Ways to Reduce Allergies
Allergic reactions are caused by the immune system's overresponse to allergens substances such as certain insect venoms (bees, wasps), foods (peanuts, seafood, eggs), or chemicals (medications like penicillin or sulfa-containing drugs). Most allergic reactions in children are not life-threatening, but there are important exceptions Severe allergic reactions that cause swelling of the upper part of the airway can make it difficult or impossible to breathe, and the whole-body allergic reaction known as anaphylaxis is a rapidly progressing, life-threatening emergency. Call 911 promptly if you notice the sudden onset of the following signs of anaphylaxis or severe allergic reaction If your child has an emergency allergy medication (such as injectable epinephrine), make sure it is given.
People commonly take antihistamines to treat seasonal allergies. The older, first-generation medications, such as chlorpheniramine (Chlor-Trimeton or Sinutab), have been around for a long time, and most obstetricians are comfortable with their use in pregnancy. The newer antihistamines, such as Claritin or Zyrtec, have an additional benefit of not causing as much drowsiness. Although researchers haven't studied these newer medications as much in pregnancy, we know of no reports of an increased risk for fetal malformations or adverse effects. A third option is a nasal spray containing cromolyn or low-dose steroids that are also very effective.
Food allergies are remarkably common, though in some people the obvious symptoms may be slight or masked. Allergies are linked to a range of conditions, including asthma, eczema, hayfever, migraine, hyperactivity and depression, any of which may require drug treatment. For prospective parents there is particular reason to investigate and clear up any allergy. Many food allergies are the result of nutritional imbalance, and in particular of zinc deficiency. Any allergy is an impairment to good health and may well lead to poor absorption of vital nutrients.
This chapter looks at the way in which parents can influence the health of their unborn child by optimising their own health before conception occurs. It examines the simple measures that can be taken to eliminate toxins, allergies and environmental pollutants from the body, along with all the other negative influences on prenatal health. It discusses methods of natural family planning and the vital role that nutrition plays, both preconceptually and throughout pregnancy. It explains
(e.g. peanut butter, unrefined groundnut oil, some snacks, etc.) if you or your baby's father or any previous children have a history of hayfever, asthma, eczema or other allergies. This may reduce the risk of your baby developing a potentially serious allergy to peanuts. Read food labels carefully and, if you are still in doubt about the contents, avoid these foods.
Proteins and other substances from foods you eat can be passed on to your baby in your breast milk. If there are allergies, asthma, or eczema in the family, your doctor may advise you to drink little or no milk while nursing. He or she may suggest that you avoid other foods that are most likely to cause allergies, such as peanuts, soy, fish (including shellfish), egg whites, and wheat. But if allergies or asthma do not run in your family (and you don't have any yourself), you can eat just about anything you enjoy, including spicy foods. To minimize trouble, eat a variety of foods in moderate amounts rather than eating the same thing every day or having huge helpings of a single food. If you suspect your baby is reacting to something you ate, becoming fussy or refusing to eat, try eliminating the food for a few days or a week. If the symptoms disappear, try eating the food and see if they recur. The foods you eat may flavor your milk, and some babies may simply like or dislike certain...
Another example of sucking blisters in an infant at 6 days of age. Note that the mucous membrane portion of the lip has a superficial furrowed appearance. With time, the outer layer dries with lifting and shedding of the cornified epithelium and new blisters may develop for a few weeks. They occur most commonly in breast-fed infants or babies who feed vigorously. Pathologically, this can also occur from overheated formula, or as an allergic reaction to the components of the nipple or the formula.
Amoxicillin is excreted into breast milk in low concentrations. Following a 1-g oral dose given to six mothers, peak milk levels occurred at 4-5 hours, averaging 0.9 pg mL (range 0.68-1.3 pg mL) (6). Mean milk plasma ratios at 1, 2, and 3 hours were 0.014, 0.013, and 0.043, respectively. Although no adverse effects have been observed, three potential problems exist for the nursing infant modification of bowel flora, direct effects on the infant (e.g., allergy or sensitization), and interference with the interpretation of culture results if a fever workup is required. The American Academy of Pediatrics considers amoxicillin to be compatible with breast feeding (7).
