Childhood Allergies

An allergy is the immune system treating a harmless protein as a threat. The first exposure teaches it the pattern and produces no symptoms; later exposures set off the reaction. What the reaction looks like depends on where it happens, so the same process gives a streaming nose and itchy eyes in one child, hives and swelling in another, and vomiting or loose stools in a third.

The common triggers in Indian children are house dust mite, pollens, mould, animal dander, insect stings, a small number of medicines, and foods. Among foods, cow's milk, egg, wheat, soya, peanut, tree nuts, fish and shellfish account for most reactions. Timing helps separate them: food reactions usually begin within minutes to two hours of eating, while an environmental allergy tracks the season, the room or the animal.

Allergic conditions travel together. A child with eczema in infancy is more likely to develop an allergic nose and asthma later, and the tendency runs in families. Some allergies fade: milk, egg, wheat and soya are frequently outgrown during the school years, while peanut, tree nut and seafood allergies more often persist into adult life.

The history is where the diagnosis is made. Your paediatrician will want each reaction reconstructed in detail: exactly what your child ate or came into contact with, how long afterwards the symptoms began, what appeared first, how long it lasted, what was given, and whether the same thing has happened on another occasion without a reaction. Photographs of a rash taken at the time are genuinely useful, so take them.

The examination covers the skin for eczema and hives, the nose and eyes, the chest, and the inside of the mouth. Your paediatrician plots height and weight at every visit, because families often remove several foods while waiting for answers and growth is the measure of whether that has gone too far.

Testing supports a history and does not replace it. A positive result in a child who eats the food without any trouble means the immune system recognises it, and that on its own is not an allergy. Your paediatrician interprets any result against the story you have given, so the detail of that story carries real weight.

Allergy is managed instead of cured, and most children live entirely normal lives once the plan is clear. Medicines for an allergic nose or skin work within days, though a nasal spray needs a fortnight of daily use before it is fairly judged.

Avoidance is the other half, and it should be as narrow as the evidence allows. Removing one confirmed trigger is reasonable; removing five on suspicion costs your child nutrition and social ease for no benefit. Your paediatrician will review the list periodically and reintroduce what can safely be reintroduced.

Food allergies of infancy are re-checked every one to two years, since many resolve with time and a food removed at eighteen months may be eaten freely at six years. Where desensitising treatment is appropriate for an environmental allergy, it runs for three to five years, and it is a long commitment. Every child with a history of a severe reaction leaves with a written plan for what to do at the next one.