Fostering a Child With Allergies and Anaphylaxis

Somewhere in the paperwork before a child moves in, you read the word anaphylaxis, and your stomach drops. You are being handed a plastic tube of adrenaline and asked to work out, in under a minute, whether a child needs it. Most people’s first thought is some version of: I am not qualified for this. You don’t need to be. What you need is a short list of actions, learned properly, and a team behind you who have done it before.

Please note: this is general information about allergies in foster care, not medical advice about any individual child. Guidance and figures here are correct as at October 2026 and follow NHS and Resuscitation Council UK advice. Always follow the written allergy action plan the child’s clinician has given you, and in an emergency call 999. See the NHS page on anaphylaxis.

What an allergy actually is

An allergy is the immune system treating something harmless as an attacker. For most children the something is a food, but stings, pet dander, dust mites, pollen, latex and some medicines all do it too. Reactions run from itchy lips and a blotchy rash up to anaphylaxis, where the airway swells or blood pressure drops and the child needs adrenaline fast.

Here is the most useful sentence on this page: a mild reaction last time tells you very little about the next one. Carers who have watched a child come up in hives and settle with an antihistamine can talk themselves into waiting. Severity is not a ladder a child climbs one rung at a time.

The numbers are less frightening than the word sounds. Around 4% of preschool children and 2.4% of school-age children in the UK have a food allergy (Turner and colleagues, Lancet Public Health, 2024). Hospital admissions for anaphylaxis roughly tripled between 1998 and 2018, but deaths from food allergy stayed at about ten a year nationally. Children get to hospital, and they come home.

What you should have in your hand before the child arrives

Ask for this at the planning meeting.

• the written allergy action plan, signed by the child’s clinician, naming the trigger and the symptoms to act on
• two in-date adrenaline auto-injectors, plus a trainer device you can keep
• the delegated authority section of the placement plan, so you know in writing which medical decisions are yours to make
• the allergy clinic’s name, and whether the child is still under review
• confirmation that the school has the plan, the pens and the written consent

Everyone in the house needs to know, including your own children and anyone who stays over. An allergy kept quiet to spare a child embarrassment is an allergy nobody else can spot.

Anaphylaxis: the part to learn by heart

Learn these now, because you will not be reading a website while it is happening.

The NHS lists the signs as swelling of the throat or tongue, fast or difficult breathing, wheezing or noisy breathing, a tight throat or hoarse voice, trouble swallowing, feeling faint or dizzy, confusion, and skin going cold, pale, grey or blue. On darker skin, look at the palms and soles. A raised itchy rash often appears, but not always, and a child can be in anaphylaxis without a single spot on them.

What to do, in order:

• use the adrenaline pen straight away, into the outer middle of the thigh, through clothing if that is quicker
• call 999 and say the word anaphylaxis
• lie the child down and raise their legs; if breathing is the harder problem, raise their shoulders or sit them up slowly
• if nothing has improved after five minutes, give the second pen
• go to hospital every time, even if they look completely well again

The step people get wrong is the third one. Every instinct says to sit a frightened child upright, or get them on their feet and into the car. Don’t. The NHS says not to stand or walk at any point, even if the child feels better.

The opposite fear is just as common: what if I use the pen and it was nothing? Resuscitation Council UK guidance says, in terms, if in doubt give the adrenaline. A dose given to a child who did not strictly need it is a bad afternoon. A dose withheld from a child who did is something else entirely.

The pens themselves

Two pens, always, on the child and on you. Not one in the kitchen drawer and one in the car. Set a calendar reminder a month before they expire; the pharmacy will not chase you. Order the trainer device and use it, with the child, until the movement is boring.

There is also a needle-free option now. EURneffy, a nasal adrenaline spray, was approved by the MHRA in July 2025 and reached UK prescriptions that October, for anyone weighing 30kg or more. A 1mg version for children aged four and over weighing 15kg to 30kg was approved in June 2026, expected towards the end of this year. Never swap a child from injectors on your own judgement, but it is a fair question for the allergy clinic if needles terrify them.

