Tame Your Child’s Al­ler­gies Y

Here’s ev­ery­thing you need to know about man­ag­ing kids’ al­ler­gic re­ac­tions

Women's Weekly (Malaysia) - - Smart Parenting -

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.


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.


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.

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