Infants with Allergies: prevention and management
By Dr. Atul Shah, the ‘AmazingAllergist’ and author of Allergies, and Awesome You!
I was recently giving a presentation for a group of pediatricians and heard the common theme that many of them are seeing more and more infants with eczema, food allergies and other allergic conditions. This is a common observation, not only in the U.S., but all across the globe. There are many theories, including the hygiene hypothesis, but we do not know for sure the underlying cause of this influx.
It is a common misconception among many, including some physicians, that infants do not develop allergies or cannot be tested for allergies until two years of age. Our clinical experience and current medical literature supports early detection and proper management of infants and young children to minimize their suffering and prevent complications related to delayed diagnosis.
The development of allergies in infants is considered multifactorial, meaning there are other factors playing a role besides genetic predisposition. If parents, family members or siblings have allergies, infants have a higher chance of developing allergies. Other factors that influence immune systems include breast feeding, the type of formula, timing of introducing solids, respiratory infection, exposure to pets, secondhand smoke exposure, urban vs. rural living and gut bacterial flora. The relationship of these factors in developing allergies vs. protecting from allergies is very complex and we still do not have clear answers.
The common symptoms of underlying allergies in infants include eczema, rash, allergic reactions, poor weight gain, reflux, colic, vomiting, bloating, diarrhea, cough, nasal and respiratory symptoms, frequent ear infections, etc. Food allergies can cause life-threatening allergic reactions.
As we now know, restricting a mother’s diet during pregnancy and while breast-feeding has not been proven to be effective in preventing allergies. Restricting a mother’s diet can be beneficial only if the infant’s specific food allergies are confirmed. Breast milk is least likely to trigger an allergic reaction, and it strengthens an infant’s immune system. Most experts agree on exclusive breast-feeding for the first four to six months.
After four to six months of age, introduce one food at a time, starting with fruits, vegetables and cereal grains. This allows parents a chance to identify and avoid any food that causes an allergic reaction. Delaying introduction of solids beyond six months of age has not been proven to be beneficial in preventing food allergies.
Avoiding secondhand tobacco smoke exposure and reducing dust mites in the infant’s environment has been linked to reduced wheezing and respiratory symptoms.
The relationship between early life exposure to pets, such as dogs and cats, and the development of allergies and asthma is not clear. It was once believed that infants exposed to animals early in life were more likely to develop allergies and asthma. Recently conducted research and published data shows that early exposure to dogs, cats and farm animals may actually protect children from developing allergies and asthma.
What can you do?
1. Recognize the symptoms of allergies. Keep a diary of your infant’s progress and discuss with your physician
2. Find out the underlying triggers of your infant’s allergies with an allergy skin test and /or blood tests
3. Avoid the identified allergic triggers, whether the trigger is in food or in the environment
4. Control allergy symptoms with recommended treatment from a physician, and monitor the nutrition, growth and overall development of your child
5. Keep learning more about allergies and available options. New research findings happen all the time, and being on the forefront of information can only benefit you and your family.
About the Author:
Atul N. Shah, MD, FACAAI, FAAAAI, is a board certified allergist and the bestselling author of the children’s book, Allergies, and Awesome You. He is also a medical director of www.Center4AsthmaAllergy.com and the founder of the educational website www.AmazingAllergist.com. He has earned an honor of fellowships in both the American College of Allergy, Asthma & Immunology and the American Academy of Allergy, Asthma & Immunology. He has personally treated more than 20,000 patients, made a significant impact on more than 100,000 lives as an allergist and earned the nickname “AmazingAllergist” from his patients and peers. He has been recognized with various awards, including the America’s Top Physicians’ Award, the Patients’ Choice Award, and the Most Compassionate Physicians’ Award. He believes that every allergic child and individual has a potential to live a great life, allergy-free.