The vaccine is given at ages 2 months, 4 months, and 6 months. At ages 12 to 15 months, a child receives a booster shot. The possible side effects include fever and soreness at the site of injection. Your child's doctor will probably advise delaying the vaccine if your child is sick with anything more serious than a cold or if she experienced an allergic reaction after an earlier Hib dose.
The initial assessment takes into account the diet history of the woman as well as any symptoms or problems that might hinder adequate intake. Typical dietary, appetite, gastrointestinal symptoms (i.e., nausea, vomiting, diarrhea, and constipation), difficulty with chewing and swallowing, food allergies, ethnic and cultural food practices, and household food security should be considered and included in the assessment. Furthermore, all medications and supplements as well as complementary therapies should be investigated in order to determine possible drug-nutrient interactions.
Some foods are more likely than others to cause allergic or other adverse reactions in babies. Among these foods are cow's milk, eggs, soy, peanuts, and wheat, as well as shellfish, other nuts, and corn. It is best not to give these to your baby until she is older than one year and is eating the cereals, fruits, and vegetables mentioned earlier as good first foods. If food allergies run in your family, talk to your child's doctor before giving any of the allergy-prone foods. Delaying them may reduce the chance of developing allergies. Here are tips on some potential problem foods Peanuts and peanut butter. These products can pose a double risk, as a possible cause of allergies and as a choking hazard. (Toddlers and babies can choke on sticky globs of peanut butter, as well as on the nuts themselves.) To be safest on both counts, wait until age three before giving peanut butter, and then spread it on bread or crackers rather than serving it plain. Wait until age four to serve nuts.
If you speak with your child's doctor before going to the ER, he or she may call the ER to let them know you are on the way and to give any helpful medical information about your child. It's always a good idea to bring available copies of your child's health information, including medications taken, allergy history, and immunization records.
If your child is critically ill, he's brought directly to the patient-care area to be evaluated by a doctor as soon as possible. Once your child is in a bed, the doctor comes in to evaluate the situation, take a history, and examine your child. Remember to tell the doctor and staff about any allergies or other health problems your child has and what medications he takes. The doctor who sees your child first may be a resident doctor if the ER is in a teaching hospital. (A resident doctor is a physician still in the training phase of his or her career.) The resident presents the case to the supervising doctor (attending physician), and generally the child is examined again by the supervising doctor. In some cases, your child's own doctor (or someone covering for him or her) may see your child in the ER. The ER doctors may also contact your child's doctor to obtain additional medical information about your child and let him or her know about their evaluation and treatment plans. The...
The other well-documented advantages of human milk are the infection-protection qualities that protect the breastfed infant from respiratory infections, otitis media, gastrointestinal infections, and even urinary tract and meningeal infections (Hanson 2004). The study of the immunologic properties of human milk has shown that infants who are exclusively breastfed for at least 4 months have a reduced risk of childhood onset diabetes, Crohn's disease, celiac disease, and childhood-onset cancers - especially leukemia. Hundreds of articles testing the allergy protection of human milk have shown a clear advantage in being breastfed for potentially allergic children.
A 2000 publication reported the antiemetic effects of cetirizine in 60 women who were using the antihistamine (10 mg day) for the treatment of allergies during pregnancy (5). A control group of pregnant women, matched for the use of pyridoxine (vitamin B6) but who were not taking an antihistamine, was used for comparison. The cetirizine group had a significantly lower rate of nausea and vomiting (7 vs 37 , p 0.0001). No pregnancy outcome data were provided.
Body art, which includes piercing, tattoos and permanent make-up, has various health risks. The risks most relevant to pregnancy include the safety of the dyes and the possibility of infections or allergic reactions. Because the skin is punctured for all body art procedures, there is a risk that a local infection could develop at the puncture site. There is also a small risk that blood-borne infections could be transmitted, such as HIV or hepatitis B or C, from improperly disinfected body art tools. With a tattoo or permanent make-up, ink is injected into the second layer of skin. The safety of this ink is unknown. Some inks are approved for skin application as cosmetics, but their safety when injected into the skin has not been thoroughly studied.
