What is allergy
Allergy is a reaction of the body in the presence of a particular protein of external origin (we speak of allergen). The allergic reaction has the particularity of being triggered by minimal amounts of allergens and especially of worsening as and when contact with it. In extreme cases, but fortunately very rare, this reaction is violent and is accompanied by a drop in blood pressure: it is anaphylactic shock. In more moderate forms, the allergy causes skin reactions (urticaria) with itching, digestive symptoms (diarrhea, vomiting) or damage to the nasal or ocular mucous membranes (rhino-conjunctivitis). In some cases, the allergy is responsible for asthma attacks.
A progressive disease
The allergy is expressed as and when it comes into contact with the allergen. At the beginning, there are no symptoms, only indirect signs, which can be found either by doing skin tests (prick tests) or by measuring certain allergy-specific antibodies (IgE) in the blood: c This is the stage of allergen sensitization. After a certain time (days, months or years depending on the case) with continued contact with the allergen, the symptoms appear more and more important and more and more rapidly: this is the stage of the disease. allergic.
It should be noted
Allergy evolves a lot over time and with the allergens encountered. Thus, the allergies of the first months of life are essentially food allergies: first cow’s milk then egg, fish, or peanuts. The dust mite allergy occurs a little later and pollen allergies do not appear until after several years. Likewise, there are soy allergies among Asians, shrimp allergies among West Indians, birch allergy is characteristic of children in Ile de France, and older children in the south of France are allergic to cypress. .
Skin tests
From what age can we do skin tests? We often hear that the child must be over 2 or 4 years old to have skin tests.
This is not entirely correct: it is possible to highlight signs of allergy to cow’s milk in the first months in infants. What is needed is to adapt the desired allergens to age: more food allergens before 3 years old, food, dust mites and peanuts before 6 years old, pollens, birch, grasses, cats and mites in older children. The tests must be redone every 3 or 4 years: the allergy changes a lot, food allergies gradually improve while allergies to pollen or animal hair can gradually appear.
Desensitize rather than suppress
The treatment of allergies acts first on the symptoms: in particular, antihistamine antiallergic drugs are used systemically (syrup) or local (nasal spray or eye drops). It is also possible to modify the course of the allergic disease by modifying the environment.
We tried to completely eliminate contact with the allergen (avoidance of the allergen) in order to eliminate the allergy. We noticed that the allergy did not disappear and that if, after several years of eviction, the allergic child was suddenly brought into contact with the allergen, the allergic reaction reappeared in an even more brutal way.
Today, we are trying to improve tolerance to the allergen by maintaining repeated contact with very small amounts of allergen: for example, under medical supervision, we continue to eat foods containing minimal doses of peanut (in the form of “traces”) to children with peanut allergy.
This same principle is used when allergens, other than food, are involved (pollens, mites, etc.); this desensitization is now mainly done orally (and no longer by injections). The allergic child is taken every day (it is possible from the age of about 5 years) of very small amounts of the allergen which are contained in drops. Gradually we increase the number of daily drops and then, if all goes well, we increase the concentration of allergens in each drop. The technique is effective but a little restrictive since it is generally a treatment to be continued for 5 years.
In case of confirmed food allergy
Homemade cooking is recommended because the ingredients are known while ready-made meals may contain ingredients at risk of allergies. The regulations facilitate the purchase of food products by making it compulsory on the labels to mention the presence of the most frequent allergens. The foods and derivatives concerned are: cereals containing gluten, crustaceans, eggs, fish, peanuts, soybeans, milk, nuts, celery, mustard, sesame seeds, lupine and molluscs (shellfish), sulfur dioxide and sulphites.
Do not worry if your child has less variety in food: a simple diet, combined with a sufficient quantity of milk, or the equivalent, provides all the elements necessary for growth.
In the event of multiple allergies, many foods may be prohibited to the child; in this case, the doctor will prescribe the supplements he deems useful.
If, despite your precautions, your child was in contact with food again, you will have provided the doctor with a kit containing various drugs: an antihistamine in the event of urticaria alone, an oral corticosteroid in the event of edema, and in the event of edema. the most serious, in case of discomfort for example, an adrenaline pen.
Peanut allergy
It is in fact an allergy to peanuts and its derivatives (peanut butter and, in rare cases, peanut oil). More and more frequent, it occurs more and more precociously. Unlike other food allergies (milk or egg for example), it does not tend to improve over time. It is a potentially serious allergy which therefore justifies a precise initial diagnosis and specialist medical follow-up.
The diagnosis
Monitoring depends first of all on the conditions in which this allergy is discovered: whether the child has had a severe allergy reaction (swelling of the lips or tongue, or even facial edema or discomfort) from the first ingestion of peanuts , the allergy is certain and the removal of any peanut presence in the diet is mandatory. If the allergy has been discovered in less clear circumstances or, as is often the case, only suspected by a positive skin test or with a positive result in a blood test, it is necessary to have a specific test performed. hospital setting: this is called an oral challenge test. Here is how we do it.
