7 steps to tackling children's allergy

Work through this new-style module to increase your confidence in reassuring parents of children with allergies, and know what advice and products to recommend

Admin , 8 Min Module

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7 steps to tackling children's allergy

Start

Learn from key healthcare brands with a range of sponsored education to help your understanding of how to use and advise on products in the pharmacy.

8-minute module

7 steps to tackling
children's allergy

This module will help keep you up to date on how to tackle allergy symptoms in children. Follow the module down the page and note the instructions as you go.

Objectives

Understand the causes and symptoms of children's allergies
Be able to confidently recommend Clarityn Allergy syrup (loratadine)
Be able to advise parents with concerns about allergy on how to minimise contact with allergens
Be aware of the signs of anaphylaxis

Did you know?

Allergic rhinitis affects as many as 4 in 10 children¹

An allergic response can vary from being relatively mild to very severe (anaphylaxis) and parents may be seeking advice to manage symptoms experienced by their child.

Allergies, intolerances & sensitivities

An allergy occurs when the immune system perceives something as a threat (e.g. a food protein even after ingesting a small amount) and reacts, releasing histamine and other chemical mediators that result in symptoms such as a runny nose or itchy eyes. Common allergens include pollen, certain foods and dust mites.^{2, 3}

An intolerance occurs when someone finds it difficult to digest particular foods and may have symptoms such as bloating or tummy pain, or a skin rash after eating the food. It is not life-threatening and doesn't involve the immune system. An example is lactose intolerance, where sufferers find it difficult to digest lactose.^{3, 4}

A sensitivity is when someone is more sensitive to the effects of something, such as getting palpitations after drinking a caffeinated drink.³

Examples of causes of allergies³

Indoor allergens e.g. pets, dust mites, household chemicals and mould

Outdoor allergens e.g. pollen, grass, trees and weeds

Food Common food allergies in children include peanuts (and other nuts), milk, eggs and fish and a severe reaction can be life-threatening⁴

Insect bites / stings For example wasp / bee stings or flea bites

Medicines e.g. ibuprofen or antibiotics (aspirin can cause allergies but should not be given to those under 16)

Symptoms of allergy³

Symptoms of allergy include:

A skin allergy can result in red, itchy skin or a rash.

Hives (also known as urticaria or nettle rash) are red, itchy bumps that can appear on the skin as a response to mediators such as histamine. Idiopathic urticaria is the term used when the cause is not known. Causes can include insect venom, animal dander (flakes of skin shed by animals), medicines such as penicillin, washing powders or latex.⁵

Children that are affected by eczema or asthma may find that an allergy exacerbates these conditions.³

Customers can purchase a range of products for children to help manage allergy symptoms including: oral antihistamines (such as loratadine); decongestants for a blocked nose; moisturising creams to reduce skin redness; topical antihistamine creams for insect bites/stings or nettle rash; anti-pruritic creams; nasal washes or barrier products to prevent contact with allergens.

Clarityn Allergy 1mg/ml Syrup (loratadine)

Mini quiz

Sammy is 4 years old and weighs 16kg.
What dose of loratadine syrup should he be given?

10ml once daily 5ml once daily 2.5ml once daily

Incorrect, the dose for a child over two that weighs less than 30kg is 5ml once daily

Correct - Sammy weighs less than 30kg

Incorrect, the dose for a child over two that weighs less than 30kg is 5ml once daily

Additional advice

Serious allergies - anaphylaxis

In anaphylaxis, chemicals that cause allergic symptoms, such as histamine, are released into the bloodstream. Symptoms usually occur within minutes of exposure to the allergen but can occur up to an hour or so later. Anaphylaxis is a medical emergency that should be treated immediately once identified.⁶

The first line of treatment is adrenaline (epinephrine), given as soon as possible. Pharmacists can administer adrenaline for the purpose of saving life in an emergency to customers presenting with anaphylaxis. If a pharmacist gives adrenaline, they must also call for an ambulance and report the suspected anaphylaxis.⁷

Pharmacy staff should advise parents to make sure their child carries 2 auto-injectors with them everywhere if appropriate. They should also consider informing teachers/friends/other parents of the child's allergy and what symptoms to look out for.⁸

Anaphylaxis symptoms

Symptoms are:^{6, 9}

Swelling of the tongue/throat
Difficulty in swallowing/speaking, or vocal changes
Difficulty breathing (such as fast, shallow breathing), noisy breathing, wheezing/persistent coughing/severe asthma
Tachycardia (fast heartbeat)
Feeling lightheaded, dizzy or faint
Collapsing/loss of consciousness (or floppiness in babies)
Clammy skin
Confusion/anxiety
Stomach cramps/vomiting after an insect sting

Advice for parents

Parents concerned about whether their child has an allergy should speak to their GP, who may refer them to an allergy specialist for testing and advice about treatment.

Avoiding allergens can be difficult but there are steps they can take, for example:

Dust mites: Have surfaces that can be easily cleaned such as vinyl floors, roller blinds, leather/vinyl furniture. Clean soft toys regularly, use allergy-proof covers on mattresses and bedding, and regularly wipe surfaces with a damp cloth.⁸

Food allergy: Keeping a food diary can help identify foods that may be causing a problem, but any changes to a child's diet should be checked with their GP or a dietitian.⁴ Parents should speak to waiting staff and let them know about allergies when eating out and avoid places where there is a high risk of cross-contamination (such as buffets). Parents should carefully read food labels - even for products that have been eaten before - as sometimes ingredients can change.⁸

Reflection points

Are you aware of different adrenaline auto-injectors and how they should be used?
What advice would you give to help minimise exposure to pollen?

Now proceed to the next page to test your learning.

Product information References

Clarityn Allergy 1mg/ml Syrup (loratadine) is indicated for the symptomatic treatment of allergic rhinitis and chronic idiopathic urticaria. Dosage and Administration: Adults and children over 12 years of age: 10ml (10mg) of syrup once daily. Children 2 to 12 years of age â€“ Bodyweight more than 30kg: 10ml (10mg) of the syrup once daily. Bodyweight 30kg or less: 5ml (5mg) of the syrup once daily. Contraindications: Hypersensitivity to the active substances or to any other ingredients. Warnings and Precautions: Should be administered with caution in patients with severe liver impairment. Clarityn should be discontinued at least 48 hours before skin tests. Contains maltitol and sorbitol; thus patients with rare hereditary problems of fructose intolerance should not take this medicine. Side-effects: Hypersensitivity reactions (including angioedema and anaphylaxis), dizziness, convulsion, tachycardia, palpitation, nausea, dry mouth, gastritis, abnormal hepatic function, rash, alopecia and fatigue listed as very rare (< 1/10,000). In children (2 to 12 years of age), headache, nervousness and fatigue are listed as common (≥ 1/100 to < 1/1). Use in pregnancy and breast-feeding: Preferable to avoid during pregnancy. Clarityn should not be recommended during breast-feeding. RRP (Excl. VAT): 60mlÂ£4.17. MA Number: PL 00010/0656. MA Holder: Bayer plc, 400 South Oak Way, Reading, RG2 6AD. Legal Category: GSL. Date of Preparation: December 2020.