Managing Childhood Allergies
by Kua Chong Han, Patient Care Pharmacist
We often hear the older generation commenting on children’s immunity and how it feels like kids these days are more prone to falling sick. Well, as much as we wish it isn’t true, it is.
During early childhood, exposure to foreign invaders like bacteria will train the body to suppress allergies.
Unfortunately, living in cleaner indoor environments and getting antibiotics and vaccines earlier give children a lower chance of developing tolerance to foreign substances. This increases the occurrence of childhood allergies.
How does an allergic reaction develop?
The allergen causes the body’s immune system to produce lgE antibodies, a substance that neutralises directly or recruits other components of the immune system to attack the foreign substance. This in turn triggers our body’s allergic reactions.
Symptoms may range from itchy eyes and nose to having breathing difficulties or losing consciousness.
Food allergy, in particular, may manifest conditions like swollen mouth and throat, abdominal cramps, nausea and vomiting, or diarrhoea.
Exercise-related food reaction can happen after a combination of exercise and the consumption of specific types of food within a time frame. However, this reaction does not occur with food or exercise separately.
Airborne allergens can cause sneezing, coughing, allergic conjunctivitis or allergic rhinitis (hay fever). They can also lead to the shortness of breath and wheezing, which may worsen to asthma.
Childhood asthma is likely to be of allergic origin. Rarely, a severe form of life-threatening reaction (i.e. anaphylaxis) may occur.
In such cases, the person may experience a loss in consciousness, breathing difficulties, swelling, hives, low blood pressure and dizziness. When any of these happens, it is an emergency and immediate medical attention is required.
Types of allergens
Common allergens include airborne allergens from pets, mites, cockroaches, mould and pollen.
Food allergens are mainly from milk, eggs, shellfish and seafood, peanuts and wheat. Tree nuts (e.g. cashew nuts, walnuts) and peanuts are usually the cause in fatal and near-fatal cases of allergies.
An individual allergic to certain substances may also have an increased risk of developing another allergy – this is known as cross-reactivity. Other allergens include insect bites, chemicals and medications.
Some allergens can be hard to identify, and will require a doctor to perform one of the following tests.
Skin prick test
A small amount of the tested allergen is pricked onto or injected into the skin to detect if small reddish lumps appear, usually within 15 minutes.
Though more expensive and slightly slower, a blood test may be required in serious or widespread allergic response.
In diagnosing food allergy, an elimination diet can be used to rule out specific foods. Specific foods are eliminated from the diet each time for four to seven days progressively until the symptoms resolve.
The patient may be encouraged to keep an allergy diary, including the occurrence of allergic reactions, activities and the use of chemicals or products on a daily basis.
Treating childhood allergies
There is no real cure for allergies, but there are ways to relieve the symptoms and reduce recurrence in children.
Mild cases of skin allergy can be relieved with non-perfumed emollients. Medications like antihistamines and steroids, and other immune-modulating medications may also be given.
In severe allergic reactions, an adrenaline injection may be given and the child will be monitored in a medical setting. Thereafter, the child should wear an allergy alert bracelet to ensure prompt treatment if he or she encounters the same problem.
If the child is unable to avoid the allergens, immunotherapy may be used to desensitise the child. Immunotherapy is performed by giving the child monthly doses of allergens.
How to prevent allergic reactions
Parents of children with airborne allergies can do the following to prevent the next allergic reaction.
- Keep pets out of the child’s room
- Clean rooms frequently
- Remove carpets, rugs or items that accumulate dust
- Use special covers that seal pillows and mattresses, or have an anti-dust mite solution
- Keep bathrooms clean and dry
- Use a dehumidifier to keep the room dry
Some allergies resolve with age. Parents can start reducing their child’s risk of developing an allergy even before he/she is born.
Women should avoid breathing in smoke or smoking during pregnancy. Breastfeeding for the first four to six months from the child’s birth is also advisable.
If breastfeeding is not possible, partially hydrolysed or hypoallergenic formulas can be used. Soya milk can be offered to infants allergic to cow’s milk.