Baby Allergy Facts
Baby Care Basics: Allergies
Although you may not dare leave the house these days without checking the pollen count and stuffing your pockets with Kleenex, luckily you need not worry -- yet -- that your baby will also experience hay fever. "Allergies develop after a cumulative exposure to an allergen," explains Anne Miranowski, M.D., a pediatric allergist in Fairfax, Virginia. "An infant doesn't spend enough time outdoors to develop a reaction to tree pollen, grass, or ragweed." However, allergic reactions to food and indoor environmental irritants can occur during baby's first year and might trigger symptoms like red eyes, sneezing, sniffling, or eczema.
If you or your partner has an allergy, your baby is at increased risk. Her allergy may be completely different, though; if you're allergic to pollen, your child might react to cats. But even if you and your spouse never itch or sneeze, your kid isn't necessarily in the clear. Childhood allergies are on the rise, and many young sufferers have no family history. Some experts think our superclean, ultra-hygienic lifestyle plays a role. If kids live in an almost-germ-free bubble, the theory goes, their immune system will pick fights with other invaders, like foods or household particles. Of course, we're not suggesting you abandon hand sanitizer -- which is why we asked experts for practical advice on how to manage the types of allergies that affect infants most.
Where did your baby's glowing, flawless complexion go? If you see a red, dry patch on his forehead, cheeks, forearms, legs, scalp, or neck, it's probably eczema. This skin reaction is sometimes the first sign of an allergy. Because eczema is itchy, your little guy might wake up during the night to scratch and then be extra tired during the day. But don't be alarmed. Eczema is very common -- 1 in 5 kids has it -- and it gets less severe with age.
How to Prevent It: You might love nuzzling your sweetly scented baby, but perfumed products for bath, skin, and even laundry can aggravate sensitive skin and cause eczema. So switch to fragrance-free products for a quick fix. (Avoid unscented ones, which can still contain fragrances used to mask another odor.)
How to How to Treat It: Dr. Miranowski says a simple daily bathing regimen clears up many mild cases. "Years ago, people thought that you shouldn't bathe a baby with eczema too often because it would dry out the skin," she says. "But that's not true. Water restores moisture to dry skin." So she recommends a daily "soap-and-seal" routine. After washing your child with a mild, fragrance-free cleanser (try Dove, Cetaphil, or Eucerin), pat her skin dry and apply moisturizer. Ointments (like Aquaphor) are best, and cream-based formulas (like Cetaphil) also work well. Both are better than lotion, which contains more alcohol and can be drying.
If your baby's eczema is advanced, a bleach bath -- which isn't as shocking as it sounds -- may help. Soaking for five to ten minutes two to three times weekly in a diluted bleach bath is five times more effective at treating eczema in children (ages 9 months and up) than plain water is, shows a 2009 study published in Pediatrics. "Bleach isn't harmful to the skin," Dr. Miranowski says. "It's similar to swimming in a pool, only cleaner. This bath is helpful because it reduces a type of bacteria on the skin that contributes to eczema." An oatmeal bath can also soothe itchy skin. Unlike bleach, though, it won't kill the bacteria that cause eczema.
Been there, done that, and no improvement? See a pediatric allergist for a skin or blood test to determine if your little one is reacting to a household particle (dust mites, mold, or pet dander) or a food (baby's formula or food you're eating as a nursing mom). Once you pinpoint the cause, eliminate it, which should clear up baby's skin. An allergist can also prescribe a steroid cream to stop the itch.
Peanuts are on everyone's radar, but they aren't the only troublesome food. Eggs, milk, wheat, soy, tree nuts, fish, and shellfish are also top allergens. About 3 million kids (almost 4 out of every 100) have a food allergy. Some fade as a child ages; others tend to stick for life. As for reactions, your child might have a mild one, like getting a few hives around the mouth. Or he might experience a more severe response, such as swelling of the lips, tongue, or throat, or trouble breathing.
How To Prevent It: You might not be able to stop an allergy, says Jacqueline Eghrari-Sabet, M.D., founder of Family Asthma & Allergy Care in Maryland. The American Academy of Pediatrics used to tell parents to delay the introduction of certain foods like nuts and shellfish if their kids battled eczema or if they had a family history of food allergies. Some docs also used to advise pregnant women to avoid nuts. Now we know there's no proof that either tactic works, but there is good reason to introduce new foods gradually. Spacing out their intro over several days will help you ID a problem food if your baby does have an issue, says Trong Le, M.D., an allergist at The Children's Hospital of Philadelphia.
