Allergy in Childhood

Anxiety in children with allergies

Children with allergies often experience heightened levels of anxiety due to the constant vigilance required to avoid potential triggers. The fear of an allergic reaction, the need to carry medication, and the social implications of being “different” can all contribute to increased stress and worry.

Allergy can affect the wellbeing of children in many different ways, including: 

• Anxiety around a potential allergic reaction 
• Fear of using adrenaline auto-injectors 
• Negative relationships with food including food aversions and refusal 
• Sleep deprivation due to allergy symptoms, affecting mood and concentration at school 
• Visible symptoms such as eczema and hives causing low self-esteem 
• Isolation around social events such as birthday parties and eating out at restaurants. 

Connect with other parents, caregivers, and individuals who understand the unique challenges of raising a child with allergies and anxiety. Share your experiences, ask questions, and find solace in a supportive community that genuinely cares.

Anxiety can manifest in various behavioural changes. Look out for signs such as increased irritability, restlessness, changes in sleep patterns, or difficulty concentrating. Our guide below provides insights into these behavioural cues and their potential connection to allergies.

Cow’s milk allergy in children

A cow’s milk allergy (CMA) in children is an immune system response to proteins found in cow’s milk. This common allergic reaction occurs when the immune system mistakenly identifies certain proteins in cow’s milk as harmful, leading to the release of chemicals such as histamines.

Symptoms of cow’s milk allergy can manifest within minutes to hours after consuming cow’s milk or products containing it. Common symptoms include:

• Skin reactions: Hives, eczema, or red, itchy skin.
• Gastrointestinal issues: Abdominal pain, vomiting, diarrhoea, or constipation.
• Respiratory symptoms: Runny nose, sneezing, coughing, wheezing, or difficulty breathing.
• Swelling: Swelling of the face, lips, tongue, or other parts of the body.
• Anaphylaxis: In severe cases, a potentially life-threatening reaction characterized by a sudden drop in blood pressure, difficulty breathing, and loss of consciousness.

It’s essential for parents and caregivers to work closely with healthcare professionals to manage and monitor a child’s cow’s milk allergy, as well as to educate others who may be responsible for the child’s care, such as teachers, caregivers, and family members.

Food allergies in children

Almost 1 in 12 young children suffer from a food allergy and they seem to be getting more and more common.

Symptoms of an immediate food allergy

Mild to moderate symptoms typically affect the skin, the respiratory system, and the gut.

• A flushed face, hives, a red and itchy rash around the mouth, tongue, or eyes. This can spread across the entire body.
• Mild swelling, particularly of the lips, eyes and face.
• A runny or blocked nose, sneezing and watering eyes.
• Nausea and vomiting, tummy cramps and diarrhoea.
• A scratchy or itchy mouth and throat.

Symptoms of delayed food allergy

Delayed food allergies in children can manifest in various ways, and it’s essential for parents to be aware of potential symptoms. Unlike immediate allergic reactions that occur within minutes of exposure, delayed food allergies may take hours or even days to show symptoms. Here are common symptoms associated with delayed food allergies in children:

• Eczema: worsening or flaring of eczema or other skin conditions.
• Rashes: development of hives, redness, or other skin rashes.
• Reflux: recurrent episodes of vomiting, which may occur intermittently.
• Poor growth and failure to thrive: poor weight gain or growth compared to other children of the same age.
• Abdominal Pain: complaints of stomach pain or discomfort.
• Bloating: abdominal bloating or distension.
• Constipation and/or diarrhoea: persistent, long-term diarrhea or constipation that may be accompanied by abdominal pain.
• Raising knees to chest with tummy pain
• Frequent distress and crying

Food Protein-Induced Enterocolitis Syndrome (FPIES)

Food Protein-Induced Enterocolitis Syndrome (FPIES) is a rare and potentially severe type of food allergy that primarily affects infants and young children. Unlike typical food allergies, FPIES doesn’t manifest with immediate allergic reactions such as hives or respiratory issues. Instead, it primarily involves the gastrointestinal system.

Key Features of FPIES:

• Gastrointestinal Symptoms: FPIES often presents with symptoms like severe vomiting, diarrhea, and dehydration a few hours after consuming a trigger food.
• Delayed Onset: Unlike other allergies, FPIES reactions typically occur several hours after ingesting the trigger food, making it challenging to identify the cause.
• Common Trigger Foods: Common culprits include dairy, soy, grains, and certain proteins. However, triggers can vary from one individual to another.

Weaning your food allergic child

The journey of introducing solid foods to your little one is an exciting milestone, but for parents of children with known or suspected allergies, it requires an extra layer of diligence and awareness.

