What you should know about your kids' allergies

Alex had an allergy/that no one can explain/ It made him wheeze and cough and sneeze/ and moan and groan in pain/A single slight exposure, and he’d start to squawk and squeal/ A second time ensured/ that he’d be barking like a seal/ He’d salivate and slobber /as his nose began to twitch/ He’d squirm and say his body felt /like one gigantic itch.” 

So starts the poem called “Alex’s Allergy” by American writer Kenn Nesbitt who writes humorous poetry for children. But allergies are no laughing matter.  This is because an allergy, defined as an “abnormally high sensitivity to substances,” can have potentially dire consequences. The most severe of these may be anaphylactic shock, or a very serious reaction wherein the swelling of the tongue and breathing tubes can result in blockage of the airways, heart failure, and even death.

“Allergies peak at different times in life,” says Professor Sibylle Koletzko, division head of Pediatric Gastroenterology & Hepatology of the Dr. V. Haunersches Kinderspital, Ludwig Maximilians University in Munich, Germany. She was in Manila recently, and took time out to talk about what mothers need to know about children’s allergies.  

She identifies cow’s milk allergy as one of the most common food allergies that peaks from the time of birth to about six months of age. And while allergic reactions to food are most common, adverse reactions can result with exposure to dust mites, pollen, and dander (scales of dried skin and hair, or feathers similar to dandruff that is shed from the body of animals.) Allergies can manifest as atopic dermatitis, or eczema, that is characterized by itching, with rash formation at the sites of scratching (hives, swelling, itching or redness of the skin); runny nose, sneezing, and lightheadedness or breathing difficulties; or stomach upsets or diarrhea; nausea, vomiting, and stomachaches.

“Over the last decades, we observed a rising prevalence of allergic diseases among children in Europe,” says Professor Koletzco. “In view of this, preventive measures are of increasing importance. The development of both tolerance and sensitization to food allergens, as well as prompt intervention strategies is vital to allergy prevention.”

Why the increase in the incidence of allergies? Professor Koletzko explains the “Hygiene Hypothesis” where a decrease in infectious diseases results in the increase of immune disorders.  “The Hygiene Hypothesis postulates that with improved hygienic conditions, there is less exposure to microbial and infectious agents during early childhood, resulting in a slower maturation of the immune system.” Simply put, this means that being in a too-clean environment isn’t good at all. In an overly antiseptic environment, the immune system does not have enough practice fighting bacteria, viruses, and other agents. The result is that it over-reacts when exposed to these.  And thus, it is good for overly protective parents to keep in mind that a little dirt does not hurt anyone. In fact, it can be a good thing.

Family history is major one factor to consider in determining your child’s predisposition to certain allergies. If one parent has an allergic disease, a child will have a 20-percent risk to the same allergy. If both parents are prone to allergies, the risk is 40 percent to their child. (The risk for the child rises to 75 percent if both parents suffer from the same allergy.) If both parents and a sibling manifest the allergy, the risk is greater at 85 percent. However, it would be good to keep in mind that even if both parents have no allergies, there is a five-percent risk of allergy for their child.

What else can be done to lower a child’s risk for allergies?  Dr. Koletzco mentions that vaginal delivery presents a distinct advantage because “babies ingest the mother’s gut flora” as they pass through the birth canal during delivery. Consequently, they have ready immunity from allergens and pathogens in the mother’s environment. The positive effects of breastfeeding have also been widely documented.

She adds, “There is some evidence of the protective effect of fish consumption during pregnancy and breast feeding.”

Likewise, Dr. Koletzco recommends introducing the child to different foods to encourage and stimulate tolerance. “Delaying the introduction of solid foods beyond the sixth month of life has no protective effect. It may even increase the risk for allergies.”

However, she frowns on tolerance induction (or introducing small amounts of the allergen.) “Do not induce tolerance on your own without medical supervision. It can result in anaphylactic shock.”