Testing and monitoring
The level of allergy will be evaluated under medical supervision: we start by having the child absorb a few drops of peanut oil then larger volumes. If there is no reaction, we test a few milligrams of peanuts, then hopefully larger and larger quantities of peanuts (up to 3-4 peanuts).
This test will guide the level of monitoring necessary: if there is no reaction to taking peanut oil but only to more than one peanut, the allergy is moderate and monitoring may be more flexible ( the child can eat in the canteen for example). If, on the contrary, the signs of allergy appear from the first drops of peanut oil, the allergy is important and the monitoring must be intensive (the child cannot go to the canteen).
In all cases of true peanut allergy, it is necessary for the child to be followed in a specialized environment so that the parents can be informed of the precautions to be taken according to the severity of the allergy and of the specific procedures to be followed. accidental ingestion of peanuts.
New recommendations for babies at risk of allergies
These recommendations recommend the early introduction of peanuts (in the form of peanut paste more commonly known as peanut butter) in babies at risk, between 4 and 11 months. However, this recommendation only concerns specific infants: those suffering from significant eczema because it is they who are most at risk of later developing this allergy. Second requirement: to have taken care to verify by skin tests or by a blood test that these children were not already allergic to peanuts. Last precaution: it is recommended that the very first peanut intake be done under medical supervision, in the office for example. The toddler is offered a teaspoon of peanut butter diluted in a little milk. If there is no reaction, it will be necessary to offer him at home three times a week two teaspoons of this mixture for three years.
Cow’s milk protein allergy
Cow’s milk protein allergy is one of the four most common food allergies in children (along with egg, peanut and fish) and the most common allergy before the age of 6 months.
How does this allergy manifest itself?
Most often by a reaction on the skin of sudden onset (acute urticaria), occurring from the first bottles, especially during weaning. The allergy can also be revealed by acute digestive signs (diarrhea which may have traces of blood, vomiting). It requires a quick consultation. Exceptionally, these reactions can be accompanied by edema of the face (angioedema), or even allergic shock, called anaphylactic.
Allergy to cow’s milk proteins can sometimes manifest as less acute reactions: eczema, severe gastroesophageal reflux disease, persistent colic. The allergic origin of these symptoms is often difficult to prove.
The diagnosis
In the case of acute reactions, the diagnosis is usually quickly confirmed by the detection of signs of allergy in the blood (appearance of IgE, that is to say of antibodies, against the proteins of the milk of cow) and by standard skin tests with immediate reading (Prick test) which are done either in the pediatrician’s office or at the allergist doctor.
In the event of more chronic symptoms, the blood tests are most often negative as well as the classic skin tests. The diagnosis can then be made through skin tests extended over 48 hours (Patch test). In the most complex cases, it is only possible to demonstrate the allergic origin of the symptoms by carrying out an eviction / reintroduction test: cow’s milk and dairy products are removed for four weeks in order to see if the symptoms disappear, then reappear when milk is reintroduced.
The treatment
When the diagnosis of allergy to cow’s milk proteins is confirmed, all dairy foods must be excluded (we speak of eviction). This exclusion obviously concerns milk but also dairy products and any product that may contain milk proteins (small jars, cookies, etc.).
In infants, first-age milk is most often replaced by special milk in which the proteins in cow’s milk have been modified to lose their allergenic capacity: we speak of milk based on “hydrolyzed proteins”. Allergic babies should not be given milk
milk based on “hydrolyzed proteins”. An allergic baby should not be given milk from other mammals (mare, goat, sheep) or vegetable drinks (chestnuts, almonds, etc.): they do not contain the nutrients necessary for its growth and lead to serious deficiencies. Infant milk made from soy protein is not recommended: many infants who are allergic to cow’s milk protein are also allergic to soy. On the other hand, we now have a first age milk made from proteins from rice which could constitute an interesting alternative to milks based on hydrolyzed milk proteins.
Food diversification is offered, like other babies, between 4 and 6 months. However, greater vigilance is recommended when introducing new foods because other food allergies are more frequent in these infants: the foods will be introduced one after the other, without mixing them.
Cow’s milk protein allergy heals as the child grows and, most children who have been allergic will tolerate cow’s milk before the age of 3. Cow’s milk is reintroduced in a hospital environment at around 1 year of age during a “reintroduction test day” during which milk is given little by little, under supervision (from a few drops to several tens of milliliters at a time. end of the day). If signs suggestive of allergy appear, the test is stopped, the eviction renewed, and a new attempt at reintroduction is proposed six months later. If no reaction is noted during the day, the milk products are reintroduced into the diet.
This article is taken from the book “.
Find all the news related to the works of.