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Do allergic reactions get worse with time?
Children tend to outgrow their allergies to cow’s milk, egg, soya and wheat. For these foods reactions usually get milder and resolve. We now know that avoiding foods completely when you are can tolerant or partly tolerant can make the allergy more severe. It is therefore important to seek advice from your doctor, nurse or dietitian as to what is safe to eat.
Will my child outgrow their food allergies?
For cow’s milk, egg, soya and wheat the answer is often yes. See your doctor to see how you can help speed up the process. For peanuts, tree nuts and fish most importantly, you need to make sure the diagnosis of allergy is correct. Again see your doctor. If confirmed, children are less likely to outgrow these food allergies. However, sometimes you might be pleasantly surprised and find the child was not allergic to the food in the first place.
Is all eczema triggered by foods?
The short answer is no, particularly in older children and adults where foods rarely cause eczema. In preschool children with eczema not under control with standard moisturisers and mild steroids, food allergies might be considered. Foods should not be avoided without taking advice from your doctor. We now know that children who avoid foods unnecessarily can develop new or worsening of their allergies.
Is my child's eczema due to dairy?
If the child is over one year old and has been having dairy regularly with no flares, then the answer is no. Children who were previously tolerant to dairy don’t suddenly develop an allergy to this or to other foods. If the child has always had bad eczema and it is not controlled with moisturisers and regular 1% hydrocortisone ointment, then cow’s milk allergy may be worth considering. You should not just take cow’s milk out of the child’s diet, but rather seek advice from your health visitor, doctor, nurse or dietitian.
Is lactose intolerance an allergy?
Lactose intolerance is an inability to break down the sugar in cow’s milk. It is not an allergy. It usually follows a bout a gastroenteritis and gets better a few weeks to months after the diarrhoea settles. Symptoms include watery diarrhoea, stomach pain and gas, but no rashes, swellings or wheeze. Lactose-free milks may be used. This is in contrast to cow’s milk protein allergy where lactose-free milks are not appropriate as many still contain cow’s milk protein.
Can infants eat foods containing peanut?
In the past, peanut containing foods were not recommended until after a child is five years old. We now know that avoiding peanuts and other foods in early childhood can promote rather than prevent allergies. The LEAP study suggested that infants with eczema or egg allergy should start eating a little peanut butter three times a week from the age of 4 – 6 months old. This also applies to infants with siblings with peanut allergy.
I think my child is allergic to gluten. Should I remove wheat from my child's diet?
As wheat is an important part of most children’s diet, if you are concerned about the possibility of your children being allergic to wheat you should talk to your doctor. You should not take wheat out of your child’s diet unnecessarily, as this will affect the result of tests for Coeliac disease that your doctor may want to do.
Is Hayfever getting more common?
Yes, there seems to be an increase in the number of people with hayfever. Increased levels of air pollution might be partly to blame, as the pollutants may damage the membranes of the eye and nose and may make the allergic effects of pollens more potent.
How can I or my child see an Allergy Specialist?
Speak to your GP. They can then refer you to your local specialist at a nearby district hospital or tertiary centre.
Things to remember if you are going to see your doctor about your allergies.
- bring some photos of what the reaction looked like
- bring the packaging or at least details of what you think caused the reaction
- find out from someone who saw the reaction exactly what happened so you can tell the doctor
- if going to a specialist for allergy tests – STOP your antihistamines 5 days before you go
What's a RAST test?
RAST (Radioallergosorbent test) is the old-fashioned name for allergy IgE tests. We rarely use radioactivity in the laboratory any more, so a more accurate name for the test is “specific IgE test”.
IgE is a special type of antibody that triggers allergic reactions. IgE can sometimes be neutralised by IgG4 antibodies in the blood. Thus having IgE antibodies doesn’t mean for sure that you are allergic to the substance. The only real way to prove you are allergic is to do a challenge with the substance. Your doctor will help you to decide if a challenge test is necessary and safe. Challenge tests are often done in hospital where we can keep an eye on you.
What's a skin prick test?
Skin prick tests are a quick way to see if your skin responds to a substance. It only takes 15 minutes and does not involve needles. A drop of water containing the substance e.g. food or pollen is placed on the skin of the forearm and “pricked” with a plastic or metal lance. After 15 minutes we look to see if you have developed a little raised lump where the test was done. If the diameter of the lump is 3mm or more it is positive. Skin reactions don’t always mean you will react to the food if eaten. The only way to prove this is to do a challenge test. Your doctor will decide if a challenge test is necessary and safe.
What about complementary & alternative allergy tests?
Routine allergy tests are not 100% accurate and it is therefore understandable that you might pay for complementary or alternative tests. These include vega, applied kinesiology, hair analysis and IgG tests. If you want to spend your money, that is up to you. In our opinion and that of the UK National Institute of Health & Clinical Excellence (NICE, February 2011) these tests have no scientific basis and no place in the diagnosis of allergies.
How can supervised food challenges help?
Even with a seemingly clear history and routine allergy tests, the diagnosis of allergy can be wrong. Allergy specialists will therefore sometimes recommend a challenge in hospital. Challenges, particularly to foods, are done increasingly frequently and are proving very useful. Sometimes they show that the child is not allergic. That’s great as the child doesn’t need to spend the rest of their life avoiding the food unnecessarily. Even if the challenge causes a reaction, because we start with a tiny amount, the result is likely to be some lip swelling, hives or vomiting. More severe reactions such as wheeze as less common and can be effectively dealt with by the doctor.
Should you avoid all foods that state "May contain"?
In the UK and Europe, packaged foods should have on the ingredient’s list whether or not it contains the food. If it is not on the ingredients list it can be eaten.
You should however be cautious with unpackaged foods bought from deli counters or take-a-ways, as there is a risk of spoons getting mixed up and used for more than one item leading to risk of contamination.
Are all antihistamines the same?
Antihistamines are great for treating hives and skin swellings. They don’t reduce the itch of eczema, for that you need your eczema creams.
Piriton is quite short acting and can make you sleepy. It is the only antihistamine licensed in children under 1 year old. In older children, we recommend you consider one of the longer-lasting antihistamines such as cetirizine or loratidine.
Should all allergy patients have an adrenaline auto-injector?
Not Always. The need for an auto-injector is dependent on the allergy, how easy it is to avoid and any underlying conditions.
At what age should a child or young person be responsible for carrying their own adrenaline auto-injector?
On moving from primary to high school, most young people should be able to take responsibility for their antihistamine tablets, keeping a supply in their blazer pocket.
In the second or later years at High School, a young person is usually ready to take responsibility for carrying their adrenaline auto-injectors, although this varies form person to person.
Should my child's friends be shown how to use an adrenaline auto-injector?
Needle stick injuries are a risk for people who don’t know, or can’t remember how to use the auto-injector properly. If your child has an allergic reaction where they are struggling to breath or faint, friends or carers should ring 999 and call for an ambulance. Only if they are confident and properly trained, should they try and use it.
Can allergies be cured?
No, most treatments for allergies aim to suppress the symptoms but none are a cure.
Desensitisation, or allergen immunotherapy, can make you more tolerant to a specific trigger of an allergic reaction. It is however not a cure and the treatment will have to be repeated periodically. The treatment requires your cooperation and can trigger an allergic reaction. Your allergy specialist can discuss the pros and cons of this treatment with you.