CRYING BABIES & BEYOND the ins and outs & ups and downs


CHAPTER 7

ALLERGIES AND INTOLERANCES

The medical term for allergy is atopy. People who have problems with allergies or intolerances [or both] are described as ‘atopic’ meaning prone to allergies.

It would be helpful in the understanding of distressed babies to understand about allergies and intolerances.

There are significant differences between allergies and intolerances. The details of the differences will be discussed in this chapter.

The term ‘allergy’ is widely used in the community. When people think of allergies, most think of hay fever [called allergic rhinitis], asthma, eczema, ‘hives’ [called urticaria], reactions to bee stings, peanuts, or seafood. They may also think of allergies from medicines [particularly antibiotics], or skin allergies [e.g., to plants, detergents, or other chemicals, or ‘sticky’ tape dressings]. Some children even react to the vapour of a food [e.g., nuts or eggs].

Allergies have become a major cause of morbidity [discomfort and illness] in Western communities. As infections become less of a problem in a society, allergies tend to become more of a problem. Allergies are rarely a problem in Third World countries—perhaps because infections are still a major cause of illness and death.

Allergy and immunity are closely allied as the problems from allergies are mediated through parts of the immune system. Most allergies are mediated through the IgE system, which is part of a group of proteins called immunoglobulins. Other immunoglobulins [IgA, IgG and IgM] are involved in dealing with infections. Other allergies are mediated through T cells [lymphocytes in the blood and tissues] and these are not as well understood.

Allergy problems have increased hugely in Western societies over the past few decades. The current medical theory to explain this increase is the ‘too clean’ theory. It is thought that because our society cleans everything very thoroughly [so our children are not exposed to as many bacteria or viruses as previously], the infant and child’s immune systems aren’t challenged as much or as severely as previously, so the immune system switches to responding to allergens instead.

My own suspicion is that some of the products that we use regularly to produce this degree of cleanliness are damaging our immune system. If detergents can kill bacteria and viruses then perhaps they may cause some more subtle harm to us as well. Detergents are used readily in most households and residues will remain in contact with food, clothing and utensils. They are then absorbed through the gut, respiratory system or the skin.

Pollution from chemicals in the atmosphere and soil are also an issue. Chemical pollutants in the air come from industry, motor vehicles, fertilisers and pesticides. We know that residues of DDT [now banned for many years] are still present in the fat of human bodies and are still secreted in breast milk.

The increased use of chemicals as additives and preservatives for foods may also be a problem. Chemicals are used extensively to prevent mould [additive 282]. This is found in many brands of bread, to allow it to be packaged in plastic while still warm. Many chemicals are used as additives to prolong the shelf life or to improve the appearance of food. Many children react to….


SUMMARY

Allergies and intolerances have increased significantly in the past few decades, now affecting about 40 percent of the population.

The tendency to being atopic is usually inherited, but there is evidence that allergy may follow the use of antibiotics during the mother’s pregnancy or in the first weeks of the infant’s life.

People who are atopic have tissues that react more vigorously than normal to any form of irritant [e.g., contact with an allergen or irritant chemical]. The tissue reaction produces mucus and swelling and this can produce symptoms depending on the part of the body that is involved.

Intolerances occur in allergy prone children and are usually seen in infants related to particular foods with dairy protein being the most common intolerance. Other foods include soy, eggs, fish and sea foods, citrus, sesame, wheat and yeast products. Intolerances to colouring agents and preservatives [especially 282] are common in children. Most infants outgrow food intolerances by three years of age and most children outgrow intolerance of colouring agents and preservatives by about eight years of age.

There are no specific tests available to diagnose intolerances. Trials of withdrawing foods are the only way of identifying intolerances at this stage. Checking the family history may help decide which foods are likely to be a problem.

Symptoms related to food intolerances include mucosal swelling, excess mucus secretion, nasal snuffliness, eczema, hives, abdominal pain, diarrhoea or constipation. Intolerance of preservatives and colouring agents is often seen as behavioural problems with excessive activity, poor concentration and impulsivity.

Allergies are more likely to continue throughout life and produce more severe problems [including life threatening anaphylactic reactions] than intolerances. They may involve the respiratory system [causing allergic rhinitis, asthma and croup], the skin [causing eczema, urticaria], the gut [causing abdominal pain, diarrhoea, constipation] and the nervous system [causing behavioural problems] and a feeling of lack of well being.

Allergies may be related to foods [particularly dairy, soy, eggs, fish and other sea foods], medications [particularly antibiotics], inhaled allergens [including dust mite, pollens, grasses, moulds], insect bites and stings, bacteria and viruses, and skin contact.

Allergies are most commonly mediated through the IgE system, although some people with a typical clinical picture of allergy do not have an elevated level of IgE.

Testing of IgE mediated allergy is done by skin prick testing or RAST [blood tests]. Test results do not always agree with the clinical picture and the testing and understanding of allergies still needs more study.

There is still no cure for allergies but hopefully before too long, treatment may be more directed to curing rather than just trying to reduce symptoms.

Managing allergies aims to reduce the person’s contact with the allergen, modify the response using medication or more specifically with desensitisation--either by injection or oral drops.

Prevention of allergies developing is still not totally understood and the recommendations are not universally accepted. The use of probiotics may be helpful to try to delay, or prevent allergies from developing….


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