Allergy

Allergy related topics

Is it ‘Asthma’? Or a ‘viral wheeze’?

Many children present to their GPs or come to A&E with difficulty in breathing and are given inhalers / nebulisers, which sometimes make them better. (more…)

COW’S MILK PROTEIN ALLERGY ! (CMPA)

CMPA is quite common and may present as persistent vomiting, diarrhoea / constipation, poor weight gain, dry skin / rash, blood in stool and excessive crying. Treatment is by eliminating cows milk (CMP) from diet but only under specialist supervision. (more…)

Asthma / Viral wheeze

Many parents ask if their child have Asthma! It is quite a concerning diagnosis as they have heard lot of ‘things’ about Asthma. (more…)

How to reduce risk of children developing allergies ?

The LEAP & EAT studies

https://www.facebook.com/plugins/video.php?href=https%3A%2F%2Fwww.facebook.com%2Fkingscollegelondon%2Fvideos%2F1089248141095455%2F&show_text=1&width=560

http://www.bbc.co.uk/news/health-38518185

Allergies in children

Allergies to various substances is getting more and more common for various reasons including ‘Hygiene Hypothesis’ (Google it).  Some families are prone to have allergies and these people are known as ‘ATOPIC’. They are more likely to have allergies, asthma, eczema, hay fever, allergic rhinitis etc. These are all related conditions.

Most children grow out of allergies to food like milk and egg, while some allergies like nut allergy are more likely to stay. Milk allergy usually gets better between 1-2 years of age, egg allergy is variable and so is fish / shrimp. Children have a 20% chance of growing out of nut allergy.The treatment usually involves, avoiding the ‘allergen’, emollients, steroid creams, antihistaminics etc. There have been trials going on for ‘Immunotherapy’, to challenge the body with very small doses to develop ‘Tolerance’. It’s availability is limited at the moment.

Diagnosis of allergies should be done by a specialist and diet modified only after discussion with a dietician. Mothers on dairy free diet should consider taking extra Calcium and Vitamin D. The Cow’s milk free formulas usually have adequate supplements. There are some extremely useful websites for patients and even Health Professionals containing useful videos, leaflets etc. like

https://www.allergyuk.org/

http://www.itchysneezywheezy.co.uk/

http://www.eczema.org/

 

 

Cow’s milk protein allergy ! (CMPA)

CMPA is quite common and may present as persistent vomiting, diarrhoea / constipation, poor weight gain, dry skin / rash and excessive crying. Treatment is by eliminating CMP from diet but only under specialist supervision.

There are two types, IgE mediated and Non IgE mediated. Basically, the latter is usually presents later and is milder but there is no test for it. If baby is breast fed, then treatment is eliminating dairy from mum’s diet (I know, it’s sad, but luckily only for few months).

If formula fed, then there are several hydrolysed formulas available like Aptamil Pepti, Similac Alimentum, Nutramigen. They are broken down proteins, so taste and smell horrible (Honestly, they have not been able to improve the taste of any of these). Fortunately, babies haven’t developed lots of taste buds, so are usually able to drink these (sometimes takes a lot of perseverance!). Parents can close their noses while making them!

The effect of dairy elimination from maternal diet or change to Hydrolysed formula is not apparent immediately, as CMP takes 2-4 weeks to be eliminated from baby’s body. But slowly symptoms start to resolve like reflux, skin, vomiting, irritability, blood in stool etc.

The good news is that most children grow out of Non IgE mediated CMPA (the much more common one) between the age of 1 to 2 years. We recommend challenging them with milk formulas beginning from 6 month onwards by use of a milk ladder:

http://cowsmilkallergyguidelines.co.uk/downloads-and-resources/downloadable-map-milk-ladder/