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Thriving Kids - Paediatricians

Paediatric Allergology

What is an allergist?

Allergists specialise in the treatment of allergic diseases. This includes the diagnosis and treatment of allergic rhinitis (hayfever), asthma, allergic eye diseases, atopic eczema and urticaria (hives). Allergists also see patients with food allergy, medication allergy,   bee sting allergy and latex allergy.

An allergist provides expert medical advice and treatment in the evaluation and management of people with allergic diseases. This includes performing and interpreting allergy tests, expertise in treating complex allergic diseases and asthma, as well as the ability to prescribe allergen immunotherapy .

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Why should I see an allergist?

The following is a list of reasons which may warrant an evaluation by an allergist:

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Allergy appointments:

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Help! I think my child has allergies!

What is an allergy?

An allergy is an immune reaction to a substance in the environment called an allergen.

When a child with allergies comes into contact with an allergen - either by touching it, breathing it, eating it, or having it injected - her body mistakenly views it as a dangerous invader and releases histamines and other chemicals to fight it off.

These chemicals irritate the body and cause symptoms such as a runny nose, sneezing, itching, and coughing.

Symptoms can be mild or more severe, intermittent (seasonal, for example) or ongoing because of constant exposure to the allergen.

In some cases, an allergen can cause a severe reaction, called anaphylaxis. This is a medical emergency, as the symptoms — including breathing difficulty and swelling — can be life-threatening.

What are examples of allergens?

Possible allergens include food, drugs, insects, animal dander (pets), dust mites, mould, and pollen. Allergens can cause respiratory symptoms, as in nasal allergies or allergic rhinitis, skin symptoms like eczema, or intestinal problems — from food allergies, for example.

What causes nasal allergies?

Some children are allergic to feather pillows or wool blankets. And remember cigarette smoke can make allergy symptoms worse.

How can I tell if my toddler has nasal allergies or just a cold?

Because the symptoms of nasal allergies are much like cold symptoms — runny nose, watery eyes, cough, nasal congestion, sneezing — it can be tough to tell the difference. There are some telltale signs of allergies, though. Ask yourself the following questions:

If you answered yes to one or more of these questions, there's a good chance your toddler is allergic to something in her environment. Kids with nasal allergies are also more prone to ear infections, asthma, and sinus infections.

Are allergies inherited?

A child inherits the tendency to be allergic but not necessarily the specific allergies. For example, if one of your child's parents has hay fever or pet allergies, there's a 40 to 50 percent chance that your child will have some sort of allergy as well. That probability jumps to 75 to 80 percent when both biological parents have allergies. Family members may differ widely in the kinds of things they are allergic to.

If my toddler is allergic, when will I know?

It can take time for an allergy to develop. Each allergic person has a threshold that must be reached before an allergen causes a reaction, and this can take several months.

Seasonal allergies to things such as pollen and grass usually don't rear their ugly (and stuffy) head until a child is about 3 to 4 years old. That's because the exposure to each individual pollen is only for a few weeks each year.

How can I figure out what my child is allergic to?

It takes some careful detective work and sometimes the help of medical tests to pinpoint the cause of an allergy. One clue may be when the allergy attacks occur.

Mould allergies usually develop during damp or rainy weather and can be hard to distinguish from colds. Dust mites or pet allergies often cause morning congestion throughout the year. Pollen-related allergies are more common in spring, summer, and autumn.

Sending the cat or dog away for a few days won't tell you whether your toddler has a pet allergy. It can take more than a year after a cat is no longer around for cat dander to degrade to the point that it doesn't bother allergic people.

On the other hand, if you take your toddler away from your pet (on holiday, for example) and she seems much better, then you have a good — but by no means conclusive — lead. You'd also want to consider that your toddler might be allergic to something else in your house.

If your own detective work doesn't give you the answer, it's time to see the doctor. He'll examine your toddler and ask lots of questions. If he believes the problem is allergies, he may refer you directly to an allergic specialist or he may suggest a blood test to measure levels of IgE (allergy) antibodies in your toddler's blood.

Blood tests may be less accurate than skin tests. So if the blood test does suggest an allergy, the next step is a skin test. You'll need to see an allergist for that.

