These are the telltale clues of five childhood allergies that parents should watch out for, according to a professional doctor in Dubai
3 November 2020| Last updated on 4 November 2020
If you are a parent worried that your child might be allergic to something, you are not alone.
Worried about a rash? Suspicious of that sniffy nose? Curious about that cough? Concerned your child has a food allergy? Dr. David Cremonesini is a Consultant Pediatrician at Mediclinic Parkview Hospital in Dubai with a special interest in allergy.
In this article, he outlines his expert medical approach and some useful tips if you believe your child has a possible allergy.
"Every day I see parents who have been told their child has an allergy and it’s a common belief from doctors they do. Sometimes they have had a test but this doesn’t always mean they are allergic," said Dr. David.
Let’s breakdown the common problems where allergy is diagnosed, often wrongly, and share some clues that tell us it may not be an allergy.
1. Runny nose and itchy eyes
Now that children are back at school, medical professionals are seeing this a lot, and in many cases, this will be due to viruses.
A big clue is how your child was feeling before school during the extended lockdown period. During this time, the child wouldn’t have been exposed to many viruses, but exposure to allergies won’t have changed much, especially ones in the home like dust mite, molds, or pets.
Therefore, if your child was well before, then it is unlikely allergies causing symptoms back at school. A fever, thick nose secretions, or absence of an itch makes allergy unlikely but if you are in any doubt, doing an allergy test can help.
Confirming an allergy helps make things better as doctors then know what treatment to give. You can also try changes at home to reduce exposure to the allergic cause, e.g. bed and pillow covers for dust mite allergy.
2. Stubborn cough
All children cough, but many cough a great deal and most coughs are caused by viruses.
Typically, sudden onset with fever or runny nose is likely to be a virus and it can take up to 4 weeks before it passes. In early childhood, it's normal for children to get 10-12 viruses in a year so if they are unlucky, a persistent cough for months might be one virus after another.
Doctors usually see children get better for short periods in between coughs, and even if it’s just a week or two, periods of being normal are reassuring.
Allergy coughs will normally either be accompanied by an itchy nose and persist for a long time, or be associated with wheezing or difficulty with breathing.
Asthma is a possibility, but the cough must be associated with a breathing problem (often during exercise) and it's very rare to just be a cough.
Dr. David said he often sees a “habit” cough where a child is coughing all day, breathing normally but at night no cough at all. In asthma, a child would be coughing at night too.
3. Itchy dry skin or eczema
Eczema is a skin problem caused by irritation to the skin. There are many things that aggravate the skin that parents can’t avoid.
Sweat, viruses, clothing, chlorine, and soaps all irritate the skin, but often parents worry about an allergy, especially related to food. It is possible that food might be one trigger, but it's actually less likely in children who are older than 2 years.
Dr. David's main priority is treating eczema properly, using moisturizers 3-4 times a day and steroid creams when the child is itchy and suffering.
Steroids are safe and the best initial option to alleviate itching, as constant scratching can make the skin bleed thereby causing more damage than steroids.
Allergy tests, especially those related to food, are not always helpful in eczema cases and can lead to unnecessary food avoidance. So, it is important that if you are avoiding foods to bring them back in the diet when the eczema is better in order to challenge the skin and see what happens.
4. Food allergy
According to Dr. David, here's how parents in Dubai should diagnose a food allergy.
Firstly, the parents must visit a doctor and tell him or her a story, one where the child had an itchy rash, swelling in the face, vomit and (rare) breathing problem less then 2 hours after eating a certain food. Such a reaction always happens when the child eats that food.
The doctor will hear the story and if they suspect an allergy, the clinic will do a skin prick or blood test. A positive test will support the story and confirm the allergy.
In fact, allergy is defined not by a test but by a positive story. This is why Dr. David is against food panel tests where many foods are tested as it can lead to an over diagnosis of food allergies since you can’t rely on a test. This leads to two big problems:
1. Affects a child's growth and nutrition
Firstly, a child is avoiding foods, potentially unnecessarily, and this impacts their growth/nutrition status. Furthermore, it impacts a parent’s mental health, worrying about possible reactions at school or in restaurant.
2. Increases risks of developing a food allergy
Secondly, avoiding foods as a child when they are not allergic to it, over time leads to an increased risk of food allergy.
"I would say I spend as much time undiagnosing food allergy as I do diagnosing it and to reassure parents. I do food challenges at the clinic so parents can feel safe trying different foods," he said.
5. Antibiotic allergy
"I see many children with suspected allergy after getting a rash or other problems while taking oral antibiotics," he said.
However, studies tell us that over 90% of children (and adults) who believe they are allergic to antibiotics (commonly penicillin) are actually not.
"It’s important to rule this out and in my clinic, we do this by doing a test first and then by giving some antibiotics at the clinic," added Dr. David.
Avoiding antibiotics can unnecessarily lead to problems in adulthood. When as an adult you get unwell, oftentimes penicillin might be the best antibiotic to give but doctors won’t do it due to worries about allergy. It is therefore important to try and check when you are a child.
He continued: "So, parents, my advice is to be careful when making a diagnosis of an allergy too easily. When in doubt, you can do a test to check but first, we check there is a story that suggests an allergy."
At Mediclinic Parkview Hospital, Dr. David is offering FREE skin prick tests for food or airborne allergies – the only charge is the consultation. By doing tests and discussing your child with him, you can get a clearer picture of what’s going on and a more accurate way to treat your child and make them better.
If you want to see how a skin prick test works, you can check out this video by Royal College of Paediatrics UK.