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Children's Allergies

Children's Allergies

An estimated 50 million Americans have some type of allergy. In most people, allergies first appear during infancy or childhood. Allergic disorders rank first among children’s chronic diseases.

Any child may become allergic, but children from families with a history of allergy are more likely to be allergic. Children may inherit the tendency to become allergic from their parents, but only some of them will develop an active allergic disease. Children’s allergies can show up in different ways including:
  • Skin rashes (atopic dermatitis or eczema)
  • Asthma
  • Allergic rhinitis (also known as "hay fever")
  • Food allergies
Allergic rhinitis is the most common of all childhood allergies. It causes runny, itchy nose, sneezing, postnasal drip and nasal congestion (blockage). The child with allergies may also have itchy, watery and red eyes and chronic ear problems. Despite its common name, "hay fever", these allergy problems can occur at any time of the year -- seasonally or year-round, and do not cause fever.

The following are just a few points on potential problems for children with allergic rhinitis. Early identification of allergy problems in your child will improve their quality of life, decrease missed school days and keep you at work.

Nasal congestion

Allergies are the most common cause of chronic nasal congestion in children. Sometimes a child's nose is congested (blocked) to the point that he or she breathes through the mouth, especially while sleeping. This may also cause the child to not get a restful night’s sleep and then be tired the next day. If the congestion and mouth breathing are left untreated, they can cause abnormal changes the way the teeth and the bones of the face grow. Early treatment of the allergies causing the nasal congestion may prevent these problems.

Allergy and ear infections

Allergies lead to inflammation in the ear and may cause fluid accumulation that can promote ear infections and decreased hearing. If this happens when the child is learning to talk, poor speech development may result. Allergies can cause earaches as well as ear itching, popping and fullness ("stopped up ears"). Anyone with these symptoms should be considered for testing and treatment.

Allergies at school

Fall means going back to school. For children with allergies, that may mean absences due to problems related to allergic rhinitis. The following are suggestions for helping the allergic child and problems to look for so that allergy can be properly diagnosed and treated.

Allergy or asthma action plan for emergencies

If your child has asthma or severe allergy, provide your child's action plan to the school nurse or administrative office. Also discuss your child's access to medication in case of an emergency.
  • School pets: Furry animals in school may cause problems for allergic children. If your child has more problems while at school, it could be the class pet.
  • Asthma and physical education: Physical education and sports are a big part of the school day for many children. Having asthma does not mean eliminating these activities. Children with asthma and other allergic diseases should be able to participate in any sport the child chooses, provided the doctor's advice is followed. Asthma symptoms during exercise may indicate poorly control. Be sure that your child is taking controller asthma medications on a regular basis. Often medication administered by an inhaler is prescribed before exercise to control their symptoms.
  • Dust irritation: At school, children with allergic problems may need to sit away from the blackboards to avoid irritation from chalk dust.
Food allergic infants

The best food for a newborn is mother's milk. However, some especially sensitive babies can have allergic reactions to foods their mothers eat. Babies can be tested for allergies. Eliminating these foods from the mother's diet may provide relief for the child.

As infants grow, their nutritional needs continue to change and your physician will advise when it is time for solid foods.

Cow's milk can cause allergies in children, but it is a good source of protein and calcium. Milk should be eliminated from a child's diet only if you are sure the child is allergic to it. Parents may suspect allergy if the child exhibits hives after the ingestion of milk or other dairy products. If you suspect your child may be allergic to milk, consult your physician, who may conduct appropriate tests to verify the allergy and prescribe the proper course of treatment for children allergies.

Just remember:
  • Allergies in children are common.
  • Many childhood problems are made worse by allergies.
  • Treatment of your child's allergies will make them happier and healthier.

Food Allergies in Children

About one in 13 kids under age 18 have at least one food allergy. Almost 40 percent of these youngsters have had a severe allergic reaction after consuming a food. Children with food allergy also have higher rates of asthma as well as skin and respiratory allergies.

Two things must happen before a child has an allergic reaction to a food: The child must have consumed the food at least once before or have been exposed to it, and the child's immune system must produce antibodies to proteins in that specific food. This immune response is what helps allergists differentiate a life-threatening food allergy from food intolerance.

Common Food Allergies in Children

The most common food allergies in children are caused by only a few foods, with peanuts, and cows milk leading the list. Other culprits include eggs, tree nuts, soy, fish, shellfish and wheat. The most severe food reactions are caused by peanuts, tree nuts, fish, and shellfish, allergies that tend to last a lifetime. Kids often outgrow allergies to wheat, eggs, soy, and cows milk, however.

Signs and Symptoms of Food Allergy

An allergic reaction to a food usually occurs within minutes to an hour.These are the most common signs and symptoms of food allergy:
  • skin: hives, itching, rash, swelling of the lips, tongue, face
  • digestive tract: nausea, vomiting, diarrhea, abdominal pain
  • respiratory: wheezing, congestion, shortness of breath, difficulty breathing due to swelling of the throat
  • cardiovascular: drop in blood pressure, causing dizziness, lightheadedness
Anaphylaxis, the most severe allergic response, is a medical emergency. Swelling of the throat prevents breathing and swallowing, the heart rate rises and blood pressure drops suddenly. If your child has been prescribed an epinephrine (adrenalin) auto injector, it should be with them at all times and used immediately at the first sign of an anaphylactic reaction and call 911 instantaneously. A second dose of epinephrine should always be on hand in case it is needed.

