What having kids with an allergy means

Expert advice from a Mediclinic paediatrician with a special interest in allergies

What having kids with an allergy means

Allergies are a global problem. Children all over the world are far more likely than ever to develop allergies to certain foods and specific environmental elements.

This is particularly true in the UAE, where since the 1990s, allergies among children have increased by 50 percent.

Allergies arise from an immune response to a substance (allergen) that the body doesn’t recognise and these immune responses can be mild, from coughing and sneezing to a life-threatening reaction known universally as anaphylaxis.

“When we ask ourselves why we are seeing more peanut allergies, one of the main reasons is because of the advice we have been giving for the past 15 years, namely no peanuts during pregnancy, and a delayed introduction to peanuts for children,” says Dr David Cremonesini, consultant paediatrician with a special interest in allergy at Mediclinic Parkview Hospital.

“Now we know that if you introduce peanuts early there seems to be a window of opportunity to get it in with less of a risk of allergy,” explains Cremonesini.

This new advice comes following the Leap Study where peanuts were given to children under 12 months who were at risk of having a peanut allergy because of eczema or an egg allergy. Another group of children didn’t receive peanuts until they were four. In the group of children who received it earlier, there was a dramatic drop in the number who had a peanut allergy than there were in the older group.

Dr Cremonesini suggests that parents: “start with the basic foods and then introduce potential allergens such as milk, egg and peanuts when you start weaning in a form that’s suitable for the child. Don’t delay the introduction of these foods.”

“I am happy if parents have concerns or are anxious for them to bring their child into my clinic and give them the potential allergen there,” Cremonesini explains.

“I just want them to do it as soon as possible, because they might be avoiding certain foods worried about a potential allergy, but there might be no allergy there at all – and that’s life-changing.”

When it comes to food allergies, most of us are aware of the dangers of peanuts, but there are others high-risk foods.

The main allergens in children are cow’s milk, egg, nuts (peanuts are the most common one), sesame, fish, crustaceans
and wheat.

A majority of schools in the UAE enforce a strict no nut policy, but Dr Cremonesini warns parents not to be too complacent.

“A study was carried out in the US, which found that there was a greater epipen use in the schools that had a nut free policy than those that didn’t.”

And the reasons for this? “Well, it might be because people get complacent. If you have a nut free zone, people may feel falsely reassured and drop their guard,” he explains.

“But nobody is monitoring every single lunchbox that goes into school,” he points out.

“It’s the same on a plane, nobody is checking bags for nuts as you board. Yes, having these policies may reduce the issues, but it doesn’t necessarily completely eliminate the risk.”

Dr Cremonesini points out the dangers of over-diagnosis, and also presses parents not to diagnose allergies themselves. Instead he advices that you see an allergy specialist.

An allergy doctor will be sceptical and delve deep to find the cause of any suspicious symptoms, which usually take the form of a rash on the face that might spread, but that is gone the next day, and maybe a bit of swelling. A more severe reaction is the child going pale and having breathing difficulty.

“If you suspect an allergy make a note of what your child has eaten. That information is key and the best way of finding out the cause rather than any test,” he says.

“Bring that list of ingredients to the clinic where we will go through it to find out which foods they’ve not eaten before. If we find something, we do a test specific to that food. And if the test is positive we have our answer, while if the test is negative, we get the child to eat some of those foods again, but in hospital. It’s always so important to do a thorough investigation.”

“What we don’t want is children cutting certain foods out of their diet unnecessarily, as this can have a detrimental effect on their nutrition and their growth, while giving them abnormal phobias about food.”

Dr Cremonesini says that: “We want to prevent rather than cure the symptoms. So advice is to continuously monitor the child
and update our recommendations as and when necessary.”

Thankfully, living with an allergy doesn’t have to be a life sentence.

Educate yourself
www.asthma.org.ukwww.anaphylaxis.org.ukwww.eczema.org, www.itchysneezywheezy.co.uk, www.dubaiallergy.com

Living with an allergy
Rachael Blackburn, mum to Annabelle, six and Ethan, four

I have two children who have allergic reactions that have the potential to be life-threatening. Annabelle is allergic to dairy, eggs, peanut, dust, some medicine, animals and some fruits.

Eating at school cause us lots of issues. The kids know they can’t eat anything from anyone else’s lunchbox, but making sure their friends understand is hard – even traces of allergen can cause a severe reaction.

Birthday parties are hard too, but flying is the scariest thing we do, being so far away from medical help. I would also ask that anyone who has a picnic in the park cleans up after themselves. The number of times we have arrived at a park and had to leave because the sand has been covered in nutshells is really sad.

Olivia Everett, seven
I feel normal even though I have an allergy to peanuts. I am bit scared that if I eat peanuts I might die. Mummy taught me how to use an EpiPen and if I go on playdates, I take one with me. When I buy something, I have to ask or look at the ingredients
to see if it has peanuts in it. It feels disappointing when I cannot eat stuff with peanuts or food that has been close to them.

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