Membrane that covers the whites of the eyes and lines the inner surface of the eyelids. About 80 percent of infectious conjunctivitis cases are caused by bacteria, and the rest are caused by viruses. Allergies or exposure of the eyes to chemicals or other irritants can also be causes. Treatment Often infectious conjunctivitis will resolve by itself, but doctors usually prescribe antibiotic drops or ointment to decrease the possibility of spreading it to others. Drops are usually prescribed for a week, about four doses a day. Ointment, usually prescribed for infants, is given two times daily and can temporarily blur vision (to see an illustration of giving eyedrops to a child, refer to Chapter 29, Signs and Symptoms ). Children with prolonged or repeated bouts of reddened, itchy, and watery eyes may benefit from treatment for allergies or removal of irritants (such as cigarette smoke) from their environment.
Handheld memory devices such as smart cards and USB memory devices are another advantage of electronic communication. They are small sized devices that transmit electronic information to a computer system and contain a patient's electronic health record. They can provide physicians with a patient's complete medical history, immunizations, allergies, blood type, prostheses, measurements, laboratory results,
Herbal preparations which also contain chrysanthemums can cause allergic reaction in individuals who are allergic to this family of plants (chrysanthemums, ragweed, and Echinacea are all members of the Composite family). Perrtiethrin and allethrin are synthetic pyrethroids, and are used similarly. These are rapidly metabolized and well-tolerated. No human milk data are available.
Important assessment data that need to be collected and evaluated to comprehensively develop educational approaches for pregnant adolescents can be categorized as follows (1) determining the quality, quantity, and rate of weight gain in pregnancy (2) evaluating current dietary intake to determine the adequacy of nutrient and energy intake during pregnancy and (3) assessing dietary issues that may affect intake, e.g., food allergies or vegetarianism 13 . Data derived from these assessments can provide a focus for discussions with all adolescents throughout pregnancy. Adolescents, especially those younger than 15 years of age, are at high risk for inappropriate maternal weight gain, anemia, and more serious complications such as lung and renal disease. Maternal weight gain is reportedly more influential than age of mother on fetal birth weight 11, 14 . Given that fetal birth weight 3,000 g is related to increased infant morbidity and mortality, optimizing maternal weight gain should be...
(a) Allergic reactions (most common) from oral intake of royal jelly can range from very mild (e.g. mild gastrointestinal upset) to more severe reactions, including asthma, anaphylaxis (shock), intestinal bleeding, and even death in people who are extremely allergic to bee products.
Additional problems encountered are a wide range of skin reaction from mild irritations ('tape allergy') to subcutaneous abscesses. Proper skin care and adherence to pump-use rules will prevent and treat most of theses reactions. Special hypoal-lergenic tapes and skin barriers are available to alleviate most problems. Skin reactions are not a significant cause for discontinuation of pump use.
Atopic dermatitis, sometimes called infantile eczema, is a common form of this condition, affecting 10 to 12 percent of children. Typically, symptoms appear within the first few months of life, and they almost always appear before age five. The word atopic describes conditions that occur when someone is overly sensitive to substances and other factors in their environment. Although atopic dermatitis is not necessarily caused by allergies, it often appears in infants and young children who have (or will develop) allergies, hay fever, or asthma or who have a family history of these conditions. Environmental allergens such as pollens, molds, dust, animal dander, certain foods, and other factors (such as exposure to cold, heat, soaps, rough fabrics, or emotional stress) can trigger or aggravate atopic dermatitis. Foods that most often trigger eczema are egg whites, dairy prod Contact dermatitis is an allergic reaction or irritation that results from direct skin contact with a substance,...
Most experts do not believe that the condition is caused by poor parenting, family problems, poor teachers or schools, or too much TV. Nor do food allergies, food additives, or excess sugar appear to play a major role in the development of the condition. The results of one study indicated that eating a diet low in refined sugar and food additives seemed to help only about 5 percent of children with AD HD, mostly very young children or those with food allergies. However, too much caffeine (found in coffee, tea, and some sodas) may trigger or exacerbate hyperactive behaviors in children with AD HD. (For information on discipline and hyperactivity, see Chapter 19, Temperament, Behavior, and Discipline. )
Since the mid-1980s, breast-feeding has garnered global recognition by virtually all professional organizations as the ideal form of nutrition for infants (Newton 2004). As a result, the proportion of women choosing to breast-feed continues to rise (Ryan et al. 2002), and the duration of breast-feeding has increased (Nichols-Johnson 2004). Despite this universal acceptance of breastfeeding, decisions regarding lactation are complicated by the common occurrence of postnatal maternal illness. Prescribing medications to lactating women presents a clinical conundrum in which infant exposure to mediation must be weighed against the benefits of breast-feeding. Breast-feeding women routinely take prescription medications following childbirth (e.g., opiate analgesics, allergy medications) with limited concern for exposure of the nursing infant. Furthermore, lactating women with chronic medical conditions (e.g., epilepsy, migraine headaches) are increasingly encouraged to use medications for...