During a skin test, an allergist applies small amounts of common allergens to your child's skin. If your toddler is allergic to a substance, she'll have a reaction similar to a mosquito bite on that spot.

Keep in mind that testing tells you what your child is allergic to at that point, but it may change as your child gets older. If your toddler has a negative skin test but continues to have allergy symptoms, have her reevaluated in six to 12 months.

How can I protect my toddler from allergens?

Here are the best ways to reduce your toddler's exposure to the most common allergens:

Dust mites

Dust mites live in fabrics and carpets and are common in every room of the house but children are usually exposed to the most dust mites in the bedroom, where mattresses and pillows are veritable dust-mite condominiums.

The following steps may seem like a lot of work, but they really help. Parents who take these steps may expect some improvement in their child's allergies and this could cut down the level of medication needed for the problem.

Encase your toddler's mattress and pillow in an impenetrable cover especially made for allergic children. Unlike plastic covers, these provide a barrier that's breathable and not crinkly. Avoid big, fluffy duvets and use blankets instead.

Wash bedding once a week in hot water to kill dust mites. Set your washing machine at 55-60 degrees. Expose mattresses to sunlight when possible for a few hours a week. Avoid piling up stuffed animals in your child's room. Wash the few favourites your toddler can't live without in hot water weekly or stick them in the freezer for an overnight killing frost.

Dust and vacuum weekly or every other week, but make sure your child isn't in the room when you do it. Dusting and vacuuming stir up residual dust-mite particles in the room. Wet mopping can help prevent this. Consider investing in a vacuum cleaner with a HEPA (high efficiency particulate arresting) filter, which traps even microscopic particles that pass right through ordinary vacuum cleaners. If your toddler has a severe dust mite allergy, consider replacing carpeting with a smooth floor like wood or vinyl and replacing curtains with blinds. Clean or replace filters on your fireplace and air conditioners during seasons they're in use.

Pet dander

If your child is allergic to a pet, the only solution is to give the animal away. That's not an easy decision to make, of course, and, understandably, you'll want to consider it only as a last resort.

Wash your pet frequently. You can find shampoos that reduce dander in the pet store. Try to keep your pet mostly outside, but if not, keep your pet off the furniture and never allow the pet into your child's room.

Mould

Use a dehumidifier and air conditioner when the weather is warm and moist, especially in a wet basement or other areas of your home where mould growth is a problem.

Clean your bathroom regularly with mould-inhibiting disinfectants, such as a little bleach and water or a natural solution like tea tree oil and water. And consider investing in a better ventilation system.

Avoid steaming up the bathroom at bathtime by keeping the windows open as much as possible.

Use the extractor fan when cooking (or open windows).

Limit the amount of indoor plants.

Empty and clean rubbish bins frequently.

Do not store firewood inside.

Mould can often be found growing in cupboards, attics, cellars, plants, fridges, showers, dustbins and under carpets.

Even a fake Christmas tree can harbor mould.

Outdoors, mould is found in sandpits, rotting vegetation, hay, compost heaps and piles of dead leaves.

Pollen

Pollen is nearly impossible to avoid completely.

Avoid being outside on hot, windy days or when grass has just been cut.

Wear sunglasses and a bit of Vaseline on the nostrils.

Flush eyes with sterile saline solution to remove pollen.

Close bedroom windows on windy days.

Are there any medications that can help my toddler?

Yes, but don't give over-the-counter allergy medicine without talking to your doctor first. Your doctor may suggest antihistamines and offer you a prescription. Many of the newer allergy medicines have fewer side effects than other products on the market.

What can I do to prevent my toddler from getting allergies in the first place?

At this point, there's lots of conflicting information about preventing or delaying allergies by postponing — or accelerating — a child's exposure to potential allergens.

Someday we'll be able to look at genetics and really know what a child is destined to be allergic to and what to do about it. But right now there is nothing that can predictably help.

And keeping your home — in particular your toddler's room — clean and as free of mould and dust mites as possible is a good idea, regardless of whether your child has allergies.

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Useful links for allergy sufferers

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