Allergies in Infants and Children

Any child may become allergic, but children from a family with a history of allergies are more likely to develop allergies themselves. An infant’s allergic reaction is caused by an overreaction by his immune system. The immune system is developed to fight off illnesses, but sometimes it reacts to something harmless, like pollen or pet dander, as if it were an invading virus, parasite, or bacteria. The immune system overproduces protective proteins called antibodies. This overproduction causes swelling and inflammation of tissues such as the nasal passages. Your baby’s allergic reaction can recur whenever he’s exposed to whatever triggered it.

Once developed, allergies can show up in many different ways, including:

  • Skin rashes (atopic dermatitis or eczema)
  • Asthma
  • Allergic rhinitis (also known as “hay fever”)
  • Food allergies
  • Chronic nasal congestion
  • Itchy skin, eyes, or nose
  • Dark, purple or blue skin under the eyes
  • Constantly runny nose (Usually a cold will clear up within 7-10 days. If your child’s runny nose persists with clear or yellow-tinted mucus for longer, it may be a sign of allergic reaction.)

Allergic rhinitis is the most common of all childhood allergies. It causes runny, itchy nose, sneezing, postnasal drip and nasal congestion (blockage). The child with allergies may also have itchy, watery and red eyes and chronic ear problems. These allergy problems can occur at any time of the year — seasonally or year-round.

Common Allergic Problems in Infants and Children

The following is an overview of potential problems for children with allergic reactions. Early identification of allergic reaction in your child will improve their quality of life, minimize missed school days for your child and work days for you.

Nasal congestion

Allergies are the most common cause of chronic nasal congestion in children. Sometimes when a child’s nose is so congested or blocked, he or she breathes through the mouth, especially while sleeping. This can also cause fitful sleep that leaves the child tired the next day.

If the congestion and mouth breathing are left untreated, they can cause abnormal changes the way the teeth and the bones of the face grow. Early treatment of the allergies causing the congestion may prevent these problems.

Allergy and ear infections

Allergies can cause inflammation in the ear and may encourage fluid build-up that can lead to ear infections and decreased hearing. If this happens when the child is learning to talk, poor speech development may result. Allergies can cause earaches as well as ear itching, popping, and fullness (“stopped up ears”). Anyone with these symptoms should be considered for allergy testing and treatment.

Skin Problems

Newborns are prone to rashes and you will likely see at least one within the first year. But most rashes (including infant acne) will go away by 2 or 3 months of age. After this point, allergic rashes tend to appear. The most common allergic rash is atopic dermatitis or eczema, and for many babies, it’s the first warning sign of allergic tendencies.

Eczema is a red, scaly, and sometimes oozing rash on baby’s cheeks, torso, arms, and legs. In toddlers and older children, it appears as persistent dry, itchy patches of skin, usually on the neck, wrists, and ankles, and in the creases of the elbows and knees.

Contact dermatitis is an allergic rash caused by a reaction to soap, detergent, wool clothing, poison ivy, or another allergen that has touched baby’s body.

The classic allergic rash — the itchy, welt-like hive — is relatively rare in infants, and when it does occur tends to be smaller than in older children and adults (usually less than an inch long).

Stomach Sensitivities

Viruses can cause vomiting, diarrhea, upset stomach, and gassiness. But these symptoms can also result from allergies — and not just to food. Children with environmental allergies may have stomach ailments as a result of swallowed phlegm, which can irritate the stomach. “Fussy” babies should be evaluated for allergies if other causes have been ruled out.

Behavior Issues

Problems with eating, sleeping, or irritability can result from allergies. Your allergic baby will be fussy and uncomfortable. That’s usually due to his chronic congestion, abdominal pain, or itchy skin, eyes, or nose.

Food allergic infants

The ideal food for a newborn is mother’s milk and breast milk has been linked to a reduction in allergies. However, some especially sensitive babies can have allergic reactions to foods their mothers eat. Eliminating these foods from the mother’s diet may provide relief for the child.

As infants grow, their nutritional needs continue to change and your physician will advise when it is time for solid foods. Always introduce new foods one at a time so you can easily identify the trigger if a reaction occurs.

Cow’s milk can cause both allergies and non-allergic digestive intolerance in children, but it is a good source of protein and calcium. Milk should be eliminated from a child’s diet only if you are sure the child is allergic or intolerant of it. Parents may suspect allergy if the child exhibits hives after the ingestion of milk or other dairy products. If you suspect your child may be allergic to milk, consult your physician.

Diagnosis and Treatment

Another clue to look for is when symptoms occur. Colds are more common in the winter, but indoor allergies (such as a dust mite allergy) may be present all year. A food allergy can manifest itself anytime from a few minutes to an hour and a half after the offending food is eaten. Seasonal hay fever is most common in the spring and/or fall, but it usually doesn’t affect babies.

Allergies often get worse unless exposure to allergens decreases. However, it’s often difficult to identify what’s causing the allergy. You should keep a diary of what symptoms occur and when. You may find that a specific pet, article of clothing, food, or room in your house may be the culprit that’s causing the allergy.

Allergy Testing

Allergy testing, either by blood or skin test, can be done on toddlers but most allergists prefer to wait until the child is at least three years old because test results are harder to interpret in younger children, as their immune system is still immature. Try to minimize baby’s exposure to some common allergens before resorting to testing by

  • Covering mattresses and pillows with dust mite-proof covers
  • Keeping your dog or cat out of baby’s bedroom and bathing the animal every week
  • Putting away feather pillows
  • Switching to a hypoallergenic laundry detergent

Treatment

If your baby has been suffering from allergies, you’ll want to relieve his symptoms and minimize the chances of their recurring by changing his environment. Usual treatments for allergies include:

  • Skin moisturizers or 1 percent hydrocortisone cream for eczema and other allergic rashes
  • Oral antihistamines, like Benadryl (diphenhydramine) or Zyrtec (cetirizine), for rapid relief of an older baby’s symptoms (always consult your physician before giving medication to an infant)

If allergies run in your family, there are measures you can take to help your child avoid allergies:

  • Breastfeed your baby for at least six months.
  • Contrary to older thinking there is no need to withhold commonly allergenic foods such as milk, eggs, fish, and nuts. Quite to the contrary, recent studies indicate that their early introduction may actually lessen the chance of developing food allergies.

If your toddler does seem to be having allergy-induced problems reduce exposure to common allergens by creating a hypoallergenic environment:

  • Don’t allow smoking in your home
  • Use dust-mite-proof mattress covers and pillowcases
  • Clean regularly to decrease the concentration of dust, mold, and feathers in your home
  • Avoid carpeting (especially in baby’s room)
  • Keep your home pet-free if possible
  • Introduce new foods one at a time, and separated by a week or more. Watch closely for reactions.

If simple measures are not completely eliminating symptoms, consider seeing an allergist.