ALLERGIES

What are allergies in children?

Allergies are problems of the immune system. Most allergic reactions happen when the immune system reacts to a ‘false alarm’.

Normally allergies are harmless but when a person has allergens, the body thinks these allergens are harmful. The body then attacks allergens with antibodies. These antibodies are attached to special cells called mast cells. The mast cells then release chemicals causing an allergic reaction.

Who can get allergies ?

The tendency to develop allergies is often hereditary, which means it can be passed down through genes from parents to their kids. But just because you, your partner, or one of your children might have allergies doesn’t mean that all of your kids will definitely get them. And someone usually doesn’t inherit a particular allergy, just the likelihood of having allergies.

Some kids have allergies even if no family member is allergic, and those who are allergic to one thing are likely to be allergic to others.

What are the symptoms of allergies in a child?

An allergic reaction can happen anywhere in the body. This includes the skin, eyes, lining of the stomach, nose, sinuses, throat, and lungs. These are the places where immune system cells are found to fight off germs that are breathed in, swallowed, or come in contact with the skin. Allergic reactions can cause:

  • Stuffy nose, sneezing, itching, or runny nose, and itching in ears or roof of mouth
  • Red, itchy, watery eyes
  • Red, itchy, dry skin
  • Hives or itchy welts
  • Itchy rash
  • Asthma symptoms, such as shortness of breath, coughing, wheezing
  • A severe, life-threatening allergic reaction (anaphylaxis). This can cause trouble breathing, vomiting, diarrhea, low blood pressure, fainting, or death.

What causes allergies in a child?

Many things can trigger allergic reactions. But the most common triggers or allergens are:

  • Tree, grass, and weed pollens
  • Natural rubber latex
  • Molds
  • Dust mites
  • Animal dander, urine, and oil from skin
  • Foods
  • Medicines
  • Feathers
  • Bee stings
  • Pests such as cockroaches and mice

How are allergies diagnosed in a child?

To diagnose an allergy, the healthcare provider will take a complete health history and examine your child. The provider may also do these tests:

  • Skin test. This is the most common allergy test. Skin tests measure if there are IgE antibodies to certain allergens (like foods, pollens, or animal dander). A small amount of diluted allergen is placed on the skin. The area is pricked or scratched. If a person is allergic to the allergen, a small raised bump (like a mosquito bite) appears after about 15 minutes. Testing for many allergens may be done at the same time. An allergist may also do an intradermal test. In this test, a small amount of allergen is injected just under the skin. This type of skin testing is more sensitive than prick or scratch testing. Skin test results are available right after the testing is done.
  • Blood test. Blood tests for allergies measure IgE antibodies to certain allergens in the blood. The testing that is most often used is called RAST (radioallergosorbent test). Blood tests may be used when skin tests can’t be done. For example, in people with certain skin conditions. Or people with a very recent severe allergic reaction. A positive blood test does not always mean that you have a certain allergy. Any positive blood test needs to be interpreted by a healthcare provider who is familiar with the tests and knows your child’s health history. These tests take longer to get results. They may cost more than other allergy tests.
  • Challenge test. This test is supervised by an allergist. A very small amount of the allergen is given to the child by mouth. Or it is breathed in. Only a challenge test can figure out how severe an allergy is. Skin or blood test reactions only tell the likelihood of having any type of reaction, not what that reaction will be.

Any positive test needs to be explained by a healthcare provider who is familiar with the test and your child’s health history.

How Are Allergies Treated?

There’s no cure for allergies, but symptoms can be managed. The best way to cope with them is to avoid the allergens. That means that parents must educate their kids early and often, not only about the allergy itself, but also about the reactions they can have if they consume or come into contact with the allergen.

Telling all caregivers (childcare staff, teachers, family members, parents of your child’s friends, etc.) about your child’s allergy is also important.

If avoiding environmental allergens isn’t possible or doesn’t help, doctors might prescribe medicines, including antihistamines, eye drops, and nasal sprays. (Many of these also are available without a prescription.)

In some cases, doctors recommend allergy shots (immunotherapy) to help desensitize a person to an allergen. But allergy shots are only helpful for allergens such as dust, mold, pollens, animals, and insect stings. They’re not used for food allergies.

Airborne Allergies

To help kids avoid airborne allergens:

  • Keep family pets out of your child’s bedroom.
  • Remove carpets or rugs from your child’s room (hard floors don’t collect dust as much as carpets do).
  • Don’t hang heavy drapes and get rid of other items that allow dust to build up.
  • Clean when your child is not in the room.
  • Use special covers to seal pillows and mattresses if your child is allergic to dust mites.
  • If your child has a pollen allergy, keep the windows closed when pollen season is at its peak, have your child take a bath or shower and change clothes after being outdoors, and don’t let him or her mow the lawn.
  • Keep kids who are allergic to mold away from damp areas, such as some basements, and keep bathrooms and other mold-prone areas clean and dry.

Food allergies

If a new mother is breast-feeding, 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.

The most common allergies in children are to peanuts and milk; other frequently seen triggers include eggs, fish, shellfish (crab, lobster, crayfish and shrimp), soy, tree nuts (for example, pecans, cashews and walnuts) and wheat. The most severe reactions are typically to peanuts, tree nuts, fish and shellfish — all allergies that can last a lifetime. Children often outgrow allergies to milk, eggs, soy and wheat.

All parents of a child with a food allergy should be aware of the possibility of anaphylaxis — a potentially life-threatening reaction that impairs breathing, causes a sudden drop in blood pressure and can send a body into shock. For that reason, most children with food allergies are prescribed epinephrine (adrenaline), administered with an auto-injector as soon as symptoms develop.

Allergies and school

Your child’s school should be informed of any allergies. If your child has asthma or a severe allergy, give a copy of your child’s action plan to the school nurse or the administrative office. Also, discuss your child’s access to medication, including epinephrine (adrenaline), in case of an emergency.

  • School pets: Furry animals in school may cause problems for allergic children. If your child has allergy or asthma symptoms while at school including coughing, difficulty breathing, a rash, runny nose or sneezing, 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 poor control, so 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 symptoms.
  • Dust irritation: At school, children with allergic problems may need to sit away from the blackboard to avoid irritation from chalk dust.

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