Allergies in Children
Allergy is a ‘hypersensitive’ reaction or exaggerated sensitivity to substances which are normally tolerated (allergens) such as food, animals, medicines, or pollens.
There is sometime confusion as to the difference between food intolerance and allergy. Food intolerance tends to produce less dramatic affects and is more likely to be grown out of whilst allergy can often be life threatening.
How common are allergies?
18 million people in the United States are estimated to have an allergy, 3 million of which have severe enough symptoms to need to see a specialist allergist.
Children are particularly affected with as many as 40,000 born each year developing an allergy or allergy related condition such as asthma, eczema, rhinitis (including hayfever), food allergy, drug allergy, allergy to stings, urticaria, angiodema and anaphylaxis.
At least 1 in 50 of all children are allergic to nuts. All allergies are on the increase particularly in the developed, western world but there is no conclusive evidence to confirm why this should be. At least 10% of children and young adults with an allergy have more than one allergic disorder.
What are the most likely foods to cause allergies?
Milk, eggs, peanuts, tree nuts, sesame, fish, crustaceans, fruits and soy are the most common food triggers which cause 90% of all allergic reactions. However, any food can cause a reaction and it need only be a minute trace that can cause a life-threatening reaction. Some people can react to skin contact or even the smell of a food.
Who is most likely to suffer with allergies?
Food allergies are most common in the first 3 years of life. They are more common in those children with a family history of food allergies, or in those with a history of asthma, eczema, allergy or hayfever.
Food allergies are also more common in babies who are exposed to allergic foods at an early age. About 90% of food allergies in babies and children are to cow’s milk, soy, egg, peanuts or wheat.
Most children with food allergies have an allergy to one food only, although there is evidence to suggest multiple allergies are on the increase. A large proportion of those allergic to cow’s milk are also allergic to soy.
Usually the symptoms of food allergy are mild but can be one of a number. Gastriointesinal symptoms are the easiest to recognise and these include loose stools, excess gas, diarrhea, nausea, or vomiting. Sometimes there may be streaks of blood or mucus in the stools, especially with allergies to cow’s milk. Sometimes allergies can cause constipation.
Other symptoms include hives, ear infections, stuffy noses, runny noses, watery or red eyes, wheezing, asthma flare-ups and eczema.
There may be a mild tingling or itching in the mouth, or a localised rash. These are not serious and should be treated with oral anti-histamines but in some cases the reactions can get worse over time.
What is Anaphylaxis?
More severe symptoms can cause Anaphylaxis which is a severe allergic reaction when the whole body is affected often within minutes of being exposed to the allergen but it can sometimes be delayed hours.
Symptoms of anaphylaxis could include one or more of the following but it is very unlikely to include all:
Generalised flushing of the skin
Nettle rash (hives) anywhere on the body
Sense of impending doom
Swelling of throat and mouth
Difficulty in swallowing, speaking or breathing
Alterations in heart rate
Abdominal pain, nausea and vomiting
Sudden feeling of weakness (drop in blood pressure)
Collapse and unconsciousness
What is the treatment for a severe reaction?
Pre-loaded adrenaline injection kits are available on prescription for those identified to be at risk. They are available in two strengths, adult and junior, and are normally prescribed following tests done by an Allergist. It is vital to follow the guidance given by medical advisors but this would normally include administration of oral anti-histamines, and then if symptoms do not subside and are severe as listed above, the administration of adrenaline. The patient should be taken to hospital for observation as it maybe necessary to administer further adrenaline or steroids.
Testing for Allergies
To determine the cause of an allergy an allergist will almost certainly perform skin tests for the most common environmental and food allergens. Although children under 2 can be tested results tend to more reliable once they are over this age.
Skin tests can both be performed by dropping a purified form of the allergen onto the skin and then pinched with a small pricking device or a small amount of the allergen is injected just under the skin. The test can sting a little but is not painful.
After approximately 15 minutes if a lump surrounded by a reddish area appears at the injection site, the test is positive. The size of the reaction is measured and recorded so that subsequent tests can be measured against this. However, reactions can vary from time to time and any discrepancies over time do not necessarily mean that the sensitivity to the allergen has altered.
Treatment of Allergies
Although there is no cure for allergies as yet, it is possible to relieve the symptoms. The only real way of coping on a day to day basis is to ensure the exposure to the known allergens is reduced (in the case of house dust mite, pollens etc for example) or best avoided especially in the case of life threatening allergies. It is important that parents and guardians educate their children early and often, not only about the allergy itself but also about what reaction they will have if they consume or come into contact with the allergen. Communication with carers, teachers, other parents, and other family members, anyone who may take care of the child is vital. Everyone should know how to recognise a reaction and how to deal with it should it occur.
There are many different phases in coping with an allergy and whilst the child is very young it falls upon parents and carers to take responsibility. However, as the child gets older they should gradually learn to cope with their allergies in a variety of different situations so that as they reach adolescence and adulthood they are confident to mange it themselves.
Medication is available to help symptoms of allergies and anti-histamines maybe prescribed or purchased over the counter as well as inhaled or nasal spray steroids. Any prescribed medicines including adrenaline injections should be carried at all times. Source-KidsAware.