Learn the signs of anaphylaxis (a life-threatening allergic reaction) and what to do if your baby develops anaphylaxis, from Michael Pistiner, MD, of the Food Allergy Center at Mass General for Children (MGfC).

What is anaphylaxis?

Anaphylaxis is a serious, life-threatening allergic reaction. Anaphylaxis must be treated right away to help your baby feel better faster and to prevent their symptoms from getting worse.

What are symptoms of anaphylaxis in babies?

Anaphylaxis symptoms look a little different in babies than they do in children and teens. Keep in mind that since babies cannot talk, they cannot tell us what they are feeling.

Symptoms in babies can include:

  • Vomiting
  • Diarrhea
  • Crankiness or inability to be soothed
  • Hives or a rash all over the body
  • Swelling of the lips, eyes or other parts of the body (angioedema)

Other symptoms can include:

  • Fast heartbeat (tachycardia)
  • Dizziness, fainting or excessive sleepiness (lethargy)
  • Scratching or rubbing of the skin
  • Inconsolability

People of all ages can have different reactions each time they are exposed to an allergen (something they are allergic to).

How to treat anaphylaxis in your baby

The best way to treat anaphylaxis is to REACT:

  1. R: Recognize the symptoms of anaphylaxis. Common signs of anaphylaxis in babies include vomiting, diarrhea, crankiness, fast heartbeat, hives and swelling of the lips, eyes or other parts of the body. Other signs include shortness of breath, trouble breathing, wheezing (whistling sound while breathing) and dizziness. Make sure that your provider has given you an Anaphylaxis Emergency Plan and that it is available at all times. Use it to train others how to recognize anaphylaxis.
  2. E: Give epinephrine. This is the best and safest way to treat anaphylaxis. Epinephrine comes in an auto-injector, such as a generic epinephrine, EpiPen® or AuviQ®.
  3. ACT: Activate the emergency response. The steps include:
    1. If your baby has an Allergy Action Plan, follow the steps included on the plan.
    2. After giving the epinephrine then call 911.
    3. While you wait for the ambulance to arrive, keep your child sitting or lying down (if not vomiting). Do not hold them so their legs are dangling.
    4. Go to the hospital in the ambulance with your baby.

Epinephrine has side effects that are expected, but not dangerous. Remember, we are calling an ambulance because your baby had a severe allergic reaction,not because epinephrine was given. The ambulance brings additional things that may be needed, including oxygen, IV fluid, trained personnel, more epinephrine and a safe ride to the hospital.

Tips to care for an epinephrine auto-injector

  • Keep two epinephrine auto-injectors with you at all times. Sometimes, babies need a second dose of epinephrine or the first auto-injector might not work as expected. Follow your baby’s anaphylaxis action plan.
  • Train everyone who cares for your child how to use the auto-injector (also called a training device) and how to spot the signs of anaphylaxis (listed on your baby’s anaphylaxis action plan).
  • Avoid storing the auto-injector in extremes temperatures.


Rev. 2/2019. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this webpage. This webpage is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.