Diagnosis and Treatment

If a food allergy is suspected, we will collect a complete medical history and perform a physical exam of your child. Be prepared with a complete list of foods the child consumed before the reaction as well as the signs, symptoms, severity and length of the reaction. Again, this can help diagnose actual food allergy from food intolerance.

An allergy skin test can help determine which foods caused a reaction in your child. A small amount of food extract is applied to the skin on the arm or back. The appearance of a red, itchy bump (or wheal) within 15 minutes may suggest an allergy. Blood tests may also help indicate an allergy exists. Any positive food allergy test can be wrong as much as 90 percent of the time. The most important part of the evaluation is talking to your allergist, who is skilled in making a correct diagnosis, before testing is done. Allergy testing only confirms the history.

There is no cure for food allergies. The only treatment is avoiding foods that cause reactions in your child. Your allergist will prescribe an epinephrine auto-injector to be used immediately if your child has a severe allergic reaction. Always carry the epinephrine auto-injector and use it at the first sign of severe allergic reaction. After epinephrine is injected, call 911.

Living with Food Allergy

Keeping a child with food allergies safe is challenging and stressful. Parents must search food labels for ingredients that can cause reactions in their child; notify family, friends, schools, and restaurants of their childs allergy; and always be prepared for an emergency. An allergist can provide you with tips and tools to help your child stay safe and healthy.

Allergy Testing in Children and Infants

Few young people like getting a test or going to the doctor. When an allergy is suspected in a child, both of these stressful tasks are combined and can cause quite a bit of dreadfor parents and children alike.

Knowing what to expect when you take your child for an allergy test may lessen appointment-day anxiety. Below is information about the common methods allergists use to test infants and children for allergies. Use it as a reference to prepare youngsters for a visit to the allergist.

When to Schedule an Allergy Test?

Allergies in infants and children are common. In fact, allergy-related disorders are among the leading chronic diseases diagnosed in children. According to one study, 4 percent to 6 percent of children have food allergies, 8 percent to 10 percent have asthma, and 15 percent to 25 percent have allergic rhinitis (hay fever). Children with allergies miss hundreds of thousands of school days every year.

For infants and children experiencing the following symptoms or conditions, an allergy test may determine if the problem is caused by specific allergens:
  • Rhinitis
  • Asthma
  • Food, insect sting, or medication reaction
  • Skin rashes (atopic dermatitis or eczema)
Other indicators of an allergy can be cold-like symptoms that last for more than a week and occur around the same time every year, as well as coughing and wheezing, especially at night, which might be allergic asthma caused by an indoor allergen.

What Allergy Testing Methods Are Used?

Parents and caretakers who suspect that a child has an allergy can come in for a consultation. The diagnostic process, which usually takes place in the allergists office, typically involves taking the childs detailed medical history and the family history of allergy or asthma, a physical exam, and allergy sensitivity testing.

Skin tests. Immediate-type hypersensitivity skin tests are useful for detecting allergies to airborne particles, foods, insect stings, penicillin, and other substances. Here are the most common, least expensive types of allergy tests used for allergy testing in children:

Percutaneous and intradermal skin tests. Skin tests are administered by applying a diluted allergen to a prick or a scratch in the top layer of the skin (the percutaneous method) or by using a 26- to 30-gauge needle to inject the diluted allergen into the skin (the intradermal method). Both are considered extremely safe and relatively accurate. Percutaneous skin testing is rarely conducted on infants younger than 6 months old, but there is otherwise no age limit.

The accuracy of both tests can be undermined if children are on certain medications such as antihistamines, antidepressants, and high-dose, long-term steroids so the use of these drugs should be curtailed well before appointment day. Asthma medications or short bursts of oral steroids will not affect the results. According to the National Heart Blood and Lung Institute, selected patients with asthma should undergo skin or blood allergy tests to better understand how allergens are affecting their disease and learn how to avoid specific substances, such as dust mites or pet dander, that worsen symptoms.

After either type of test is administered, the area of the skin is observed for about 15 minutes to see if a reaction flare develops. A wheala raised, red, itchy bumpindicates the presence of the allergy antibody when the child comes in contact with specific allergens. The larger the wheal is, the greater the sensitivity.

Blood (in vitro) tests. Another way to perform allergy testing in children is through a blood test, such as a radio allergosorbent test, which is used when skin tests are hard to administer (for instance, if the child is unable to stop taking medication that would obscure the wheal and flare results). This and other similar tests may be less sensitive than skin tests for detecting food allergies, but samer in some situations.

Elimination diet tests. For children with suspected food allergies, we may recommend a week-long diet that eliminates and isolates certain foods suspected of causing a reaction. Common culprits for food allergies are milk, soy, eggs, peanut, wheat, tree nuts, or shellfish. The downside to this approach is that such diets may be hard for children and parents to follow. They also may produce inaccurate or unclear results because of the many foods allergens disguised in packaged and processed foods.

For young children, an allergy test can be a little scary, but helping them understand what to expect can go a long way to reducing their fears.