How to Diagnose a Baby Allergy

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A rash can be the first sign.

Many newborns get small pimples on their face, but eczema is a more widespread rash that looks red and scaly and may be itchy. It starts on the face, arms, and legs, and later appears in the folds of the knees and elbows. A baby with eczema is more likely to go on to have other types of allergic conditions—a progression experts refer to as the atopic march. In fact, approximately 37 percent of young kids with moderate to severe eczema also have food allergies. Experts believe that food allergies may play a role in causing eczema in some children. 

To treat affected skin, your doctor will likely recommend that you bathe your baby with a hypoallergenic, fragrance-free cleanser and moisturize frequently with a fragrance-free cream. He might also prescribe a topical medication to help heal affected skin or an antihistamine to control itching.

A true food allergy can cause a body-wide reaction.

Food allergy and food intolerance are often used interchangeably, but they’re very different. An allergy is an immunesystem response that causes a severe, often immediate reaction. Hives, lip swelling, vomiting, diarrhea, and wheezing may all be signs of an allergy. When a baby has an intolerance, he’s missing the enzyme needed to break down a protein into digestible parts. This causes a milder reaction isolated in the digestive tract, like gas or cramps. Symptoms of allergies and intolerances can occur when babies begin solids but also during exclusive formula-feeding or breastfeeding. (Breast milk contains proteins from the foods that a mother eats, and most formulas contain milk or soy, which are common allergens.) 

If your pediatrician suspects a food allergy, she may refer your child to an allergist who can perform skin and/or blood tests to confirm a diagnosis. Treatment usually focuses on avoiding a trigger food, but it’s important that a doctor guide that plan. If you take a food out of your child’s diet that he isn’t truly allergic to, this can actually make him more likely to have a reaction the next time he eats it.

A prolonged cough could be early asthma.

Asthma causes inflammation in the airways, resulting in coughing, wheezing, and shortness of breath, and babies who have eczema and food allergies are more likely to develop the chronic condition. Although symptoms of asthma can begin in infancy, most babies don’t get the diagnosis that early—the symptoms instead are attributed to a cold or a virus. But when coughing or wheezing lasts beyond a cold, a doctor will often treat a baby with inhaled medications to help decrease inflammation and then monitor her for asthma symptoms as she grows. 

Sources: Sakina Bajowala, M.D., an allergist at Kaneland Allergy & Asthma Center, in North Aurora, Illinois; Jackie Eghrari-Sabet, M.D., founder of Family Allergy & Asthma Care in Gaithersburg, Maryland; Crystal Y. Pourciau, M.D., assistant professor of dermatology and pediatrics at Baylor College of Medicine, Texas Children’s Hospital, in Houston. 

Parents Magazine

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