Intravenous immunoglobulin (commonly referred to as IVIg) is used to treat many immune deficiency disorders and inflammatory conditions. 

An IVIg infusion is a common and relatively safe procedure. IVIg is prepared from blood donated by thousands of healthy people to make a concentrated collection of antibodies (immunoglobulins). All IVIg products are tested to protect patients from infection. The risk of infection from IVIg is exceptionally low. IVIg products also undergo at least two processes to destroy viruses. 

IVIg is slowly administered directly into your child’s vein through a drip (intravenous or IV therapy). 

Why does my child need IVIg?

There are two main reasons children are prescribed IVIg treatment:

• Immune replacement therapy: IVIg given to babies or children who do not make enough of their own antibodies to fight infections. These infections may be present from birth or develop as a result of other diseases or treatments, e.g. chemotherapy. IVIg may help reduce the chance of developing an infection and will likely need to be given repeatedly.
• Immunomodulation therapy: Prescribed when the immune system attacks the body's normal cells. IVIg may help to regulate the immune system to improve symptoms.

If your child needs IVIg, your doctor will discuss with you: 

• why they think your child needs IVIg
• the likely benefits
  
• any risks
• any alternative treatment options
• Any special considerations before the infusion starts, e.g. making sure your child is well hydrated (has been drinking fluids) on the day of the infusion, or taking a medication before the infusion to prevent side effects.

Giving consent

You will be asked to sign a consent form to allow your child to have an IVIg infusion. You can ask questions and discuss any concerns you may have with the doctor before you agree to your child being given IVIg. 

You will also be asked for your consent (oral or written) to the collection, retention and use of your child's personal information and clinical data. The clinical staff at the Australian Red Cross Lifeblood, who authorise IVIg, require this information to ensure:

• the correct type of IVIg product is authorised for the correct medical condition
  
• the correct dose
• the IVIg is shipped to the correct hospital. 
  

What to expect with an IVIg infusion

IVIg is slowly administered directly into your child’s vein through a drip (intravenous or IV therapy). 

Unless your child already has one, an IV will be inserted into a vein, which may cause some brief pain and discomfort. If your child is distressed or uncomfortable, you can try distracting them using some of these techniques.

Before the IVIg infusion begins, two nurses will check that the details on your child's wristband (full name and date of birth) exactly match those on each IVIg bottle. You may be asked to participate in this check. This will happen each time your child receives an IVIg infusion, even if your they need many.

The infusion will take a number of hours to administer. A pump will be used to ensure it is delivered over the correct time frame. 

Most children feel comfortable and no different to usual during their IVIg infusion; however, they may become bored or restless. If your child is going into hospital to have an infusion as a day procedure, it is a good idea to bring in a smartphone, tablet, MP3 player or books to keep your child occupied.

Your child will be carefully monitored during their infusion. Nurses will frequently check their temperature, heart rate, breathing rate and blood pressure.

What are the risks?

It is not uncommon to experience mild side effects with IVIg. are a number of possible side effects associated with IVIg. Some of these may be reduced by ensuring your child is well hydrated prior to the infusion. Sude effects can happen during an infusion or up to three days after an infusion, and may include:

• fever or chills
• tiredness
• mild headache
• nausea or vomiting
• stomach or back pain
• rash
• racing heart rate
• dizziness.

Please let your nurse know if your child feels unwell or you are concerned. These side effects can usually be easily managed.

Very rarely, more serious side effects can occur. These can include:

• very severe headache with nausea, vomiting and fever (this can happen up to three days after the infusion)
• shortness of breath or wheezing
• tongue or throat swelling
• chest pain.

These should be reported to a doctor or nurse immediately. 

If your child experiences side effects that means they cannot continue their normal activities (e.g. go to school), please contact your treating team/clinician or present to your local emergency department.

Key points to remember

• Your doctor will speak with you about why your child needs an IVIg infusion and ask for your consent before the procedure. 
  
• IVIg is carefully tested so that the risk of getting an infection or virus is very small.
  
• Nursing staff will monitor your child carefully during the IVIg infusion.
  
• Most children feel comfortable and no different at all during the infusion. Some children experience mild side effects and very rarely, more serious side effects occur. 
  
• Let nursing staff know if your child starts to feel unwell during the infusion or, if they become unwell during the days after the infusion please contact your treating team/clincian or present to your local emergency department. 
  

For more information

• Kids Health Info fact sheet: Reducing your child's discomfort during procedures
• Kids Health Info fact sheet: Blood product transfusions
• Australian Red Cross Blood Service: My transfusion
  
• Victorian Department of Health: Blood Matters Program (includes transfusion information in languages other than English)
  

Developed by The Royal Children's Hospital Blood Management committee. We acknowledge the input of RCH consumers and carers.

Reviewed March 2024.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.