Food labels, and the part nobody explains

UK law names fourteen allergens that must be declared: celery, cereals containing gluten, crustaceans, eggs, fish, lupin, milk, molluscs, mustard, peanuts, sesame, soybeans, sulphur dioxide and sulphites, and tree nuts.

On a packet, those fourteen are emphasised in the ingredients list, usually in bold. Since 1 October 2021, under what everyone calls Natasha’s Law, food packed on the premises where it is sold carries the same thing, so the sandwich made in the back of the deli at eight in the morning needs a full ingredients list with the allergens picked out. Loose food is different. The tray of pastries and the buffet at the party need no label, but the business still has to tell you if you ask, item by item. So ask, every time, and let a child old enough to ask for themselves get the practice. Read it with our piece on food, mealtimes and fussy eating.

Allergens hide outside food: soap, shampoo, hand cream, some glues, play dough made with wheat flour. Soy sauce usually contains wheat.

One piece of advice you may come across, including in older training material, is to rub a tiny bit of a suspect food on a child’s lip or skin and watch what happens. Do not do this. Whether a child can try a food they have reacted to is a clinical decision for the allergy team, who will tell you if it can be done at home and how.

School, parties and everyone else’s house

Since 1 October 2017, schools in the UK have been allowed to buy spare adrenaline auto-injectors without a prescription. A spare can be used on a pupil whose allergy the school knows about, where there is medical authorisation and written parental consent, and in an exceptional emergency on anyone having a severe reaction. Holding spares is optional, so find out whether the school does, and whether the consent form has actually been signed. Raise it alongside the child’s education plan.

Then there is the rest of life: birthday parties, the sleepover, the away match, the auntie who means well and has made a cake. Teaching a child one sentence to say for themselves, “I’m allergic to peanuts, I can’t have that”, does more over ten years than any amount of vigilance on your part.

Asthma usually travels with allergy

Many children with food allergies also have asthma, and poorly controlled asthma makes a severe reaction more dangerous. Keep the reliever inhaler with the pens. Asthma and Lung UK’s advice for an attack is to sit the child upright, give one puff every thirty to sixty seconds up to ten puffs, using a spacer if they have one, and call 999 if the inhaler is not helping after ten puffs or if you are worried at any point. If the ambulance has not come after ten minutes and things are not improving, repeat the puffs.

You won’t have to do this alone

None of this is knowledge you are expected to arrive with. You get the training before a child with a medical or additional need moves in, your supervising social worker goes through the action plan with you rather than emailing it over, and someone answers the phone at three in the morning when you are in a hospital corridor wondering whether you overreacted. You did not. Ofsted inspected us in July 2025 and rated us Outstanding in all three judgements, and the support carers get is much of the reason.

The pay does not change because a child has an allergy. It is one fixed weekly fee per child while they are with you: 479.50 pounds a week under 11, and 507.50 pounds a week for a child aged 11 or over, as at October 2026. Homes taking children with higher needs are paid more, usually 100 to 200 pounds a week on top.

Plenty of carers wondered whether they could cope. Then it happened, and they found they could.

Frequently asked questions

Can I foster a child with a severe allergy if I have no medical background?

Yes. Almost no foster carer arrives with one. You will be trained on the child’s own action plan before they move in, and shown how to use the auto-injector with a trainer device. The standard is not paramedic. It is a calm adult who knows when to phone, and what to do in the four minutes before somebody arrives.

Am I allowed to give another person’s adrenaline pen?

Yes. Regulation 238 of the Human Medicines Regulations 2012 lets anybody give adrenaline in an emergency to save a life. That covers you, a teacher, a sports coach and a stranger in a park.

We have a dog. Does that rule us out for a child with allergies?

Not by itself. Matching exists for this reason, and most children with allergies react to a food rather than to animals. We talk your household through honestly first, as we do with anyone asking about fostering with pets.

Why go to hospital if the child has recovered?

Because symptoms can come back hours after the first reaction settles. The NHS says most people stay two to twelve hours for observation, some longer. You should also leave with two replacement pens or a prescription.