NEW YORK (Reuters Health) — Parents of children who are in danger of having a serious allergic reaction to certain foods are urged to have an auto-injector on hand to administer a dose of epinephrine in an emergency, to halt any severe reaction.However, parents are often uncomfortable using the device, a survey shows, even when they’ve been trained to use it.

Food allergy affects up to six percent of children. A severe allergic reaction, or anaphylaxis, is a potentially life-threatening event and appropriate treatment involves injecting epinephrine, available in convenient pre-loaded systems such as EpiPen.

The devices only require a trigger to be activated to administer the injection into the thigh.

“Several studies have described infrequent use of epinephrine in children with recurrent episodes of anaphylaxis,” Dr. Jennifer Kim of Children’s Memorial Hospital, Chicago noted at the American Academy of Asthma, Allergy, and Immunology meeting underway in San Diego.

To determine factors associated with proper use of an EpiPen and parents’ comfort in using the device, Kim and colleagues mailed a survey to 240 parents of children with a doctor-diagnosed food allergy and a prescription for EpiPen.

A total of 121 completed surveys were returned. These racial diverse families were from inner city Chicago. Ninety-one percent of parents reported prior EpiPen training and 18 percent had had to use the EpiPen for a severe allergic reaction in their child in the past. Two-thirds of the children were boys, half were younger than age five, and 40 percent had a history of anaphylaxis.

Sixty-three percent of children had a food allergy to two or more foods; the most commonly reported food allergy was to peanuts and tree nuts — two allergens known to cause serious allergic reactions.

In analysing the survey data, Kim and colleagues found that neither a history of anaphylaxis nor prior EpiPen training correlated significantly with increased parental comfort levels in using the potentially life-saving device. What did matter significantly, Kim said, was what parents knew, and how they felt, about their child’s food allergy.

Parents who were knowledgeable and felt a sense of empowerment over their child’s food allergy and who actually used the EpiPen on their child on a number occasions displayed high levels of comfort in using the device, she explained.

“Empowerment is generally defined as the ongoing capacity of individuals to act on their own behalf to achieve a greater measure of control over their lives,” said Kim.

“Parental sense of empowerment appears to be an important psychological measure that contributes to a higher level of adherence to a treatment” — in the case of food allergy, this includes the use of epinephrine in cases of allergic reactions, Kim noted.

Efforts to increase empowerment in parents of children with food allergy are needed, she added. “We would encourage healthcare providers to continue to ensure that education and training is provided to patients and their families about epinephrine auto-injectors and ways to help parents empower themselves to use these devices need to be explored,” said Kim.