Questions and answers about the allergy in children

Assoc. Dr. Mahmut Doğru / Child Immunology and Allergy Diseases Specialist

The questions that parents are most curious about allergies in children…

• What is the age limit for allergy testing in children?

There is no lower age limit for allergy tests, it can be applied at any age. However, the allergens to be selected vary depending on the disease, age and history of the patient.

• In what periods should allergy tests be repeated?

Allergy tests do not need to be repeated routinely at regular intervals. But it can be repeated if new allergies are suspected. In addition, if the allergic complaints continue in children who are made before the age of 3 or 5 and have no allergies, they can be repeated after 5 years of age.

• What is the effect of genetic factors in allergic diseases?

Allergic diseases occur under the influence of both genetic and environmental factors. If one of the parents is allergic, the probability of allergy of children is 20-30%, while if both are allergic, this rate climbs to 50-60%. If one of the twins has an allergic disease, the probability of an allergic disease is 77% in the other. In double twins, this rate is 15%.

• Is there a lower risk of allergies in babies who are breastfed enough?

Due to its positive effects on health and being the most suitable nutrient for the baby, all babies should definitely take breast milk for at least 6 months, ideally for 2 years. Studies have shown that children fed ready-made food from cow's milk or soy protein have higher rates of asthma / wheezing than those fed with breast milk. Similar results have been shown in studies for food allergy (peanuts), atopic dermatitis eczema) and allergic rhinitis. In the national asthma diagnosis and treatment guidelines, it is recommended that babies are fed with breast milk only for the first 4-6 months for primary (primary) protection from asthma.

Since there is no encounter with beneficial microbes during cesarean section, the baby's immune system development is affected.

• Does cesarean delivery trigger allergies?

Although the study results about the allergic diseases that may develop in the future with cesarean delivery are contradictory, recent studies have found that especially asthma is more common in children born by cesarean section. During normal delivery, babies are exposed to the mother's microbes in the birth canal and these microbes play an important role in the formation of the microbiota in the baby's gastrointestinal tract and skin. Since there is no case of encountering these beneficial microbes with cesarean delivery, the development of the immune system is affected and may cause allergic diseases such as asthma in the future. GINA (Global Initiative for Asthma), an international asthma guide, emphasizes that normal delivery should be encouraged to prevent asthma.

• Should children with allergies be removed from allergens completely?

Of course. These allergens should be avoided if the child's allergy is detected by skin tests and if he / she has complaints (cough, runny nose, rash, etc.) when he / she comes into contact with substances with allergies. While doing this is easy for food and drug allergies, it is difficult for airborne allergens (house dust mite, pollen, mold, animal epithelium). But the first rule in the treatment of allergic diseases is to stay away from the allergic allergen. Therefore, it should be avoided as much as possible.

• Does asthma in childhood continue in adulthood?

Children who have asthma in childhood have an asthma rate at puberty or in their 20s. Especially in men and children with mild disease severity, asthma is more likely to pass with advancing ages. However, asthma may develop again in about 1 in 4 of the children whose asthma decreases. As with all chronic diseases, regular doctor follow-up is important in asthma. Asthma is more likely to continue in those with the following characteristics:

* If the gender is female,

* If asthma is severe,

* If the family has asthma,

* If you have other accompanying allergic diseases (atopic dermatitis, allergic rhinitis, food allergy),

* If there is sensitivity in skin tests,

* Bronchial sensitivity vasa,

* If there are defects in pulmonary function tests,

* If he smokes or is exposed to his smoke,

 * If he had a lower respiratory tract infection (pneumonia) in early childhood.

• If there are cough attacks in asthma, what treatment is applied?

Asthma is a disease characterized by recurrent cough, wheezing, chest tightness and shortness of breath. In these cases, the patient is given breathing medications and, if necessary, drugs with cortisone. Apart from this, there is also a type of asthma, with shortness of breath, wheezing and chest tightness without coughing.

• How innocent are airborne drugs in asthma attacks?

Medicines given by air are of 2 types. These are breathtaking and controlling drugs (drugs with cortisone). They do not have any significant side effects when used in appropriate doses in accordance with the doctor's recommendation. However, when used in high doses and improperly, they can have side effects like all medicines. However, if any difference is observed from the use of the drug, the doctor should be informed.

• Which points should be considered about allergy medicines containing cortisone?

Drugs with cortisone are among the most effective drugs in the treatment of allergic diseases. While cortisone rates of these drugs vary, cortisone drugs used according to the disease also change. In asthma, cortisone mouth sprays, allergic rhinitis cortisone nasal sprays, atopic dermatitis, cortisone cream / ointments are used. When using all these drug forms, strong cortisone varieties should not be used as much as possible. As a result of improper use of these drugs at high doses, cortisone-related side effects (skin atrophy, skin streaking, vasodilation, acne, osteoporosis, cataracts, glaucoma, growth retardation, adrenal axis suppression, hypertension, ulcer, diabetes) may occur.

• Should children with asthma never run or play?

We do not prohibit children with asthma from doing sports. It is especially recommended to swim. However, some children with asthma may experience chlorine related asthma symptoms in pools. According to the child's allergy, the places where he plays sports are important. It may be inconvenient for a child with house dust mite sensitivity to play sports in indoor gyms that are not properly cleaned. It is necessary to create more suitable environments for children who play sports in such a place and then suffer from shortness of breath, cough, wheezing, and nose. Likewise, it may be inconvenient for a child with a pollen allergy to exercise outside during the spring season when the pollen is heavily scattered.

Editor's note: Be sure to read our columnist for other allergies.