Allergies More Common, Even Among Children

What are the most common allergies in children?

It depends on the age of the children, said Alireza Nejad, M.D., a physician with Allergy & Immunology, Internal Medicine, at the Allergy & Asthma Center in York.

Up to age 1, they are mostly food allergies. More specifically, in the first year of life, allergies to eggs and milk are the most common.

As children age—after their third birthdays—the allergies tend to be more environmental. The body has to recognize the environmental allergen. Among the environmental allergens are dust mites, cats and dogs, tree pollen, grasses, mold spores, and weeds.

What are the most dangerous allergies in children? In food, it is probably peanuts, which can result in severe allergic reaction, or anaphylaxis. If this occurs, the person will need immediate medical attention, including a prompt injection of epinephrine.

Dr. Alireza Nejad, outside of the Lancaster office.

In environmental allergies, indoor allergens, such as dust mites, are dangerous because increased exposure could lead to asthma. Although environmental allergies are not associated with anaphylaxis, uncontrolled asthma can lead to respiratory arrest and death.

What reactions occur from allergies? With environmental allergies, they can be upper respiratory, such as nasal congestion; sneezing, runny nose, and postnasal drip; itchy, watery eyes; and ears clogging and popping. Other possible symptoms are wheezing, coughing, shortness of breath, and skin reactions, such as hives, itching, and irritation as well. Headaches, malaise, and fever are other, less common symptoms.

Anaphylactic reactions are mainly a sign of food, medication, or insect-sting allergies. These reactions involve more than one system in the body. As an example, with a peanut allergy, the patient may experience hives, runny nose, and at times GI symptoms, such as nausea and abdominal pain.

If the reaction becomes severe, the cardiovascular system might be involved, and there might be shock, e.g., a severe drop in blood pressure.

Why do allergies lead to headaches?
Environmental allergies can lead to nasal and sinus congestion, which can trigger headaches.

What foods help fight allergies?
There is no hard-and-fast evidence that this is the case. It’s not big science but anecdotal—that foods that are plant-based, rich in omega-3, are helpful. It is believed these foods decrease inflammation. No well-designed study addressed this issue.

In studies performed at Mt. Sinai Hospital in New York City, specific Chinese herbal remedies showed some promise in treating peanut allergy.

And what foods aggravate allergies?
On the flip side, foods high in animal fat and refined carbohydrates are less healthy in general.

It may seem there are more allergies because there is greater awareness of them, but Nejad said that is not the case.

“It is absolutely right—there is evidence—that there are more allergies and not just more awareness,” said Nejad. “Allergies have increased significantly over the past 40 years. Environmental pollution in general is the culprit.”

Do children grow out of most allergies?
Infants tend to grow out of milk and egg allergies but grow into peanut and tree nuts allergies. Around 2 or 3, children start growing into environmental allergies.

“So, the answer isn’t yes or no,” said Nejad. “It has been observed that people tend to grow out of their environmental allergies as they age, such as in the seventh decade of life.”

Are there tests to determine what someone is allergic to?
There are skin tests, as well as blood tests. There are also variations of skin tests. With the prick test, the doctor scratches the skin and exposes the patient to the allergen. With an intradermal test, the allergen is injected inside the skin. The patch test has an allergen on it, and you look for reactions over several days.

Immunoglobulin E (IgE) for environmental and food allergens can be measured. With suspected asthma, you can do spirometry, a test that measures different volumes in lungs during inhalation and exhalation.

What treatments are available today?
Basically, there are medications and non-medication treatments. Antihistamines, antileukotrines, steroids, and decongestants are among medications prescribed. Most over-the-counter medications for allergies are antihistamines, such as diphenhydramine.

The non-medication treatment modality is basically allergen immunotherapy for both food and mainly environmental allergies. Allergy injections are purified allergens in a solution. Over a period of time, allergen injections change the immune system, which sees them as harmless.

“This is the best way to treat with the chance of a cure, because otherwise, you’re just treating symptoms,” said Nejad.

If allergies run in one’s family, is it likely the children will have them too. If one parent has an allergy, there’s 30 percent higher chance the child will. If both parents do, it’s more than 80 percent.

Allergies are complex maladies, with both genetic and environmental factors, as opposed to say, cystic fibrosis, which is a purely genetic disease. In complex diseases many genes are involved, and the child may not necessarily have the same allergy as the parent(s). BW