How do allergies manifest in children?
Manifestations depend on age and route of exposure to the allergen. In children, the skin most often suffers: dryness, redness, itching and scratching on the cheeks, in the elbow and popliteal folds - this is a picture of atopic dermatitis. With food allergies, regurgitation, vomiting, and loose stools with mucus, sometimes streaked with blood, are also possible. In older children, the reaction of the respiratory tract comes to the fore: congestion and watery discharge from the nose, sneezing, itchy eyes, night cough, wheezing. The most dangerous form is anaphylaxis, a rapid reaction with swelling, a drop in blood pressure and difficulty breathing.
- Atopic dermatitis: dryness, itching, rash
- Urticaria and swelling
- Allergic rhinitis and conjunctivitis
- Cough and wheezing, bronchial asthma
- Food reactions: vomiting, loose stools, abdominal pain
- Anaphylaxis is a life-threatening condition
Common allergens
In children of the first years of life, food proteins play a leading role: cow's milk, chicken eggs, wheat, soy, fish, nuts. Many of these allergies go away with age, especially to milk and eggs, while reactions to nuts and fish often persist. For preschoolers and schoolchildren, inhalation allergens come to the fore: house dust mites, tree and grass pollen, mold spores, animal hair and epithelium. Allergies to wasp and bee venom and medications are considered separately. It is important to remember that a child’s rash is not always allergic: it is caused by viral infections, prickly heat, and contact irritation.
- Cow's milk, egg, wheat, soy
- Fish, seafood, nuts
- House dust mites
- Pollen from trees and grasses
- Animal wool and epithelium, mold
- Insect poison and medicine
What tests are really needed?
The examination begins not with tests, but with a detailed question: what did the child eat, how long did it take for the reaction to appear, how long did it last, and whether it happened again. A food diary is helpful. Total IgE and specific IgE to suspected allergens are determined in the laboratory; panels are used if necessary. Skin tests are performed by an allergist in children of appropriate age and when antihistamines are discontinued. It is important to understand: a positive test in itself only means sensitivity, not illness. If a child calmly eats a product to which antibodies have been found, there is no need to exclude it from the diet. The final decision is made by the doctor, sometimes after a provocative test in a clinical setting.
- Detailed reaction history and food diary
- Total IgE and specific IgE
- Allergy panels for suspected groups
- Skin tests with an allergist
- Provocative test only in the clinic
- A positive test without symptoms is not a reason to go on a diet.
Treatment and control
The basis is eliminating contact with a confirmed allergen. In case of food allergies, exclude a specific product and its hidden sources, teaching parents to read the ingredients on the package. For allergic rhinitis and asthma, cleaning, reducing the amount of dust, using covers for mattresses and pillows, regular ventilation, and stopping smoking in the house are important. Antihistamines reduce itching and runny nose; for asthma, inhalation therapy is used as prescribed by a doctor. In atopic dermatitis, daily skin care with emollients plays a key role, and in case of exacerbation, local anti-inflammatory drugs for a short course. For confirmed respiratory allergies, an allergist may suggest allergen-specific immunotherapy.
- Exclusion of a confirmed allergen
- Reading the composition of products, monitoring hidden sources
- Hypoallergenic life: dust, covers, ventilation
- Antihistamines as prescribed
- Emollients and external therapy for dermatitis
- Inhalation therapy for asthma
- Allergen-specific immunotherapy according to indications
What to do in case of an acute reaction
If, after eating, an insect bite, or taking medication, a child develops swelling of the lips and eyelids, hoarseness, difficulty breathing, widespread hives, vomiting, severe pallor or lethargy, this is an emergency. Immediately call an ambulance by number 103. Before it arrives, put the child down, if there is difficulty breathing, let him sit, do not leave him alone, do not force him to drink or eat. If your doctor has previously prescribed your child an emergency medication, use it as directed. For children with a history of severe reactions, the allergist will provide a written plan of action, and a copy of this plan should be available to parents, the school, and educators.
- Call 103 immediately for swelling and difficulty breathing
- Put the child to bed or sit down, do not leave him alone
- Use the prescribed emergency medication
- Do not give food or drink if the larynx is swollen
- Have a written action plan from your allergist
- Report the diagnosis to school and kindergarten