Hand foot and mouth disease Coxsackie virus infection For information see Mouth Pain Problems in this chapter
The mere presence of a runny nose can cause a sore throat. Mucus from the nose running down the back of the throat (called postnasal drip) can be irritating. Treatment for a runny nose depends upon the cause. Most of the time, a minor viral infection is the culprit, and the sore throat will resolve in a few days. Sometimes the cause is a bacterial infection in the sinuses called sinusitis. A child with sinusitis usually has a persistent runny nose for at least two weeks, often with thick green or yellow nasal drainage. The child may also have low-grade fever. Mucus from the infected sinuses drips down the throat and causes irritation. Sinusitis can be treated with antibiotics. Sometimes a runny nose is due to an allergy to pollen, dust mites, pet dander, or molds (see Chapter 32, Health Problems in Early Childhood, for more information about allergies). Children with allergies tend to have clear mucus from the nose, watery eyes, and itchy throats. If you...
Rule out history of allergy to antibiotics. if woman has allergy to penicillin if partner has allergy to penicillin observe for signs df allergy After giving penicillin injection, keep the woman for a few minutes and observe for signs of allergy. ALLERGY TO PENICILLIN
Small amounts of fluid or mucus in a newborn's nose can cause her to breathe noisily or sound congested even though she doesn't have a cold or other problem. This happens because newborns tend to breathe through their noses, and their nasal passages are narrow. Talk with your baby's doctor about using saltwater nose drops and a bulb syringe to help clear the nasal passages if necessary. Sneezing is very common in newborns. This is a normal reflex and is not due to an infection, allergies, or other problems.
Allergen immunotherapy (allergy shots) is an antiallergy therapy in which continuously increasing doses of an allergen arc injected sub-cutaneously. This therapy stimulates the production of immunoglobulins that bind the allergen before it can react with the mast cells. After immunotherapy, the allergic reaction on exposure to the allergen will be diminished because less histamine will be released by the mast cells. Immunotherapy is often effective for those allergic patients in whom the symptoms persist despite optimal environmental control and drug therapy. No specific embryo- or fetotoxic effects are to be expected after immunotherapy in pregnancy (Gilbert 2005, Shaikh 1993). However, a maternal anaphylactic reaction can cause hypotension and decreased uterine perfusion, which may result in fetal damage induced by fetal hypoxia (Luciano 1997),
Ask your baby's doctor to recommend a formula. The American Academy of Pediatrics' Committee on Nutrition recommends using a formula that is based on cow's milk and fortified with iron. In such formulas, the cow's milk has been modified to be more digestible and somewhat more like human milk. If a baby is fussy, gassy, or colicky, with daily crying spells that seem to have no cause, parents often suspect an allergy or intolerance to formula, but studies have shown that such intolerances are uncommon. Sometimes, however, a baby may prefer one milk-based formula to another. It may be just a matter of taste.
Low molecular-weight heparins (LMWHs) are increasingly preferred to unfractioned heparin (UH) for thromboprophylaxis, as well as for the treatment of VTE, and in the pregnant patient. They arc heparin fragments produced by chemical or enzymatic depolymeriza-tion, and their molecular weight ranges from 4000-6000 daltons. They specifically inhibit factor Xa. Their advantage lies in a longer half-life (injecting once a day), their better bioavailability (85 ), and their association with a lower incidcncc of osteoporosis, allergy, and heparin-induced thrombocytopenia (HIT), which may cause thrombotic events. There is evidence that LMWH. just like UH, do not cross the placenta. Based upon safety data, UH was previously considered to be the anticoagulant drug of choice during pregnancy for most indications. Maternal disadvantages include the risk of HIT, allergy, and osteoporosis. Long-term heparin therapy ( 1 month) may be associated with increased bone loss, particularly during pregnancy,...
