FOOD ALLEGY

Food allergy in children- Can I eat this Mummy?

By Boniface Kanyugo Kagumba

A sick child keeps her parents worried the whole day and affects the whole family as well, especially the mother or the care giver. In most cases when a child falls sick the blame falls on food, even when the cause has nothing to do with food. This at least explains that parents are aware of the effect of food on a child’s health. Food can affect both children and adults in a variety of ways one being Food allergy

What is it?

An allergy is a hypersensitivity disorder that affects the immune system. This over reaction is caused by a substance which is harmless to most people called an allergen found in environment and foods. When someone has an allergy the immune system treats the substance as an invader resulting to symptoms that can be anywhere from annoying to possibly harmful to the person.

In an attempt to protect the body, the immune systems of the allergic child produces antibodies called immunoglobulin E (IgE),these antibodies then causes mast cell and basophilis ( allergy cells in the body) to release chemicals including histamine into the blood streams to defend the allergen-the invader. It’s the release of these chemicals that causes the reaction affecting a persons, eye, throat, nose, skin, lung or gastrointestinal tract, as the body attempts to get rid of the invading allergen.

Allergic reactions can be very mild or may be life threatening and can cause a systemic shock (anaphylaxis)

Symptoms

Symptoms vary depending on the severity of the allergy. Most food allergies presents symptoms such as swelling, skin rash, runny nose, itchy nose or eye, itchy mouth with bumps,  vomiting, bloating, diarrhea, constipation and mucus filled stool. Skin symptoms are the most common (edema, hives or eczema)

Common food Allergy

There are no major research that estimates the prevalence of food allergy in Kenya, however few studies done shows it’s an issue of concern and allergies are becoming more common. In United States of America, it is estimated that upto 2 million or 8% of children are affected by food allergies, this is according to The American Academy of Allergy, Asthma and Immunology Eight foods accounts for most of those food allergy: Eggs, Fish, Milk, Peanut, Shellfish, Soy, Tree nuts and Wheat

Perhaps these should be a wakeup call to Kenyan parents. It is good to know what your child is allergic to and control it before it’s too late. Your pediatrician can perform a Skin prick test, blood test or a Food challenge to Identify whether your child is having an allergy or not.

·         Cow’s milk

This is the most common food allergy in infants. The highest allergic cause being protein found within it, average 3.4% protein in 100g.

To ensure your baby is not allergic to milk exclusive breastfeeding is encouraged, upto 6 months of breastfeeding. Thanks to Malezi Bora programme, a Ministry of Health and UNICEF programme that emphasis on the importance of breastfeeding here in Kenya.

Breast milk has a lot of health benefit and a little possibility of causing allergic reaction. Mothers who have reasons not to breastfeed are advised to seek counsel from their doctors or nutritionist.

·         Solid food

When weaning, it is advisable that solid food be introduced gradually, one at time. The World Health Organization (WHO) recommends that weaning starts from six months. Before this, a child's digestive system and kidneys are still developing and are not yet ready to deal with solid food.

It is good to give your child homemade food, this ensures total control of what is going in your baby’s diet the food should be free from preservatives and additives that your child tummy does not require.

Fighting the menace

Having known that your child has an allergy the next thing you are worried is how to get rid of it. Identifying the food causing the allergy makes it easier for you to watch out for foods within the same food groups/family. If your child is suffering from a peanut allergy for example, you want him to stay away from all the nuts until further test is done.

 Your nutritionist will help you identify the various food groups as well as the different names of the food/nutrient that your child is allergic to as they appear on the food labels. For Example an egg white may be called albumin.

The basic treatment for food allergies is strict avoidance of the allergen. Unlike the environmental allergens which can sometimes be effectively treated by daily courses of antihistamine or by taking allergy shots. In cases of accidental exposure to allergen it is important visit your pediatrician for further consultation.

Reference

Ø  Food allergy - Wikipedia, the free encyclopedia

Ø  muslimahfitness.com/blog

Ø   Stefano Guandalini et al,(2005) cow’s milk allergy, Essential pediatric gastroenterology, hepatology, and nutrition , page 175

Ø  The American Academy of Allergy, Asthma and Immunology,www.aaaa.org

Ø  WHO website 2010

Compiled By:

Boniface Kanyugo Kagumba,

Clinical Dietitian

Eye allergy in children

By: Boniface Kagumba, 
Consultant  Dietitian
(Submitted To Baby Love Magazine) 

If you have been following the articles in this column, by now you have got immense information on the many types of allergy that we have been discussing. You may also have some hints of the major causes of allergy of which most of them are related, by now the mention of the word allergen and histamine maybe familiar to you too.

