FAQ's for allergies in children from Epworth Allergy Specialists


1. Can your tests predict the risk of anaphylaxis in my child?

No. There is currently no available 'test' that can predict the risk of anaphylaxis. The size of the skin prick test corresponds with the likelihood of having an immediate allergic reaction, but does not correspond with the severity of the reaction.

The risk of anaphylaxis is difficult to predict, and is likely to depend on several factors, including: a) past anaphylaxis, b) amount of food allergen ingested, and c) presence and severity of co-existing asthma.

2.  Should my child carry an Epipen?

This is an important issue that is discussed at every appointment. The need for an Epipen for each child is an individualised decision that is made in discussion with your doctor. In general, an Epipen is prescribed for children who have had a history of anaphylaxis.  An Epipen may be further considered if a child has unstable asthma, or may be in a situation where he/she may be remote from hospital care, such as planned travel overseas.

3.  Will you give me an action plan to take to my school or childcare centre?

Yes. We give all children with food allergy an allergy action plan. This will clearly instruct carers what to do in the event your child has an unexpected allergic reaction.

4.  I am really concerned, is my child at risk of dying from his/her food allergy?

Although there have been children who have tragically died from food allergy, this is extremely rare and very unlikely to occur.  We advise parents not to be 'alarmed', but instead 'alert and aware'.

Importantly, as unstable asthma is a known risk factor of fatal anaphylaxis, it is important that your child’s asthma is kept under exceptional control. This means that if your child has a regular cough or wheeze that wakes them up at night, or if your child regularly coughs and wheezes when they exercises, see your GP to discuss if an asthma preventer is required.

5.  When should my child be upgraded to an adult Epipen?

Although manufacturers recommend for children to be upgraded from an Epipen Junior (150 mcg) to an adult Epipen (300 mcg) when they weigh 30 kg or more, the Australasian Society of Clinical Immunology and Allergy (ASCIA) recommends for the upgrade to occur when children are 20 kg or more. Hence, when your child is 20 kg or more, remember to remind your doctor to issue an adult Epipen with the next script.

6.  How many Epipen’s am I entitled to?  Can I purchase additional ones?

The Pharmaceutical Benefits Scheme (PBS) allows for an allergist to prescribe a maximum of two Epipen/Epipen Juniors for a child ages less than 17-years-old with food allergy, when indicated. This means that you pay approximately $30 for two Epipens, instead of the usual price of about $130 per Epipen.

One Epipen stays at school or childcare, the other stays with your child wherever they go. Once a child is aged 17-years-old or more, only one Epipen may be prescribed at the subsidised rate.

Although our view is that this is adequate, families who wish to have additional Epipens may purchase them over-the-counter without a script, at the unsubsidised cost of about $130 per Epipen. Remember, however, that the primary management in children with food allergies is focussed on avoidance, and the Epipen is there as a second line management in case avoidance has not been successful.

Read more about Our team.