When you get an allergic reaction, it can be anything from mild to life-threatening. And no matter how mild these symptoms are, it can be quite scary for parents, especially if they appear in a young baby.
In babies, an allergic reaction happens when he is particularly sensitive to certain foods or the environment, and his immune system reacts to it.
When your baby comes into contact or close proximity to a certain allergen, his body produces an antibody called IgE. Every time he encounters the allergen, this IgE binds with the fighting cells in his body to release chemicals like histamines, which cause the allergic symptoms.
In Singapore, common allergens include eggs, cow’s milk, wheat, soy, shellfish and nuts, says paediatrican Dr Dawn Lim, who wrote All You Need to Know About Your Child's Allergy.
“Breastfeeding your baby for at least the first four months of his life has been proven to reduce the incidence of allergies.”
Besides food allergies, your baby may also develop eczema if he has sensitive skin. The eczema could be triggered by the environment or other food allergies. “If your newborn has bad cradle cap, that’s a marker that he has sensitive skin. Later on, he may develop eczema in typical areas, such as the face and neck,” Dr Lim notes.
Symptoms of an allergy include:
* Severe eczema.
* Other skin issues like rashes around the mouth or hives around the whole body.
* Wheezing or difficulty breathing.
* Red and runny eyes and nose.
* Bloody stools and diarrhoea.
What causes an allergy?
Genes play a role in your child’s allergies, so if your baby has a sibling with an allergy, or if you or your spouse has an allergy, then your baby is at a greater risk of getting an allergy.
Dr Lim also highlights the hygiene hypothesis ― that allergies are more common in developed countries than underdeveloped countries because your immunity is lowered when you are “too clean”, since you have less practice at fighting germs.
She adds, “That’s why as a country develops, the incidence of allergies rises. But you’ve got to have a balance ― you can’t compromise hygiene and risk the kids getting things like pin worms and TB.”
So, can anything be done to prevent your baby from developing allergies?
“Breastfeeding your baby for at least the first four months of his life has been proven to reduce the incidence of allergies,” says Dr Lim.
Also, your baby can be exposed to allergens in the air, especially if his skin is sensitive. “There was a study where babies who never consumed the allergen actually reacted to the allergen exposed their skin,” Dr Lim explains. This could simply be nuts on the table, or traces of food particles on the floor.
What this means is that if you moisturise your baby’s skin more and maintain or restore the skin barrier, they are less likely to be sensitive to those allergens.
Dr Lim notes that there is no evidence that avoiding a certain food during the expectant mum’s pregnancy or while she is breastfeeding can prevent the onset of an allergy. She adds that solids should be introduced to your baby within the window period of four to six months. This is because if it’s later than six months, this can actually increase your baby’s chances of developing an allergy.
While it has been a common practice to delay the introduction of highly allergenic foods, recent studies show that there is no evidence that a 3-year-old toddler is less likely to be allergic to eggs, for instance, as compared to when he was 7 months old. “Some also believe that if you give it earlier, it can actually help prevent the allergy as the gut starts to develop a tolerance to the food,” Dr Lim adds.
Bring your child immediately to the nearest clinic or emergency room, as an allergy can be life threatening if severe.
If your child seems to be having an allergic reaction, Dr Lim advises that parents give an antihistamine “in the correct dose” as these can help control itching, rash, hives, as well as runny eyes and noses.
Following that, bring your child immediately to the nearest clinic or emergency room, as a severe allergy can be life-threatening.
Your baby’s doctor will treat the condition, but if the allergy is bad, he may refer you to an allergy doctor for relevant tests to be carried out to confirm the diagnosis, notes Dr Lim.
Several allergy tests are available:
1. The Skin Prick test
This involves putting a drop of the allergen on your baby’s skin. “It’s fast and painless and you get the results within half an hour,” says Dr Lim. A visible reaction will be seen if the result is positive. You can test for multiple allergies at the same time.
2. The IgE blood test
Your baby’s blood will be sent to a lab for analysis and tested for the presence of any allergen-specific IgE antibodies. “This test can also be used if the eczema is very bad and there is no area of the skin that is healthy enough to do the skin test,” adds Dr Lim. Your baby’s doctor will likely choose the most appropriate allergens to be tested.
3. The food challenge
This is for non-IgE type allergies that can’t be detected by a Skin Prick test. “For example, if I suspect the child has a gut allergy to cow’s milk because he has bloody diarrhoea, a skin test would be negative,” explains Dr Lim. “I would ask the child to stop taking cow’s milk, and if the diarrhoea stops, that would make the diagnosis.” These types of allergies would usually go away within six months, so the food challenge can be repeated in six months ― giving cow’s milk again and monitoring the stools. “Follow-up tests can give an idea of whether the child is getting better, so we can tell the parents what and when to expect any improvement,” she adds. Incidentally, the food challenge test should never be carried out at home, and must always be done under the care of a qualified doctor, in case of an adverse reaction.
Whether the baby outgrows the allergy is dependent on the type of food. “Foods like milk, wheat, and eggs ― the child would usually outgrow the allergy by the time they are 3 to 5 years old.
“But for foods like nuts and seafood, people usually don’t outgrow these allergies,” Dr Lim adds.
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