Allergy and Asthma in Children

Asthma: the most common symptoms

Asthma is a condition in which the airways leading to the lungs narrow from time to time. In children, it shows up in the following ways:

• A cough that gets worse especially at night and toward morning
• Wheezing (a whistling sound) when breathing out
• Tiring quickly and getting short of breath when running, laughing or crying
• A cough that lasts for weeks after every cold
• A feeling of tightness in the chest (older children may describe this)

Not every wheeze in a young child means asthma; wheezing caused by viruses is very common at this age, and much of it goes away on its own by school age. That is why, for the diagnosis, how often the symptoms come back, whether there is asthma or allergy in the family and how the child responds to treatment are assessed together.

Allergic rhinitis (hay fever)

It comes with a runny nose, stuffiness, repeated sneezing, and itchy nose and eyes. How it differs from a cold: there is no fever, it lasts for weeks and it gets worse in certain seasons or certain settings (dust, pets). If untreated, it can affect the child's sleep and school performance, and in children with asthma it makes asthma harder to control.

Eczema (dry, itchy skin)

In babies it appears as red, dry and itchy patches on the cheeks, and later on the inside of the elbows and behind the knees. The basis of care is using moisturizer generously and regularly; during flare-ups, creams recommended by the doctor are used. Babies with eczema are slightly more likely to have food allergy; that is why the two are assessed together.

Food allergy

It is most commonly caused by cow's milk, eggs, peanuts and tree nuts (such as hazelnuts), wheat, soy, fish and shellfish. In true food allergy, symptoms usually start within minutes to two hours of eating the food: redness around the mouth, hives, vomiting, coughing, shortness of breath.

When allergy is suspected, the diagnosis is made from the child's history, a blood test or skin test when needed, and a food challenge test done under a doctor's supervision. "Food intolerance tests" (IgG panels) sold in shops or at some centers are not used to diagnose food allergy; allergy societies do not recommend these tests, because they also come back positive in healthy people and lead to foods being cut out unnecessarily.

When should allergenic foods be introduced?

In the past, delaying foods such as eggs and peanuts was recommended. Studies showed the opposite: delaying these foods does not prevent allergy, and in some cases it may even increase the risk. Today, during the move to solid foods (from about 6 months), it is recommended that allergenic foods are also tried one at a time and in small amounts, like other foods. If there is a family history of severe allergy or the child has marked eczema, it is best to talk to a doctor before starting.

What you can do at home

• Absolutely no smoking in the home — one of the strongest triggers of asthma attacks
• Reducing carpets, stuffed toys and dust-collecting items in the bedroom
• Washing bedding in hot water
• Keeping damp and mold under control
• Not skipping the seasonal flu vaccine