Healthy Living: Allergic Reaction
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So, what’s an allergic kid (and his or her parents) to do?
There is a standard of care in the treatment of nasal allergies, according to Stone. He advises that children whose allergies occur seasonally should avoid the outdoors as much as possible when offending grasses, molds and weeds are in full flower. When they are indoors, windows should be kept closed and the AC running. After they have been out, they should change clothes and take showers to remove traces of pollen, etc.
To minimize the ill effects of indoor allergens such as dust mites, a child’s bed should be outfitted with mattress, pillow and box spring encasings. Sheets should be washed frequently in hot water, and if allergies persist, parents should consider removing carpeting and stuffed animals from the child’s room.
Nasal allergies can be treated with antihistamines, prescription medicines (in spray or tablet form) or a course of allergy injections, known as immunotherapy. Allergy shots work by gradually exposing the patient to increasing amounts of an allergen, in order to decrease sensitivity to it. Immunotherapy can require a three-to-five-year regimen, and it is not effective for everyone. Still, says Miller, “Many people experience very significant benefit from that treatment, and it has been shown to decrease the likelihood that nasal allergies will progress to asthma.”
Where food allergies are concerned, early intervention may be in order.
For years, it has been the recommendation of many pediatricians to delay the introduction of highly allergenic foods (like eggs) until a child is 2 years old (or in the case of peanuts, 3 years old), but this “may not be the best advice,” says Factor. “Instead of allowing the immune system to mature, this practice may actually heighten the risk of becoming ‘sensitized’ and increase the number of children who develop food allergy.”
According to a study conducted by the NIH Food Allergy Initiative, infants who already have a milk or egg allergy are at risk for later developing a peanut allergy. Some researchers are testing the early-intervention theory by introducing peanuts earlier, to determine if a baby’s immune system might better tolerate allergens.
Once a food allergy has manifested itself, the best defense is strict avoidance. “After a diagnosis has been made,” Stone says, “we recommend that a child simply avoid the food he or she is allergic to—and carry emergency medicine” in the event it is inadvertently ingested.
While allergy shots are not typically administered to treat food allergies, says Stone, an experimental treatment called oral immunotherapy is showing promise. Although the treatment is not FDA-approved, it is being tested with some success by allergists, Factor among them.
“This process involves having the child with a food allergy—to peanuts, for example—ingest very minute amounts of that food [initially less than 1/1000 of a peanut],” says Factor. “We slowly increase the dose over time so they will become desensitized to that food. The goal of oral immunotherapy is not to cure the peanut allergy, but to raise the threshold amount necessary to cause a reaction.”
The results have been nothing short of amazing, says Kristin Barnhardt of Hartford, the mother of one of Factor’s patients. Her son Noah, now 9, has strictly avoided peanuts after he had a severe reaction at age 1, when he was given a Saltine with a thin layer of peanut butter on it. “Every year we’ve taken him to the allergist, and based on his skin-prick test and blood work, we’ve been told his allergy has actually gotten worse,” says Barnhardt. Last year, after Noah’s doctor told them that an oral immunotherapy study was being conducted nearby, they decided to go for it. Noah was the first patient to undergo treatment by Factor.
“It’s been a gradual, easy process,” says Barnhardt, and after only a few months, “he’s eating up to one peanut every day.” She’s thrilled. “I know the doctor’s goal is just to improve his quality of life, but we’re even more hopeful,” she says. “My hope is that one day Noah won’t have a food allergy at all.”