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Prevention of Allergies and Asthma in Children

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It has long been known that allergies and asthma tend to run in families, making children where one or both parents have an allergic disease more likely to develop these conditions. Fortunately, there are steps that may delay or possibly prevent allergies or asthma from developing.

Preventing Food Allergies

Food allergies can cause problems ranging from eczema to life-threatening allergic reactions. The major strategy for preventing food allergies in children relates to the timing of feeding infants certain liquids and foods.

Breast milk is the least likely to trigger an allergic reaction, and it strengthens an infant's immune system. Experts recommend exclusive breast-feeding for the first four to six months. If that isn't possible, use a hypoallergenic formula such as extensively hydrolyzed casein or a partially hydrolyzed whey formula instead of cow's milk or soy formula.

After four to six months, single-ingredient infant foods including fruits, vegetables and cereal grains can be introduced one at a time. This slow process gives parents or caregivers a chance to identify and eliminate any food that causes an allergic reaction.

These reactions are more commonly found in cow's milk, soy, egg, fish, shellfish, peanuts and tree nuts. It is best to wait until your child's first birthday to bring these foods into his or her diet, and only if there have not been any previous signs of allergies.

Restricting a mother's diet during pregnancy and while breast-feeding have been tried as approaches to protecting against food allergies, but they have not been proven as effective as the gradual introduction of foods and liquids.

Preventing Environmental Allergies and Asthma

Dust mites

Since some airborne substances may trigger allergy or asthma symptoms, reducing contact with these substances early in life may delay or prevent allergy or asthma symptoms.

Research for this is clearest with dust mites. If your child is at high risk of developing allergies, there are steps you can take to control dust mites.

Use zippered, "allergen-impermeable" covers on pillows and mattresses and wash bedding in hot water weekly. Indoor humidity should be kept below 50%. If possible, carpets and upholstered furniture should be removed from your infant's bedroom.

Pets and other animals

The relationship between early life exposure to animals and the development of allergies and asthma is somewhat confusing.

Previous evidence suggested that children exposed to animals early in life are more likely to develop allergies and asthma. More recent research seems to show that early exposure to animals (cats and dogs in particular) may actually protect children from developing these diseases. Newer research also suggests children raised on farms develop fewer allergies and asthma.

Other Prevention Steps

It is very important not to expose your children to tobacco smoke before or after birth. Smoking during pregnancy increases the chance of your child wheezing during infancy. Exposing children to secondhand smoke has also been shown to increase the development of asthma and other chronic respiratory illnesses.

Infections that start in the lungs are common triggers of asthma. Since breast-feeding for at least four to six months strengthens a child's immune systems, it is helpful in avoiding these infections and, in the long term, asthma.

If you believe your child may have allergies or asthma, it is important to seek the right medical help. An allergist/immunologist, often referred to as an allergist, is a specialist in the diagnosis and treatment of allergies, asthma and other diseases of the immune system. Allergists have completed medical school, at least three years of residency in pediatrics or internal medicine, then at least two years of specialized training in allergy and immunology.

Seeking Help

Testing done by an allergist is generally safe and effective for children of all ages. Allergy tests, combined with the knowledge of your allergy specialist to interpret them, can give precise information about what your child is and is not allergic to.

For instance, if your child wheezes when you are at home and you don't know why, you don't have to get rid of your cat if your child's allergy testing shows that he or she is allergic to dust mites but not cats. With this information, you and your allergist can develop a treatment plan to manage or even get rid of your child's symptoms.

When to Proceed with Caution There are methods of allergy testing that the American Academy of Allergy, Asthma & Immunology (AAAAI) believes are not useful or effective. These include: massive allergy screening tests done in supermarkets or drug stores, applied kinesiology (allergy testing through muscle relaxation), cytotoxicity testing, skin titration (Rinkel method), provocative and neutralization (subcutaneous) testing or sublingual provocation.

The AAAAI's brochure on Allergy Testing offers other helpful advice.

Healthy Tips

  • Breast-feeding exclusively for the first four to six months, or using a hypoallergenic formula, may delay or prevent atopic dermatitis and milk allergy.
  • Solid foods should be introduced gradually.
  • Restricting a mother's diet during pregnancy or while breast-feeding has not been shown to help prevent the development of allergies.
  • Reducing exposure to some allergens, such as dust mites, may delay or prevent allergy or asthma symptoms.
  • Exposure to tobacco smoke before and after birth increases your infant's risk of developing wheezing and asthma.