Careful weaning is the cornerstone of ensuring your child’s safety. Introducing new foods gradually allows you to monitor and identify any adverse reactions, preventing potential life-threatening situations and creating a safe and controlled environment during weaning is key to navigating this phase successfully.

Common challenges when starting your weaning journey are:

• Identification of allergens: Work closely with healthcare professionals to conduct allergy testing and develop a clear understanding of your child’s specific allergens. This information forms the basis for a tailored and safe weaning plan.
• Limited food choices: Seek guidance from a dietitian to ensure that your child receives a balanced diet despite restrictions. Explore creative and safe alternatives to provide variety and meet nutritional needs.
• Cross contamination risks: Practice strict hygiene measures, separate utensils, and surfaces, and thoroughly read food labels. Educate caregivers, family members, and childcare providers about the importance of avoiding cross-contamination.
• Emotional impact on the child: Create a positive and supportive environment. Encourage open communication, educate your child about their allergies in an age-appropriate manner, and emphasise the delicious and safe foods available to them.

Successfully navigating these challenges requires a collaborative effort between parents, healthcare professionals, caregivers, and educators. By staying informed, proactive, and adaptable, you can create a safe and positive weaning experience for your child with food allergies.

Eczema  

Eczema (also called atopic eczema or atopic dermatitis) is a very common noncontagious dry skin condition affecting approx. 1in 5 babies and children in the UK. The common symptoms of eczema are dryness, itch, and redness to the skin. Eczema often appears in the first few months of life, and for most children their eczema often improves as they get older, however for some children with more severe eczema there is a possibility that this will persist into adult life. Eczema can be mild, moderate, or severe and treatment of the eczema will depend on the severity.

There is currently no cure for eczema, however avoidance of trigger factors and a clear eczema treatment plan for managing eczema will help manage symptoms for most children. Download our Factsheet on Eczema in Children for more information.  

Asthma 

In the UK 1 in 11 children (1.1 million) have asthma. Asthma commonly starts in childhood, and common triggers include pollen, animals/pets, house dust mites, viral and chest infection, cigarette smoke, other environmental irritants, and cold weather. In some children, exercise, changes in air temperature and stress can also provoke wheezy episodes. Asthma causes a range of breathing problems. These include wheezing, feeling of tightness in the lungs/chest and a cough (often in the night or early morning). The most serious of these is known as an ‘asthma attack’ where the sufferer struggles to breathe. An asthma attack needs to be treated promptly and if you have prescribed medication for asthma and it is not working, you must seek immediate medical help. Preventers (inhalers) are used to reduce the inflamed areas of the lungs and to prevent the symptoms of asthma occurring.  

It is common for children with asthma to also have hay fever. If this is the case then it is important that hay fever symptoms are well managed with the correct treatments and medication, as there is an increased risk that uncontrolled hay fever may impact on asthma, exacerbating asthma symptoms and increasing the risk of an asthma attack. 

Hay fever 

Hay fever is a common allergic reaction which occurs at particular times of the year. It is known as seasonal rhinitis, sharing symptoms with perennial (year round) allergic rhinitis, but occurring as a reaction to pollen from grass, trees and weeds during the early spring and summer months. The common symptoms associated with hay fever are an itchy nose, red eyes, watery discharge from the nose and/or eyes, a blocked nose and sneezing.  

Hay fever affects 10 –15% of children in the UK and it can impact all aspects of daily life. Research has shown that 40% of children can drop a grade between mocks and final exams in the summer due to suffering with hay fever. Medication for hay fever can be very effective and is important in helping to improve your child’s quality of life. Children with hay fever may have difficulty sleeping and then become irritable and/or show lack of concentration during school hours.  

Tips for families with a child with hay fever: 

• Wash your child’s face and hair if they have been playing outside (as pollen grains tend to stick to the skin and hair)  
• Keep windows shut especially in the morning and early evening (when the pollens are released) 
• Avoid drying clothes outside in high pollen counts  
• Your child should take prescribed antihistamines regularly even if they seem symptom-free. It can sometimes happen that in the morning they may not be affected, but by later in the day they are ‘full’ of hay fever. Some medications are not suitable for younger children so it is important that you discuss these with your GP  
• It can be uncomfortable if your child has a sore nose and you need to apply a nasal spray. To get your child to co-operate with their treatment you could try distraction techniques such as inventing a specific game, for example, I-spy or a word game, that can be played while you do it  
• Encourage the child to wear sunglasses (teachers need to be aware of this, and sometimes it is a reminder to the child, too, not to rub their eyes)  
• Use cool compresses (water and gauze is fine) to cool their eyes if they are really irritated  
• Shut the windows in the car so you are not driving around taking in lots of pollens  
• Stay indoors as much as possible if the hay fever pollen count is very high.