All that said, breastfeeding might offer some protection. A report in a 2008 issue of Pediatrics found that breastfeeding high-risk babies for at least four months can delay or possibly prevent the onset of food allergies, asthma, and eczema. Hypoallergenic infant formulas can also help. In these, the cow's milk proteins are broken down into such small particles that most infants who have a milk allergy can tolerate them.
How to How to Treat It: When eczema is persistent or your child has a reaction to food, visit a pediatric allergist for skin or blood tests. If the results are positive, you'll need to eliminate that food from your child's diet. This means you'll be taking your reading glasses to the grocery store so you can closely inspect labels; nuts, eggs, milk, and wheat are ingredients in many foods. Also, add two very important items to your diaper bag: Children's Benadryl (an over-the-counter antihistamine liquid) and an Epi-Pen Jr. (a prescription adrenaline injector), so you're prepared if your child accidentally eats a trigger food. You'll also need to make sure that your child's day-care provider, grandparents, and babysitters are aware of the allergy and how to manage it.
If the test results are negative, you might want to see a pediatric gastroenterologist. Your baby could have a food intolerance, which means she has trouble digesting a particular food. This can cause acid reflux, gas, bloating, or diarrhea -- which are not allergic reactions.
Something to consider: Recent research published in the January 2010 issue of the The Journal of Allergy and Clinical Immunology shows that 80 percent of children diagnosed with a peanut allergy don't have a true allergy. It's possible that a positive test result could simply indicate a minor sensitivity and not a full-blown allergy, says study author Adnan Custovic, M.D.
Constantly wiping your baby's nose for weeks on end isn't one of the perks of motherhood. A runny nose is only one possible symptom of a nasal allergy. Others include red and itchy eyes, nose rubbing, and clear (rather than yellow or green) mucus. Kids aren't typically bothered by outdoor triggers like grass and ragweed until after age 3, but they can be bothered by household allergens such as mold, dust mites, pet dander, and cockroaches. Nasal allergies affect as many as 40 percent of children, and symptoms can start as early as 6 months. Pay close attention to when your child's sneezing or itching peaks: This can clue you in to what's responsible. For example, dust mites live in bedding and furniture, so if your child is allergic to dust mites, she'll probably wake up with itchy eyes and a runny nose after inhaling them overnight. Or if your baby can't tolerate pet dander, you might notice that her symptoms erupt when you're visiting Grandma and her cats.
How To Prevent It: Get cleaning! Mold flourishes in damp environments, so kill it by wiping under the fridge, scrubbing bathrooms, cleaning or changing shower curtains, and washing and disinfecting garbage cans. Wipe off mini blinds, which trap dust, or replace them with washable drapes. Laundering sheets and stuffed animals in hot water weekly can reduce the level of dust mites and pet dander. Vacuum carpets at least once a week (and upholstery a couple of times every month), especially if you have a dog or cat. Ideally, you should use a vacuum cleaner with a HEPA filter, which actually removes allergens rather than spewing them around the room. For both carpet and upholstery, avoid wet cleaners, as they can leave rugs and furniture damp, creating an environment for mold. Cockroaches are a less common problem, especially in nonurban areas, but play it safe by removing garbage from the kitchen, keeping food in sealed containers, and regularly cleaning counters and floors. Dust mites and cockroaches thrive in humid areas, so fix water leaks and use a dehumidifier as well.
How to Treat It: If your child has a pet allergy, keep Rex and Mr. Whiskers out of your child's room, and also establish a pet-free zone in the part of your house where your baby spends most of his time, Dr. Miranowski says. In addition to vacuuming regularly, you can bathe your pet every week and install a HEPA filter in an air purifier to remove dander. If these measures don't work -- and if your child continues to have a reaction to dander or dust mites despite your best housekeeping efforts -- an allergist will likely prescribe a medication. Claritin and Zyrtec are both available as a syrup, and they're approved for children older than 2 years. Of course, if your kid has a severe allergy, you can find a new pet-friendly home for Rex, but these other tactics often work well.
Now that you know how to keep your baby's sniffles at bay (at least most of the time), sit back and relax a little. Until, of course, you have to worry about seasonal allergies in a few years!
Originally published in the May 2010 issue of American Baby magazine.
All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.