IS IT AN al­lergy?

When it comes to your child’s per­ma­nently runny nose or skin rash, an al­ler­gic re­ac­tion may be the cul­prit

Your Baby & Toddler - - You baby 6 weeks to 12 month - BY PAE­DI­A­TRI­CIAN DR PAUL SINCLAIR

Since the 1960s there has been an ex­plo­sion of al­ler­gic dis­eases, and there are many the­o­ries about why this is hap­pen­ing. But while the ex­perts look into that, it helps to know what al­ler­gies look like and how they work.

HOW DO AL­LER­GIES WORK?

The im­mune sys­tem is de­signed to recog­nise and fight for­eign in­vaders, whether this is a virus, bac­te­ria or even a splin­ter in your child’s foot. Un­for­tu­nately in more and more chil­dren and adults, the im­mune sys­tem recog­nises the for­eign pro­teins that make up peanuts, dust mites, dog dan­der, dairy and other sub­stances as dan­ger­ous. This causes an in­flam­ma­tory re­ac­tion that can re­sult in hives, a runny itchy nose or an acute asthma at­tack with in­flamed nar­rowed air­ways. There are also other parts of the im­mune sys­tem that are trig­gered by th­ese common al­ler­gens or even some chem­i­cals, drugs, preser­va­tives and colourants.

KEEP A LOOK­OUT

Luck­ily, al­ler­gies have spe­cific symp­toms that help us di­ag­nose them for what they are. This is crit­i­cal to en­sure early in­ter­ven­tion and also so that you know which trig­gers to avoid:

Kids with al­ler­gies of­ten have prob­lems with LOW EN­ERGY LEV­ELS, re­lated to high cir­cu­lat­ing his­tamine lev­els and con­se­quent poor sleep qual­ity.

A PER­SIS­TENT OR OF­TEN RE­CUR­RENT CLEAR RUNNY NOSE and snor­ing sug­gest chronic nasal in­flam­ma­tion. Snor­ing is never nor­mal in chil­dren, so al­ways get it checked out.

RUB­BING OF THE EYES OR

NOSE is another sign. So too is a wrin­kle or line across the nose – the clas­sic al­ler­gic crease – caused by rub­bing the nose con­stantly in an up­wards di­rec­tion (the al­ler­gic salute).

AL­LER­GIC SHIN­ERS ap­pear as dark rings un­der the eyes.

SNOR­ING OR PER­SIS­TENT

MOUTH BREATH­ING, which in the long term can af­fect a child’s fa­cial or den­tal struc­ture.

EN­LARGED, OF­TEN IN­FECTED

TON­SILS AS­SO­CI­ATED with mouth breath­ing and a post­nasal drip.

COUGH­ING, par­tic­u­larly if it’s per­sis­tent or noc­tur­nal and some­times as­so­ci­ated with vom­it­ing in younger kids, and when it has been in­duced by ex­er­cise or ac­tiv­ity.

IN­FLAMED, DRY AND ITCHY SKIN most no­tably in the creases be­hind the knees, an­kles and el­bows.

Any re­ac­tion to food­stuffs or con­tact sub­stances (like grass). This could be any­thing from VOM­IT­ING, TO SWELLING OF THE LIPS, A WHEEZE OR A COUGH.

WHAT’S NEXT?

If your child has any of th­ese symp­toms, it may be worth see­ing your doc­tor to find the cause. There are many un­proven meth­ods claim­ing to de­tect un­der­ly­ing al­ler­gies, so it is im­por­tant to un­der­stand that there are re­ally only three proven meth­ods of show­ing un­der­ly­ing al­ler­gies that are done by a health­care pro­fes­sional: a skin prick test, blood tests and skin patch test­ing.

