If your child is having an allergic reaction to food, insect bites, bee stings, medication, or to something unknown, here is some preliminary information on what to do:
- For HIVES, swelling, or any type of itchy skin rash, you can give a dose of Benadryl (diphenhydramine) to minimize the reaction. Genexa also makes a version of diphenhydramine, with the same dosing. Do not give an infant younger than 6 months Benadryl without asking your doctor. For older infants, the dose I tell my own patients is 2.5 ml (equal to 6.25 mg) for infants who are about 6 to 11 months old and weigh 14 to 19 pounds. Toddlers who are 12 to 24 months old and weight 20 to 25 pounds the dose would be 3.75 ml (equal to about 10 mg). Kids who are 2 years and older, and who weight 27 pounds or more would get 5 ml (12.5 mg). For kids older than that, simply follow the dose on the bottle.
- Realize, however, that you don’t have to treat the hives with Benadryl. You can use cool washclothes to cool the hives, or soak in a lukewarm bath (cool enough to soothe, but not feel cold to the child). Wait and watch, and use Benadryl if the hives keep expanding and your child is very uncomfortable. Treat the child, not the rash. You don’t have to keep the rash completely suppressed.
- If this helps, then you don’t need to rush to an ER or consult a doctor urgently.
- If the hives persist for several days or longer, and you need a non-drowsy antihistamine to control them, OTC Zyrtec is a good option.
- Causes of hives: Although you may be panicking, trying to figure out why your child has hives, realize that this isn’t a priority at first. After the emergency has settled down, consider these causes of hives:
- Viral illness – this is, by far, the most common cause of hives. If your child is currently sick, or was sick in the last week or so, the hives are likely due to this.
- Food allergy – if your child just ate a new food or a food that is commonly allergic, consider that as a cause. Common culprits are milk, nuts, eggs, peanut, wheat, soy, shellfish, and fish. Any new foods, however, could cause a reaction. Don’t rush to the ER for testing – they won’t test you. Simply avoid that food for now and make a routine appointment with your doctor for testing.
- Medication reaction, insect bite, topical allergic reaction – these and other things can also be causes of hives.
- How long will the hives last? They may last only a few hours, or come and go for 2 or 3 weeks. They are very unpredictable. See your doctor if they last longer than this, or your child is repeatedly uncomfortable.
- ANAPHYLACTIC REACTION. If you have an epinephrine prescription, have been trained in how to use it, and your child is having severe anaphylaxis, go ahead and use this and call 911. If you don’t have this medication, call 911 and seek emergency help as quickly as possible. Signs of anaphylaxis include throat closing, difficulty getting air, and severe sudden wheezing. Other signs including uncontrolled vomiting, severe drooling, inability to swallow, severe lethargy, or shock, especially if also having difficulty breathing. Simple facial swelling or hives around the head, neck, or chest WITHOUT any of the above anaphylactic signs is likely NOT anaphylaxis and can be treated with Benadryl.
