Tame Your Child’s Allergies Y
Here’s everything you need to know about managing kids’ allergic reactions
ou don’t just have to put up with your child’s allergies. If you’re not getting good relief with overthe-counter medicines, or you’ve experienced a severe reaction, it’s time to get a diagnosis.
When a person’s immune system reacts to a substance as though it’s harmful, an allergic reaction takes place. Childhood allergies were thrown into the spotlight last year when a three-year-old toddler had a severe allergic reaction to peanuts eaten by other passengers on board a Singapore Airlines flight. The boy experienced vomiting, swollen eyes, and was unable to speak properly.
“Food that mainly causes food allergy are cow's milk, egg white, tree nuts, shell fish and these are onsidered the top 90 per cent of food causing allergies,” says Dr Amir Hamzah Dato’ Abdul Latiff, Consultant Clinical Immunologist/ Allergist (Adults & Paediatrics) and Consultant Paediatrician at Pantai Hospital Kuala Lumpur.
“There is no substantial data on allergic diseases in Malaysia, but in general the number would have increased by 30 to 50 per cent.”
Here’s what to do if you suspect that your child has an allergy.
1 Consult Your Paediatrician
It’s important to see your child’s doctor, who may recommend allergy testing to get to the root of the problem and tailor treatment to your child’s needs. “It has become a norm to think all allergy-like symptoms are due to an allergy, when in reality there is a like-hood of no allergic disease present,” says Dr Amir.
Before you see your doctor, start keeping a record of your symptoms, noting when they
occur and what, if anything, seems to help. Note down answers to questions like: Do your child’s symptoms occur when you are in the house as well as outside? Does he suffer more at night or during the day? Does he wake up with symptoms in the morning? Does a particular food or drink tend to bring on his symptoms?
An allergic reaction to food can affect different parts of the body. Common symptoms include itchy, watering eyes, sneezing, a stuffy or runny nose, or an itchy, swollen mouth or throat. Allergies that affect the digestive system cause stomach pains, vomiting and diarrhoea, and may show up on the skin as rashes, hives or atopic dermatitis. Allergens may afflict the lungs, causing wheezing, coughing or asthma, or the central nervous system, leading to headaches, irritability, fatigue and convulsions. 2 Get Tested Allergy tests are used to detect allergies to dustmites, animal dander, mould spores, pollens, certain foods, some insect stings, chemicals and even certain medications. “In Malaysia, we offer skin test (mostly skin prick test) and IgE blood test – radioallergosorbent test (RAST) or ImmunoCAP,” says Dr Kee Sze Ying, Consultant Paediatrician at Columbia Asia Hospital, Setapak. The decision to do these tests would be left up to the specialist. Management of allergies requires identification of the exact allergens, lifestyle management to avoid these allergens, and carrying rescue medications in case of a dangerous reaction.
Food allergies should not be confused with food intolerances. A food allergy occurs when the immune system reacts to a harmless food. A food intolerance occurs when the body has a chemical reaction to eating a particular food or drink. It’s best to be tested, because an intolerance won’t show up in an allergy test. Also, food intolerance symptoms (headaches, diarrhoea, hives) generally take longer to develop than those of food allergies.
ALLERGY TESTS INCLUDE:
SKIN-PRICK TEST This involves putting drops of suspected allergens on the forearm and sometimes the back, then lightly pricking the skin through the drop with a needle. Sensitivity to a particular allergen can be identified by an itchy, red, raised wheal (also called a lesion).
BLOOD TESTS These are used for allergenspecific IgE antibodies. Blood testing is a useful alternative when skin-prick testing isn’t possible.
SERIAL TITRATION TEST This type of skin-testing technique helps determine the immunotherapy dosage needed for your child.
ELIMINATION DIETS AND CHALLENGE TESTING
An elimination diet is usually done over a few weeks and involves avoiding foods identified as common causes of food allergy. If symptoms improve, foods are added one at a time, under controlled conditions, to identify dietary triggers. 3 Start Treatment There are three main types of allergy treatment – non-medicated formulas, medication and immunotherapy. Your doctor or allergist will recommend the best medicines for you, and give you advice on dosage and how often you should use them, while eliminating or minimising any side effects. ALLERGEN MINIMISATION OR AVOIDANCE This is an important strategy for preventing allergic reactions and reducing symptoms. Some allergens like pollen or dustmites are more difficult to avoid than others. However, if your child is allergic to pet dander, it might be best for him to minimise contact with stray animals, or even the family pet. Likewise, a shellfish allergy is also best avoided by making sure your child does not consume seafood that triggers his allergy.
“Parents should be educated on the signs of severe allergy (such as anaphylaxis, which is potentially life threatening) and trained to administer emergency life-saving medication, such as adrenalin (EpiPen) and seek help immediately,” Dr Kee adds. NON-MEDICATED FORMULAS Basic treatments to soothe minor symptoms are available from most chemists and some supermarkets, and include saline nasal sprays or rinses that you can use as needed to treat mild hayfever symptoms like a stuffy nose. MEDICATION Decongestants and antihistamines are the most common allergy medications. They help to reduce sneezing and itching, and ease the symptoms of a stuffy or runny nose. Other medications like corticosteroids work by preventing the inflammation which leads to the uncomfortable symptoms of allergy. IMMUNOTHERAPY Immunotherapy may be recommended if your child has severe and persistent allergies that can’t be controlled with other methods. The treatment involves being given occasional small doses of the allergen – either as an injection, or as drops or tablets under the tongue – over the course of several years. The aim of treatment is to help your kid’s body get used to the allergen, so it doesn’t react to it so severely. This won’t necessary cure the allergy, but it will reduce the severity of reactions, and means your child can take less medication.