Allergies in children

Understanding, diagnosing and treating allergies in children.
By Child magazine

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There has been a dramatic rise in allergic diseases both in South Africa and globally in recent years; so much so that we are finding ourselves in the midst of what we might call an “allergy epidemic” today.
 
This is according to Dr Thulja Trikamjee, a specialist paediatrician and allergologist. Individuals today have a higher risk than ever before of suffering from some form of allergy. According to the Allergy Foundation of South Africa, a baby without any family history of allergies now has a 15% risk of developing an allergic condition within their first few years of life. If one parent has an allergy, then the child’s risk increases to between 40 and 50%. If both parents are allergic, the risk is as great as 60 to 80%. A child who has siblings with allergies also has a significantly increased risk of developing allergies.
 
What can you do to help your children?
There are ways to lower the risks of your children developing allergies, but allergy prevention should begin when a mother first finds out that she is pregnant. “As the foetus develops, so too does the baby’s immune system. As the baby develops its own antibodies, exposure to potential allergens at this time can assist in preventing them from developing allergies to these substances,” Trikamjee observes. “Most mothers don’t know that when they eat something, tiny food proteins pass through the umbilical cord to the foetus. As this continues through pregnancy, the baby’s immune system starts to recognise these food proteins. This process continues after birth and after the baby starts eating solids.”
 
What foods can cause an allergic reaction?
People can potentially have an allergic reaction to any foods. There are, however, some main allergenic food groups that cause the majority of reactions in children. These include cow’s milk, hen’s eggs, peanuts, tree nuts, wheat, soy and seafood.
 
How do I know that my child is allergic?
An allergic reaction can present with many symptoms. Often, when it comes to food, the reaction will occur the first time your child eats a specific food.
 
Symptoms to look out for include:
 
  • hives
  • stomach upset
  • vomiting
  • diarrhoea or bloody stools
  • difficulty breathing
  • change in consciousness or activity
 
Can children outgrow their allergies?
Most children outgrow their allergies. For example, a large proportion of children outgrow milk, egg and many nut allergies. An allergy specialist will be able to guide you through the process to the point where your child is able to safely overcome their food allergy.
 
“So, as much as food allergies are on the rise, so too is our knowledge on this subject, and the management and treatment of food allergies has drastically improved over the last decade. Gone are the days when children have to spend their lives in fear of accidental exposure to an allergic food or substance,” concludes Trikamjee.
 
Diagnosing and testing for food allergies
An allergologist will take a history of your child’s diet and the foods that have caused any reaction. Based on this, they will decide on targeted allergy tests that should be done to determine exactly which foods are causing the allergic reaction.
 
Tests for allergies can either be performed on the skin, or by drawing blood.
Skin prick tests: a liquid containing the allergen, or a protein extract is placed on your child’s forearm. The skin is then pierced with a small sterile lancet – this is not a needle that goes through the skin and, therefore, will not draw blood and does not hurt. The doctor will then wait 10 to 15 minutes before analysing the reaction on the skin. This reaction is measured in millimetres and gives an idea of how sensitive your child is to the food substance that was tested.
 
Specific IgE testing: For this test, blood is drawn and sent to a pathology laboratory. Your child’s blood will be exposed to the allergen proteins, and a laboratory analyst with experience in allergy tests will assess how many Immunoglobulin E (IgE) antibodies are reactive to the allergen your child has.
 
Dr Trikamjee practises at Netcare Sunninghill Hospital and is currently a consultant at the University of Cape Town Lung Institute. She is a member of the Allergy Society of South Africa (ALLSA), the American Academy of Asthma, Allergy and Immunology (AAAI), and the only African-elected board member of the European Academy of Allergy and Clinical Immunology (EAACI).

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