their eyes
• Scratching their ears
• Pulling on their tongue
• Arching their back

“If your child is having even just one of these symptoms after being exposed to peanuts — or if they’re having any symptoms that are affecting two or more areas of their bodies — treat it as a medical emergency,” Dr. Bjelac stresses.

What to do if someone is having a severe reaction to peanuts

Anaphylaxis from peanuts demands quick action. For your child’s safety, it’s critical to have an allergy emergency care plan in place.

Typically, a peanut allergy emergency action plan follows these steps:

1. Give epinephrine immediately. Follow the instructions for your child’s specific device and prescribed dosage.
2. Call 911 or emergency services. Tell the dispatcher that your child is experiencing anaphylaxis and has received epinephrine.
3. Stay with your child. If they’re vomiting or having trouble breathing, sit them up or lie them down on their side. Otherwise, have them lie flat with their legs raised — that can help keep their blood pressure from dropping too low.
4. Give another dose of epinephrine, if advised. If symptoms return or don’t improve within about five minutes, the emergency plan may call for a second dose. Only administer more epinephrine if your child’s healthcare provider has it as part of their plan.
5. Go to the emergency room, even if your child feels better. Epinephrine can work fast, but its effects are short-lived and symptoms can return. At the hospital, healthcare providers may treat your child with additional epinephrine, breathing treatments, IV fluids or other treatments as needed.

Most importantly, don’t wait to see if severe symptoms get better on their own.

“You know your child better than anyone else in the world,” Dr. Bjelac says. “If you’re worried, engage their emergency allergy action plan as quickly as possible.”

Tips to be prepared in case of an emergency reaction to peanuts

Responding to a peanut allergy reaction emergency starts with planning ahead and making sure everyone in your child’s life knows what to do. Dr. Bjelac offers this advice:

• Know when to use which meds. Antihistamines can help with some mild allergy symptoms, but they don’t treat anaphylaxis. Severe reactions need epinephrine, which can only be prescribed by your child’s healthcare provider.
• Always carry epinephrine. “The hope is you never have to use it, but it needs to go wherever your child goes,” Dr. Bjelac advises. “If you need it, you don’t want to wish that you had it.” Make sure your child’s epinephrine is available at school, daycare, activities and anywhere else they spend time.
• Have copies of their allergy action plan. Work with your child’s allergist to create a written food allergy action plan and give it to all adults who care for your child. Don’t have one yet? Download a sample plan from foodallergy.org.
• Teach your child about their allergy. As your child grows and matures, they should know how to use epinephrine, when to use it, where it’s kept and how to alert a trusted adult to get help quickly.

Knowing your child could have a severe allergic reaction can be scary. You don’t need to live in fear of a reaction, but you do need to be ready to respond if one happens. Being prepared can help replace some of that uncertainty with a plan — so you and your child know exactly what to do to help keep them safe.