Best Practices for Kids + Epinephrine

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I’m not quite sure how summer passed by so quickly. Is it really back-to-school season already?! As families gear up for the school year ahead, we thought it would be a great time to review current best practices for kids and epinephrine—something every parent should know even if your child has no food allergies! 

Here are a few things to remember as you prepare for your child’s fun (and safe!) return to school.

Educating Your School Tribe

It’s a good idea to get your child’s food allergies on the radar of their school caretakers before the year begins—especially if your child is changing schools. Contact their school nurse and teacher to plan for where the epinephrine will be stored and how it will be used in case of an emergency. You may also want to discuss how snacks and treats are handled in the classroom. Many schools have food allergy policies in place, but some protocols are at the teacher’s discretion. 

It doesn’t hurt to schedule a face-to-face with your child, teachers, and caregivers before school starts to talk through your food allergy game plan. As a bonus, this gives your child an opportunity to meet their teacher before the year begins and help them tackle some of those first-day jitters! 

Epi Dosing Options

There are currently three different epinephrine dosages available. For adults and kids who weigh more than 30 kilograms (~66 pounds), the recommended dose is 0.3 milligrams. For smaller kids weighing between 15 and 30 kilograms (~33-66 pounds), the recommended dose is 0.15 milligrams. Several brands offer both dosing options, including EpiPen, Adrenaclick, and Auvi-Q.  

For infants and toddlers who weigh between 7.5 and 15 kilograms (~16.5-33 pounds), Auvi-Q makes an auto-injector with a lower dosage (0.1 milligrams), which also features a smaller needle. 

Make sure to check with your doctor to determine the best option for your child! 

Safe Storage

Remember that epinephrine is temperature sensitive. The medication should be stored at room temperature and never in extreme hot or cold climates (e.g., car glove compartments). Some brands also recommend that users periodically check to ensure the liquid has not changed color. If the solution assumes a pinkish or brownish hue, this can indicate decreased effectiveness. Epinephrine is light sensitive too—so store your auto-injectors in cases!  

Parents should work with their child’s school or daycare provider to map out a plan for both on-site and off-site storage (e.g., field trips), to ensure availability and maximum effectiveness. 

Using Your Epinephrine

As explained in one of our earlier blog posts, the outer thigh is the best place to administer the injection, even through clothing if necessary. Most manufacturers offer videos on their websites to demonstrate how to use their product. These can be a great resource for new caregivers and anyone that should be prepared for an allergic emergency. Like CPR, administering epinephrine is a good skill for any parent to have in their arsenal.

Replacing Your Supply

Currently, most auto-injectors expire within 12 to 18 months. Make sure to check your epinephrine expiration dates and mark them in your calendar. A good rule of thumb is to always have two auto-injectors in close proximity to any food-allergic child in case one is defunct (and in some cases, two injections may be required!). 

As you replace old auto-injectors, remember that some manufacturers offer coupons or other financial assistance, especially for lower income families.  

While we hope you never have to use an epinephrine auto-injector, we share these reminders to keep all of our children safe as we send them off to the classroom! 

- Susannah and the Allergy Amulet Team