Peanut allergy - benadrl vs. epi

ArcticFox

This is all new for us.. DD touched peanut butter to her mouth on Mon (didn't eat any) and her lips swelled up, we didn't know how bad it would get so we took her to the ER, and she did great on benadryl and steroids.  Her lips were so huge but they 'deflated' pretty fast once she got the meds.

Her lips actually got a little puffy last night (nothing like the PB) because I gave her a seaweed snack without realizing it was processed in a facility that processes peanut products (I am beating myself up over this, since I have been watching her like a hawk and reading labels like crazy - lesson learned there - although it also had sesame oil in it and I don't know if there is a correlation there).

So when her lips got a tiny bit puffy, I gave her benadryl and this ranitidine (steroid?) prescription she had from Monday night (she is supposed to take it for 3 days and was due for her daily dose anyway) - and the puffiness disappeared almost immediately.

Anyway, I couldn't get an appt with an allergist for a month.  I don't know how allergic she is, like if her breathing would have been affected with the PB incident.  So at what point do you use the epi pen (assuming there are no breathing issues)?  Just do benadryl first and see what happens?  I feel like I don't know how bad her reaction could be, since she didn't actually eat peanut butter, but she also went prob 40 minutes before we got to the ER without having breathing issues, and we couldn't tell if her tongue was swollen (but it didn't look like it). 

Sorry - I still have a lot to learn - hope this question makes sense!

ElizC

My son has an egg allergy and our allergist told me to only use the epi pen if his breathing was effected. He did say it was ok to give a double dose or additional dose of benadryl if the reaction doesn't calm down.  Also if we do need to use the epi pen, we are suppose to call 911 immediately and tell them to send an ambulance. 

Does your allergist have a canalization list you maybe able to get on?  I am not sure if I could of handled waiting a month to find out more about DS's food allergies.  

luvmagoldn

I was told to use the epi if breathing was impacted OR if more than one major system was involved.  So when DS vomited and had hives and starting pulling on his tongue he got the epi.

mrs_kelly1014

luvmagoldn:

I was told to use the epi if breathing was impacted OR if more than one major system was involved.  So when DS vomited and had hives and starting pulling on his tongue he got the epi.

This is exactly the correct information. Obviously, if there is any breathing issue at all, you Epi immediately. However, if her lips are swelling AND she has hives. Or, she has hives AND an itchy throat (obviously older kids only that can actually tell you that) warrant getting the Epi too.

If ever in doubt, use the Epi. There are no negative reprocussions to giving the Epi if it doesn't actually end up being needed, but the longer the reaction goes on before getting the Epi, the more likely it is that the child will die from the reaction (terrifying, I know). Always, always, always Epi if you think you should at all.

We've had to Epi before, and while it was absolutely terrifying (his throat was closing and he couldn't breathe), he improved tremendously within seconds of getting the Epi.

Also, when you go to the allergist (and I would definitely suggest an actual allergist and not just your pedi), make sure you get an Allergy Action Plan. He/she will know exactly what this is, and a good allergist will offer it without you even needing to ask. It will detail what to do in the event of a reaction so that there is no wondering what you need to do.

When multpile systems are involved, Benadryl is not going to help. Always Epi first, call 911, and then give Benadryl. I have the ready-fill spoons of Benadryl that I keep in my diaper bag and in our kitchen and it was PERFECT in an emergency because I could just pull off the little tab and give him the pre-measured amount without needing to think. Plus, my hands were shaking so bad that I probably couldn't have actually measured it out otherwise.

luvmagoldn

Ditto MrsKelly.  I was told that Benadryl has NO life saving properties.  It's for comfort only.  

I can tell you that in that moment I thought should I give the epi?  Should I wait? Then I remembered I had heard and read, "when in doubt - epi."   

sophie888

I feel like there are a lot of misconceptions about epi pens.  My son is allergic to dairy, eggs and peanuts.  The first time he got PB he had severe vomitting, his body was COVERED in hives and his entire face was swollen.  He got an epi, benadryl and a 5 days course of steroids.  Our son didn't get his epi until we got to the emergency room.  He was at daycare and they didn't give it because he wasn't having breathing difficulties.  However, our allergist said that whenever there is a moderate to severe reaction, give the epi. 

Reactions to peanuts are nothing to mess with.  Even after the initial reaction has subsided he could still have a "rebound" reaction.  If you are even considering the epi, give the epi. 

heyitsme

For facial swelling I wouldn't hesitate to use the epi for 2 reasons:

1) Facial swelling can be followed by throat/tongue swelling that will cause breathing issues.

2) Benadryl may relieve the symptom, only to return when Benadryl wears off.

In the case of any reaction your DD appears to have, due to the severity of her initial reaction, I would go straight to the Epi and then to the ER.

My allergist never recommends using Benadryl, actually, unless there are only mild hives. But anything involving swelling calls for the Epi.

shiloh17

WHEN IN DOUBT--GIVE THE EPI! Its so scary to witness and anaphylactic reaction. If your allergist gave you a prescription for epi pens, you should also have an emergency action plan. If they didnt give you an action plan that details when to use an antihistamine vs epi pen, you should really get one. It will save you the guessing game of what to give when. Our allergist said that as a rule, if a reaction affects 2 or more systems (skin, gi, resp) than epi is to be given. Give the epi, call 911, give benadryl. I'm sorry this happened. Hopefully your little one is feeling better ) 

magdusia

thankfully she didn't eat it and it was her lips, not throat that swelled up. That's probably why she was ok with even 40 minutes passing.

My first allergist told me to give the epipen when he starts turning blue. My second allergist said he's an IDIOT b/c that means it's too late.  She said when he starts coughing and the first signs of breathing issues.

I'm always worried i will give it too soon or too late or unnecessarily.

Someone once told me that you will just know if you should give it or not. So hopefully she was right and my gut will say -inject!  

artygirl

My allergist gave me an allergy action plan, which details when to give Benedryl vs. when to give an Epipen.  He summarized it by saying, give the Epi when he is having respiratory troubles OR when you are scared. 

HannahsMom21

So glad you switched to another allergist...that first one sounds like an idiot (sorry to be rude).

I wanted to say that my daughter's "breathing issues" only sound like a simple cough (like she has a tickle in her throat) but when the doctor listens she will hear wheezing. Never hesitate to give the epi pen in a situation like that! Some children's symptoms just present differently from others.

Best of luck!