Food Allergy in the Breastfed Infant

Kirsi Järvinen-Seppo, MD, PhD

Disclosures

May 13, 2014

Management of Anaphylaxis

Despite a family's best efforts to avoid trigger foods, accidents can happen. Infants with IgE-mediated allergy require access to an epinephrine autoinjector and a written emergency anaphylaxis plan.[28] The recommended dose of epinephrine is 0.01 mg/kg for children (0.3-0.5 mg in adults), which can be repeated every 5-20 minutes.

Epinephrine is available in autoinjectable devices containing preset doses of either 0.15 mg or 0.3 mg of epinephrine per injection (EpiPen®, Adrenaclick®, or Auvi-Q™). The devices are designed for self-administration or for administration by a companion as a first-aid treatment, but parents should seek prompt professional treatment for their child immediately after administration of epinephrine.

With food allergy, it is recommended that autoinjectors with 0.15 mg of epinephrine be prescribed for otherwise healthy young children who weigh 10-25 kg (22-55 lb) and autoinjectors with 0.3 mg of epinephrine for those who weigh 25 kg (55 lb) or more. For children who weigh less than 10 kg (22 lb), the provider and family should weigh the risks associated with a delay in dosing or dosing errors when using an ampule, syringe, or needle against those of using a nonideal autoinjector dose. For patients with a history of a life-threatening reaction, an autoinjector should be prescribed.

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