THE COMMON AL­LER­GIC DIS­EASES

If your child has an al­lergy, he’ll prob­a­bly ex­hibit it in one of the fol­low­ing ways:

Also known as al­ler­gic der­mati­tis, this common skin con­di­tion can af­fect small ar­eas all over the body, but in­ter­est­ingly never af­fects the nose. It ap­pears as an in­flamed, red, dry and scaly rash. It’s most of­ten caused by a set of trig­gers and is best treated by us­ing mois­turis­ers and top­i­cal anti-in­flam­ma­to­ries if needed.

HAYFEVER

Prob­a­bly the most common and most per­sis­tent of the al­ler­gic dis­eases, hayfever (or al­ler­gic rhini­tis) is of­ten sea­sonal, par­tic­u­larly in coastal ar­eas, where grass and other pol­lens as well as wind play a big role in the sever­ity of the dis­ease. The clas­sic symp­toms in­clude an itchy nose com­bined with a per­sis­tent clear snot, as well as sniff­ing and snor­ing at night. With hayfever you may also no­tice dark rings un­der your child’s eyes and you may see your child breath­ing with an open mouth and his lower jaw pro­trud­ing. Con­sult your doc­tor for ad­vice on treat­ment.

AL­LER­GIC CON­JUNC­TIVI­TIS

This ac­com­pa­nies hayfever and is typ­i­fied by red, itchy eyes that have a clear wa­tery dis­charge, and is sel­dom painful. In this case nasal steroids help the op­tic symp­toms, but lon­gact­ing an­ti­his­tamine eye drops are the ba­sis of ther­apy, and steroids should al­ways only be given by an oph­thal­mol­o­gist.

ASTHMA

In the past, the thought of asthma con­jured up images of chil­dren on oxy­gen tents spend­ing weeks in hos­pi­tal. But with to­day’s mod­ern de­vices, ex­cel­lent medicine and a bet­ter un­der­stand­ing of asthma – that it is an in­flam­ma­tory dis­ease re­quir­ing reg­u­lar air and an­ti­in­flam­ma­tory ther­apy – means it is seen, and con­se­quently treated as, just another common al­ler­gic dis­ease by a doc­tor.

UR­TICARIA

This rash, which is com­monly re­ferred to as hives, comes up rapidly in the skin fol­low­ing ex­po­sure to, or con­tact with, an al­ler­gen or trig­ger. The rash is de­scribed as weals of raised red, clas­si­cally itchy le­sions that can ap­pear and dis­ap­pear very rapidly. It can pre­cede a more se­ri­ous ana­phy­lac­tic re­ac­tion, but is gen­er­ally a stand­alone rash that re­sponds

to an­ti­his­tamines given orally.

FOOD PRO­TEIN IN­DUCED EN­TE­RO­COL­I­TIS SYN­DROME (ALSO KNOWN AS FPIES)

This is a widely vari­able syn­drome that can af­fect any por­tion of the gas­troin­testi­nal tract. Some chil­dren will ex­pe­ri­ence a tin­gling sen­sa­tion in the mouth and spit out or vomit the of­fend­ing food­stuff, while oth­ers can tol­er­ate the food in the up­per gut but de­velop se­vere dis­com­fort and even bloody di­ar­rhoea from an in­flamed colon.

ANA­PHY­LAXIS

This is the se­vere form of al­ler­gic re­ac­tion that is life threat­en­ing, but is for­tu­nately rare in chil­dren. It can be dif­fi­cult to pre­dict, even in di­ag­nosed al­ler­gic chil­dren who have been tested for

al­ler­gens. If your child has had a pre­vi­ous ana­phy­lac­tic re­ac­tion, or even if there is a con­cern that ana­phy­laxis may oc­cur, you should have an ac­tion plan in place that in­cludes keep­ing an Epipen handy in var­i­ous places – the car, your home, etc. Al­ways let your child’s care­tak­ers know about his al­lergy and how to use the Epipen if nec­es­sary, leave your con­tact de­tails with them and make sure your child car­ries some form of med­i­cal in­for­ma­tion that iden­ti­fies his al­lergy (a Medic Alert bracelet, for in­stance). YB

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