Toddler

Allergy essentials

Dr Anna Pham
August 5, 2009
Allergy symptoms and prevention

Allergy symptoms and prevention

There seems to be an increasingly level of public awareness around children and allergies, yet not everyone understands the basics, nor how vital allergies can be. Read the basics here.

What is allergy?

Allergy is when the body has a reaction to a protein (e.g. foods, insect stings, pollens) or other substance (e.g. antibiotic)

There are 2 types of allergic reaction:

1. Immediate type: Occurs within 2 hours of a person coming into contact with their allergen. Can be identified using skin tests or blood tests. Can cause anaphylaxis (immediate life threatening reactions).

2. Delayed type: Symptoms occur > 24 hours after exposure. Does not cause anaphylaxis.

What are the common symptoms?         

- Allergic rhinitis: Runny nose, blocked nose, itchy eyes. When caused by seasonal pollens, it is called hay fever. Often caused by allergy to pollen, house dust mite, animal dander.

- Skin problems: Hives. Itch. Worsening eczema.

- Abdominal problems: Tummy pain, vomiting, diarrhoea. 

- Breathing problems: Swelling of tongue, cough, hoarse voice, wheeze

- Anaphylaxis: Indicates a severe allergic reaction. Involves breathing problem, low blood pressure,  collapse, unconsciousness. Can be life threatening.
        
Allergy testing
The most common type of skin test is called a skin prick test. A small drop of protein extract is placed on the skin (forearm) and a small prick is made in the skin through the drop. The size of the swelling (wheal) is measured after 10-15 minutes.
            
A positive test is when the wheal is bigger than 2mm x 2mm.  A significant result (i.e. more likely to cause significant allergy symptoms) occurs when the wheal is > 8mm.

Skin tests are done to confirm a suspected allergy. It is also useful to monitor allergies. Example if the skin test is negative as your child gets older they are probably no longer allergic to that allergen.

Allergy prevention
Although effective treatments are available, there are currently no cures for allergic conditions.  Therefore it makes sense to try to prevent these conditions, if possible, in infants and children.

Below is a summary of what you can do to help prevent allergies.

BEFORE PREGNANCY   
Stop smoking     Yes    

DURING PREGNANCY         
Stop smoking: Yes    
Probiotics: No, await further research studies
Dietary Restrictions: No    
Fish oil Supplements: No    

NEWBORN BABIES         

FEEDING         
Breastfeeding: Yes   
Exclusively for 4-6 months. Continue breastfeeding while introducing new foods if possible
Partial breast-feeding: Supplement with a partially hydrolysed cow’s milk formula (commonly referred to as ‘HA’ formula) for the first 4-6 months. (unless infant is already cow’s milk allergic)
Soy formula: For some forms of cow’s milk allergy (seek medical advice).
Weaning: Avoid introduction of solids until aged 4-6 months. Thereafter, introduce a new food every 2-3 days according to developmental readiness and what the family eats. Introduce one new food at a time so that any reactions can be readily identified.

ALLERGEN AVOIDANCE         
Diet restrictions: No. Introduce foods from 4-6 months  
Removal of pets: No. Only if family member is already allergic to pets
Dust mite avoidance: No. Await further research studies

AVOID ENVIRONMENTAL IRRITANTS: Yes
Avoid exposure to tobacco smoke, unflued  indoor gas heaters, remove sources of mould and dampness where possible.

LATER CHILDHOOD         
Immunotherapy: No. Useful to treat established allergies - await further studies regarding its role in prevention

Allergies, especially food allergies, have great implications for the family. It can lead to significant anxiety, have financial implications, and cause lifestyle restrictions in terms of eating at home or in social circumstances away from the home.

Therefore it is important to make a diagnosis of allergy if it is present. It is also important not to falsely diagnose allergy when it is not present. Talk to your doctor if you have concerns.

Discuss this issue with other parents in our Food Allergy & Intolerance Support forum.

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