Today we proceed to another allergy common in adults and children as well, the Eye allergy. The most common form of eye allergy is referred to allergic conjunctivitis. According to Dr. James Kinyajui, a General Practitioner, there are many non-allergic reactions that may affect your child’s eye with similar symptoms to those of an eye allergy. His advice is that it’s always wise to consider taking your child to an ophthalmologist or your pediatrician for proper diagnosis and treatment before treating any symptoms yourself.

What is eye allergy?

Eye allergy is a common condition that occurs when the eye reacts to something that irritates them (invader/allergen) just like in any other allergy the body releases substance called histamines to fight against these invaders as a result the eyelids and the conjunctiva (membrane that covers the inside of the eyelids and the white of the eye) itches, become red and swollen.

The above symptoms may be accompanied by a nasal allergy, though not always, with an itchy stuffy nose and sneezing

Major allergen

The most common allergens that may cause an eye allergy are dust, animal dander, perfumes, as well as pollen or even food. If the exposure is more the allergy can be more severe with significant burning and itching and even sensitivity to the eye

Children with a history of any other allergy are more likely to suffer from an eye allergy. However allergic conjunctivitis is not spread from one person to the other unlike other bacterial infections.

Diagnosis and treatment

In order to treat an eye allergy proper diagnosis is required to confirm that the reaction is an allergy. Your Doctor or ophthalmologist will examine your child’s eye and discuss the medical history including the child’s history and the family history. The doctor may also use a microscope to check for sign of allergies such as swollen blood vessels on the surface of the eye or if it’s not completely clear that your child has an allergy the doctor may choose to test specific type of white blood cells called eosinophil that shows up in the areas where there is an allergic reaction.

The key treatment to any allergy is to avoid the allergen that causes a reaction to occur. If necessary an allergist or ophthalmologist may perform a skin test to identify a specific allergen. The doctor may help you identify the allergen responsible for your child’s allergy thus making it easy to keep your child away from them as well as determining the best treatment for your baby.

For mild eye allergy, over the counter eye drops can be used to treat the reactions. However there are eye drops that will require prescription. These drugs may be sold as decongestant with or without an antihistamine which helps relieve the itchiness. These eye drops cannot be used for more than three days as long-term use may increase the irritating symptoms

The eye drop that may not necessarily require prescriptions are mainly the artificial tears which can be used any time they are needed they also help relieve eye allergies temporarily by washing allergen from the eye.

Eye drops with both antihistamine to relieve itchiness and a mast cell stabilizer to help prevent eye allergy may also be used.

 A home remedy for mild eye allergy can also be used, this involve washing off the allergen your baby’s face with warm water and a clean cloth.  Use a wet cloth to clean the eyelids and the surrounding face. Rinse the eyes using a small amount of warm water and tears will do the rest. Then apply a cold wash cloth to the itchy eye. Wash the hair every night as it collects a lot of allergens during the day

Steroid eye drops helps treat chronic and severe eye allergy symptoms such as itching, redness and swelling. Dr.Kinyajui suggests that these are among the eye drops that require prescription from your doctor as some children may react to the steroid.

Your child may also be given oral antihistamines such as cetirizine these however, can make the eye dry and worsen the eye allergy symptoms to some kids and therefore require prescription from a specialist as well

If the symptoms are not controlled by allergen avoidance, eye drops or oral medicine the doctor may decide to use immunotherapy (allergic shots) just like in any other severe allergy we have discussed previously.

Immunotherapy involve giving shots containing tiny amounts of the allergen thought to cause the allergic symptoms with the  dose gradually increasing over time helping the body to become immune to the allergen. 

