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My child suddenly developed an allergic reaction - is it anaphylaxis?

Emergency numbers: 108 ambulance · 112 national emergency · Poison centre (AIIMS, 24x7): 1800-116-117

Quick answer: A reaction limited to the skin - hives, itching, redness - with a completely well child is usually not an emergency, but call your paediatrician the same day. Anaphylaxis is when the reaction involves the breathing, the throat, or the circulation, and it is always an emergency: give the epinephrine auto-injector immediately if one has been prescribed, and call 108. Antihistamines do not stop anaphylaxis - never use them in place of epinephrine.

How to tell the difference

Likely milder (skin only): hives, itching or redness on the skin, with no other symptoms - your child is breathing, talking, swallowing and acting normally.

Anaphylaxis (act now): any breathing symptom (wheeze, cough, shortness of breath, tight chest); swelling of the lips, tongue or face; a hoarse voice, tight throat or trouble swallowing; repeated vomiting or severe tummy cramps with the reaction; dizziness, faintness, sudden paleness or a limp, drowsy child; a feeling that something is terribly wrong.

In infants, also watch for: sudden drooling, inconsolable crying or fussiness, and unusual sleepiness after a new food or a sting.

🔴 RED - This is an emergency: call 108 NOW if

  • Any of the anaphylaxis signs above appear, alone or together. Anaphylaxis can begin within minutes of the trigger, or up to a few hours after.
  • If your child has a prescribed epinephrine auto-injector: use it immediately - inject into the outer mid-thigh, note the time, then call 108 and go to the ER even if your child looks better. A second wave of the reaction can happen hours later.
  • Symptoms do not improve, continue, or get worse 5 minutes after the first epinephrine dose: give the second dose if one is available.

🟡 YELLOW - Call your paediatrician today if

  • Your child had hives or itching only, is now completely well, and this is the first time it happened - your doctor will want to identify the trigger and decide whether your child needs an allergy plan or an epinephrine prescription.
  • Any reaction after a medicine, a new food, or an insect sting, even a mild one.

🆘 SOS - What to do while you get help

  • Give the epinephrine auto-injector first if prescribed - nothing works faster. Note the time it was given.
  • Keep your child lying on their back. If they are vomiting or having trouble breathing, keep them lying on their side instead.
  • Stay with your child and keep them calm. If they have a prescribed inhaler for wheezing, you may give it - but never instead of epinephrine.
  • If your child stops breathing, start CPR if you know how, and tell the 108 operator.
  • Tell the doctors what your child ate or was exposed to in the last few hours, and when the epinephrine was given.

❌ DO NOT

  • Do not "wait and watch" breathing or throat symptoms - anaphylaxis can escalate in minutes.
  • Do not give an antihistamine syrup and assume the danger has passed. Antihistamines help itching and hives; they do not stop airway swelling or collapse, and they are never a substitute for epinephrine.
  • Do not make your child stand up or walk around during a severe reaction - keep them lying down.
  • Do not test the suspected trigger again at home to "check" - ever.
  • Do not assume it cannot be an allergy because "he has eaten it before" - reactions often appear on a later exposure, not the first.

What is happening and why

An allergic reaction is the immune system overreacting to something harmless - in children, most often foods (peanuts, milk, eggs, tree nuts, shellfish, fish), insect stings, or medicines (antibiotics and anti-seizure medicines are common ones). When the reaction stays in the skin, it is uncomfortable but manageable. When it reaches the airway or the circulation - swelling of the throat, tightening airways, falling blood pressure - it becomes anaphylaxis, and minutes matter.

Epinephrine works within minutes to reverse all of this, which is why it comes first and everything else comes second. Children who have had anaphylaxis once should carry two doses of epinephrine everywhere, and everyone who cares for them - school included - should know how to use it.

This page is for first-aid education and does not replace examination by a doctor. In an emergency, call 108 or 112.

Sources (last checked 13 Sep 2026)

Reviewed and approved by Dr Anjana Alekhya, MD (Paediatrics) · Published 13 September 2026