The vaccination should be delayed if your child is sick with anything other than a minor illness or cold or if he has had a severe allergic reaction to baker's yeast. If he develops a severe allergic reaction after a dose of HBV, talk to your child's doctor. Further doses may not be given.
Human insulin is recommended in pregnancy, as it is less allergenic and has a quicker absorption rate than animal-based insulin. Rapid-acting insulin analogs (Lispro, Aspart) are frequently used in pregnancy, yielding results similar to short-acting insulin 44-47 . Glargine and Detemir are long-acting, peakless insulin analogs. No clinical studies have been conducted on their use during pregnancy, though case reports have not shown teratogenic effects. Injectable therapies that have not demonstrated safety in pregnancy include incretin mimetic hormones (Pramlintide and Exenatide).
Pregnancy is a time to ensure adequate micronutrient intake in addition to sufficient energy and macronutrients for optimal fetal development. The key to ensuring dietary adequacy of the micronutrients is a varied diet that includes multiple foods from all food groups. Factors that place pregnant women at risk for micronutrient deficiencies include diets that restrict energy, diets that omit one or more major food groups, food insecurity, food intolerances, allergy or food aversions. Dietary plans should be developed according to risk factors that include alternative dietary sources. Attention should also be given to potential micronutrient deficiencies associated with the respective types of diets. Several micronutrients are of critical importance to the fetus's growth and development (Table 13.3).
Insect stings (most commonly from bees, wasps, hornets, and ants) are usually painful and distressing but not dangerous. But they can cause life-threatening emergencies in the case of severe allergic reaction or the whole-body allergic reaction called anaphy-laxis (see Allergic Reactions and Anaphy-laxis in this chapter). sudden onset of the following signs of ana-phylaxis or severe allergic reaction If your child has an emergency allergy medication (such as injectable epinephrine), make sure it is given. Call your child's doctor or go to the emergency room if your child has a history of allergic reactions to insect stings.
Breathing problems in children are fairly common and usually are not serious. But there are several causes of severe respiratory distress that require medical attention. Some of these are described here and elsewhere in this book. They include asthma and allergies, choking, croup, apnea, bron-chiolitis, pneumonia, and respiratory distress due to a life-threatening injury such as bleeding (see Bleeding, Internal and Bleeding, External in this chapter) or poisoning (see Poisoning in this chapter).
Prevention The measles vaccine is given as part of the mumps-measles-rubella (MMR) shot, given at 12 to 15 months and then again at 5 to 6 years or 11 to 12 years. The measles vaccine is not usually given to infants younger than 12 months unless there is a measles outbreak. The vaccine should not be given to pregnant women or people with weakened immune systems. People who have had a very severe allergic reaction to eggs or to the antibiotic neomycin should not take the vaccine (for more information, see Allergies in Chapter 32, Health Problems in Early Childhood ). Infants, pregnant women, or those with a weakened immune system can be protected from infection by an injection of gamma globulin within six days of exposure.
When to Call Your Child's Doctor Call your child's doctor if your child has a cold that lasts more than 10 to 14 days, if there are any symptoms of allergies that don't clear up with the usual allergy treatments, if she complains about a headache or pressure behind her cheeks or forehead, or if she has facial swelling. How the Diagnosis Is Made The doctor will ask about symptoms, how long your child has had them, and where the pain and pressure is to try to distinguish whether the symptoms are caused by nasal allergies or
Doctors and scientists don't know the exact cause of asthma, but they do know that the tendency to develop asthma is often inherited. Allergies, an infection such as a cold or sinus infection, smoke, air pollution, or exercise can trigger an asthma attack. Not every child with asthma has allergy-triggered asthma, but about 80 percent of people with asthma have some type of allergy. Even if a child's primary triggers are colds and other respiratory viral infections (the most common triggers for young children) or exercise, allergies can sometimes play a role in aggravating the condition (see Allergies in this chapter for more information). When considering a diagnosis of asthma, a doctor first tries to exclude other possible causes of a child's symptoms. He or she asks questions about the details of the child's symptoms and the family's history of asthma and allergy and performs a physical exam. With this information, doctors can diagnose most cases of asthma. The diagnosis is often...
51 Ways to Reduce Allergies
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