Remember prevention is better than cure, as a parent when you realize what allergen triggers your child’s allergic reactions always make sure they are free from this allergen as much as possible. Always consider doctor advice before using the over the counter medicine

KIDS ALLERGY TO FABRIC

By: Boniface Kagumba

     Nutrition/Dietetic consultant

     Email:drnyus@gmail.com

(Submitted to Babylove  magazine)

As we have seen in my previous articles there are several allergies that are difficult to avoid if you or your child suffer from them. Here is yet another common allergy and challenging to control as we will learn in this article. 

Fabric allergy or textile allergy is rather common allergic reaction that occur when the cloth come in contact with the skin. The most responsible fabric to this kind of allergy is the man-made fabrics thus making it difficult to leave with especially for children. However, natural fabrics do not necessarily mean they are safe   for people with skin allergy. Wool is an example of natural fabrics that can cause intense irritation to some people. Many of us will experience the itchy feeling of a woolen garment whether we are allergic or not, the effect is likely to be worse in people who already have eczema or dermatitis.

What your child is wearing or sleeps on may cause an allergic reaction. It is therefore wise to know the cause of the allergy from the fabric. This make it easier in prevent a reaction from coming. 

Symptoms
Fabric allergy may present itself with similar symptoms with that of a cold. Symptoms may  include:

·         Watery eyes and sneezing

·         Rashes, itchy skin and / or Eczema type of lesions at the site of contact

·         Presence of red macerated skins on the waistbands area under the arms and the inner thighs

·         Some people experience itching and tearing of the eyes as well as shortness of breath

Having known that your child is suffering from fabric allergy the major challenge is making sure they are not in contact with the causative allergen and knowing the different kind of fabrics that can trigger a reaction.

The synthetic fabrics known to trigger a reaction are nylon, acrylic and polyester with the latter being the commonest which is a component of plastic and adhesives. Polyester fibers can also be combined with cotton to make what is known as polycotton, this material is frequently used in clothing, bed linen, carpets and as stuffing in duvets and quilts. Children may differ greatly in the tolerance of synthetic and natural/synthetic mixtures. The dye used with polyester substance may also irritate their skin too.

Whole cotton and polycotton products labeled easy-care, crease resistant or non-iron have been treated with formaldehyde, a chemical that can cause skin irritation to some children and adults.

What is safe?

Perhaps this is a question you are asking yourself as you read this article, having a child with fabric allergy makes it difficult to shop for their beddings or clothing including socks. But when a mother realizes her child is suffering from a certain fabric allergy, the first thing she needs to learn is how to read the clothing labels and know the different kind of fabrics in the market.

It has been noted that silk and cotton is best for children clothing and rarely cause an allergic reaction. When shopping for children clothes and bedding consider the two fabric check also on the hem, finishing and fasteners used in them as a single thread in a seam can trigger a reaction. Likewise any exposed metal poppers, buttons or zipper on clothes and bedding could be the trigger. Therefore poppers popular in babies clothes should be attended in such a way that they don’t come in contact with the infant skin.

Socks also cause allergy, the lesion is mostly confined in area covered by socks and is generally form a ring encircling the upper part of the socks. The whole area covered maybe eczematous if the reaction is due to the fabric of the socks.

Management and Treatment

There are various factors that may aggravate an allergy to clothing. Just as any other condition prevention is better than cure and as we have learnt from previous article avoiding the allergen is always the key to prevent and treat an allergy.

Factor that may aggravate an allergy to clothing that should be looked into when considering treatment and prevention include:

·         Tender and sensitive skin-many infant have sensitive skin which is vulnerable to a reaction

·         Obesity- obese children are more vulnerable to fabric allergy than their lean counterpart

·         Kids who sweat excessively  normally due to a condition called hyperhidrosis-this condition need to be checked by your doctor  for treatment

·         Tight clothing-ensure that your allergic child does not wear tights

·         Skin conditions, repeated friction, trauma and damaged skin facilitate clothing allergy

·         Fine metallic dust particles

·         Clothes contaminated with greases, oils and pesticides

·         Remnants of soaps on washed clothing

·         Use of latex gloves

·         Chemical used in processing leather

Once your doctor realizes the responsible allergen to your Child's reaction treatment becomes easy. They may choose to use an antihistamine to control the reaction and may also advise you on how to avoid the trigger. Always consider visiting your doctor before purchasing over the counter drugs for your child

As a parent the greatest responsibility will still remain in shopping for the right clothing and bedding that may not be allergic to your young one.