When Julie Berghaus' three-year-old daughter Maren suffered a severe allergic reaction at her doctor's office, there wasn't the obvious "choking, gasping...[and] wheezing" symptoms that many parents expect to see.

By Rebecca Macatee
March 22, 2019

Anaphylaxis is a severe, immediate allergic reaction that can be life-threatening, but the symptoms aren't always as obvious and dramatic as what we see in the movies. As one mom's now viral Facebook post shows, the onset of anaphylaxis can look like nothing more than a mild reaction.

Julie Berghaus recently took her three-year-old daughter Maren to the allergist's office for a controlled tree nut challenge. According to Maren's mom, she'd shown false positives on skin tests before, so in this challenge, the doctor fed her 1/10 of a cashew "in a very controlled environment to see if they were true allergies."

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Within five minutes of easing the tiny piece of cashew, Maren's ears began to itch. But as Berghaus noted, the little girl "was perfectly happy and playing still, though." Shortly after that, Maren "started complaining of a belly ache and then started to itch all over," but she didn't have a rash yet.

Even so, the medical team supervising Maren's tree nut challenge gave her a Zyrtec orally and decided to administer her first epinephrine shot because she was showing two symptoms, belly pain and itching. According to Berghaus, the EpiPen shot "calmed everything for about ten minutes."

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At this point, Maren "really started itching a lot more," said her mom, "and her entire body was quickly breaking out in severe hives before our very eyes." The medical team gave her a steroid shot, and she continued playing her game without showing any signs of distress.

Five minutes later, Maren started "coughing a little bit," Berghaus said, but mom "couldn't hear her breathing hard or wheezing at all." Just to be extracautious, she called in a nurse who listened with a stethoscope and could hear that Maren was struggling to breathe. At this point, though, Maren "was still just playing, and just annoyed with the itchy hives!"

Moments later, everything changed. Maren started "blacking out," and the medical team quickly gave her an albuterol treatment, another epinephrine shot and a steroid. According to her mom, she was "was lethargic and out of it for around ten minutes, before she started coming around again."

Maren remained under close observation for several more hours, and fortunately, she didn't experience a second round of anaphylaxis. Her mom wanted to share their story—and a photo of the little girl in the midst of treatment—to raise awareness of what this potentially deadly allergic reaction really looks like.

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"[I]t was nothing like we expected to see," said Berghaus. "It snuck up on us so unexpectedly and quietly. I expected to see choking, gasping, hear wheezing, and see her grabbing at her chest and neck area. I expected the entire ordeal to be very fast and obvious and dramatic. It was actually very silent, and she didn't show any severe trouble until very late in the game."

Berghaus, who previously worked as an emergency room nurse, told Todayshe'd "never seen a reaction that severe." And according to Nicholas Hartog, M.D., a pediatric allergist at Helen DeVos Children's Hospital in Grand Rapids, Michigan, what an allergic reaction looks like can vary widely.

"Your previous reaction isn't really predictive of what your next reaction will be either in the type or the severity of it," Dr. Hartog, who did not treat Maren, told Today.

If your child has had an anaphylactic or serious allergic reaction before, you should ask your doctor whether the child should carry an EpiPen or a dose of epinephrine. Your doctor may also suggest your child wearing a medical alert bracelet that lists her severe allergies, as well as preventative treatments of allergen immunotherapy that may help to reduce the risk of severe reactions over time.

Berghaus told Parents.com she "[carries] two EpiPens at all times," and while Maren "doesn't understand the EpiPen yet, she can name off her allergens."

It's important that family members, friends, teachers and others who spend time with your kid are aware of the potential allergens that could trigger an allergic reaction.  You also want to make sure the people in your child's life know how to administer an EpiPen. And as Maren's mom put it, "DON'T be afraid to give epi. She had zero side effects from the epi. It could save her life."

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Of course, if you see or suspect a child suffering from symptoms of anaphylaxis, call 911 immediately. The red flag symptoms of anaphylaxis that require urgent medical attention include:

  • Difficulty breathing
  • Tightness of the throat
  • Hives
  • Nausea
  • Vomiting
  • Dizziness
  • Rapid heartbeat
  • Fainting

If you're ever in doubt, though, make the call. As Maren's mom said, "Much rather safe than sorry...It's a matter of life and death for her."

Fortunately, Berghaus said Maren is "great now—like nothing ever happened!" The little girl might have given her parents a scare, but she "didn't seem bothered at all by what happened," said mom, "and she only cried when they gave her shots. She was a real trooper!"

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This article originally appeared on Parents.com

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