Global Health Asia-Pacific June 2021 | Page 14

You Ask , They Answer

Q

: What signs of allergies should new parents look out for ?

A

: Food allergies can appear very early in life , even soon after birth while the baby is still being breast fed . Symptoms of allergy can appear within a few minutes or often within a couple of hours after consuming the offending food . Symptoms like flushed skin or rash appear on the cheeks and may spread to the rest of the body . The other main symptoms are diarrhoea and vomiting .
The main offending food in very young babies is cow ’ s milk given directly to the baby or indirectly through breast milk . This happens when a mother drinks cow ’ s milk and enough milk antigens reach the breast milk . A young baby reacting to cow ’ s milk must be immediately taken off it and given alternative milk , preferably extensively hydrolysed milk , which is not antigenic . Parents should seek their doctor ’ s advice before doing so .

Q

: How would you assess an allergy in infants who cannot describe their symptoms ?

A

: The symptoms described above may indicate that milk is the cause of the allergy . To be certain , an allergy test is desirable , preferably using the new advanced technologies now available that require just a few drops of blood . In the past , prick tests on the skin to the suspected allergen were performed , which would give a result within 30 minutes but put the child under undue stress . In rare cases , if the child is very sensitive to the protein producing the allergy , a severe reaction may cause a life-threatening situation .

Q

: When suspecting a food or substance allergy , what should parents do ?

A

: If the parents suspect that symptoms like diarrhoea , vomiting , or refusal of the baby to drink cow ’ s milk , or rashes on the face and other parts of the body appear , then these are indications of suspected cow ’ s milk allergy . It ’ s best to seek the advice of the paediatrician who is managing the child . The doctor may advise an allergy test .
However , I have seen many children with allergies whose doctors do not seek an allergy test in early life . Once the allergy develops in early childhood , it does not go away . The baby may also start developing allergies to other foods . The most important foods causing allergies in Malaysia are cow ’ s milk , poultry eggs , soya beans , peanuts , shellfish , wheat , fish , and bananas .
Allergies do not go away but can progress further to affect other organs . Babies with food allergies are very likely to develop respiratory allergies by the time they are two years of age . Allergies progress from food to respiratory allergies .
If respiratory allergies are not managed in early life , the risk of developing asthma is very high . Studies have shown that infants with a severe allergy to egg proteins before two years of age have a high risk of developing asthma by the time they ’ re six to eight years old . In Malaysia , the primary cause of respiratory allergies is dust mite allergens , which are found in very high levels in tropical countries . In 90 percent of cases , dust mites are the main trigger for the asthma .

Q

: When should parents suspect that their infant ’ s sniffles might be an allergy ?

A

: The typical progression of a respiratory allergy begins with food . Therefore , any sign of a food allergy should be further investigated for a respiratory allergy . A majority of children with a food allergy will develop a respiratory allergy at the age of two . However , I have seen infants at about 6 months with a respiratory allergy . Children may have frequent runny noses or may be breathing through the mouth while sleeping because the nose is blocked . These are signs that the parents should look out for and consider an allergy test .
It ’ s important to note that once allergies develop , they never go away . But they can be kept at bay if one takes care to avoid the trigger allergens or uses medication .
Dr Manmohan Yadav
Dr Manmohan Yadav is an allergist who practices at the Global Allergy Centre in Kuala Lumpur .
12 JUNE 2021 GlobalHealthAsiaPacific . com