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Subject: misc.kids FAQ on Allergies and Asthma (part 2/4)
This article was archived around: 21 May 2006 04:22:50 GMT
This FAQ is also available on the World Wide Web at
Misc.kids Frequently Asked Questions -- Allergies and Asthma
General Information -- part 2/2
This FAQ is intended to answer frequently asked questions on allergies and
asthma in the misc.kids newsgroup. Though the comments are geared towards
parents of children, there is plenty of information for adults as well.
The information in this FAQ is the collected "net wisdom" of a number
of folk. It is not intended to replace medical advice. None of the
contributors are medical professionals. Most of us either have
allergies/asthma or have relatives/children with asthma/allergies, so
this collection represents the experiences and prejudices of individuals.
This is not a substitute for consulting your physician.
To contribute to this collection, please send e-mail to the address
given below, and ask me to add your comments to the FAQ file on
Allergies and Asthma. Please try to be as concise as possible, as
these FAQ files tend to be quite long as it is. And, unless
otherwise requested, your name and e-mail address will remain in the
file, so that interested readers may follow-up directly for more
This FAQ is posted regularly to news.answers and misc.kids.info.
For a list of other misc.kids FAQ topics, look for the FAQ File Index
posted to misc.kids.info or tune in to misc.kids.
Collection maintained by: Eileen Kupstas Soo
This page last modified: April 10, 1997
Copyright 1995-7, Eileen Kupstas Soo. Use and copying of this information are
permitted as long as (1) no fees or compensation are charged for
use, copies or access to this information, and (2) this copyright
notice is included intact.
General Information Part 1/2
General Information Part 2/2 -- this page
Allergy and Asthma Resources
Allergy and Asthma Book Reviews
New material is marked by the | symbol.
New material on Contact allergies (contact dermatitis) and chemical sensitivities
Book information (section 7.3)
has been moved to the bottom of the resources section.
These topics are in General Information Part 1/2
1) What to look for to suspect allergies
2) Allergy treatment
in this file
4) Insect sting allergies
5) Inhalant allergies
6) Contact allergies (contact dermatitis) and chemical sensitivities
8) Specific advice on allergies and asthma in children
8.3 References on breastfeeding and baby allergies
9) Allergies in relation to ADD and autism
10) Personal stories
FAQ Home Page
General Information Part 1/2
Allergy and Asthma Resources
There are many
contributors involved in this FAQ.. many thanks for all the work!
4) Insect sting allergies
Contributor: email@example.com (Tom O. Barron)
How common are insect allergies?
No one knows for sure, but it is estimated that at least 4 of every
1000 people are affected. Each year 50 to 100 people in the U.S. die
from reactions to stings. Many summer deaths attributed to heart
attack or drowning may actually be due to allergic reactions to insect
stings, so the number may be even higher. More people are killed in
the U.S. each year by insects of the class Hymenoptera
("membrane-winged", including wasps, bees, hornets, yellow jackets, and
fire ants) than by any other venomous animal including rattlesnakes.
What causes insect allergies?
Essentially the same thing that causes all allergies -- the immune
system. Some people produce antibodies in response to some substances.
When this happens, the person becomes allergic to the substance.
When the substance is introduced into the body at later times, there
will be a more or less severe allergic reaction. In the case of
insect allergies (or more correctly, insect *venom* allergies), the
substance is the venom injected by the insect when it stings.
What insect stings or bites can cause allergic reactions?
Wasps, honey bees, hornets, yellow jackets and ants are the insects
most likely to cause strong allergic reactions. Some biting insects
(mosquitoes, flies, lice, kissing bugs and fleas) can cause allergies
as well because they inject saliva to thin the blood when they
bite. Finally, some caterpillars are covered with hairs that
contain a substance irritating to human skin and this can sometimes
cause allergic reactions. Less commonly, insects or insects parts
can cause allergic reactions when they are inhaled or swallowed.
Different insect species' venom has different potential allergens.
This means that a person who is strongly allergic to wasps may not be
allergic to yellow jackets at all and may be only mildly allergic to
honeybees, or vice versa.
Who is most likely to have insect allergies?
According to the Committee on Insect Allergy of the American Academy
of Allergy, insect allergies occur as frequently in people who have
no other allergies as in those who do. Severe reactions most often
occur after the age of 30, although they have been observed at all
ages. A person who has already had an allergic reaction is more
likely to have one in response to the next sting suffered. However,
the absence of a reaction one time doesn't mean that it won't occur
What are the symptoms of allergic reactions to insect stings?
In general there are three kinds of reactions to insect stings. The
first kind, normal reactions, involve pain, redness, swelling,
itching, and warmth at the site of the sting. The second kind,
toxic reactions, are the result of multiple stings. Five hundred
stings within a short time are considered likely to kill because of
the quantity of venom involved. As few as ten stings within a short
time can cause serious illness. Symptoms of toxic reactions include
muscle cramps, headache, fever, and drowsiness.
Allergic reactions are the third type. They may involve some of the
same symptoms as toxic reactions, but may be triggered by a single
sting or a minute amount of venom. Any non-local reaction to a
single sting should be considered allergic until proven otherwise.
Allergic reactions may be local or systemic. An allergic reaction
is considered local if it involves only one limb, regardless of the
amount of swelling. A slight systemic reaction may involve hives
and itching on areas of the body distant from the sting site as well
as feelings of anxiety and being run down. A moderate systemic
reaction may include any of the above plus at least two of edema
(swelling), sneezing, chest constriction, abdominal pain, dizziness,
and nausea. A severe systemic reaction has the symptoms already
described plus at least two of difficulty in swallowing, labored
breathing, hoarseness, thickened speech, weakness, confusion, and
feelings of impending disaster.
The most serious symptoms are the closing of airways and shock
(anaphylaxis) since they can be fatal if not treated quickly and
effectively. Allergic reactions may begin within ten to twenty
minutes after the sting or they may be delayed. Usually, the sooner
the reaction starts, the more severe it will be.
How can I find out if I'm allergic to insects?
It's probably not worthwhile to be tested for insect allergy unless
you've been stung and had a reaction. When you visit an allergist
after a sting, it will be helpful if you can produce the insect that
caused the reaction so it can be identified conclusively. If not,
the allergist will probably ask questions to figure out which insect
caused your reaction.
Further testing may involve injecting small amounts of specially
treated insect venoms just under the skin to find out which insects
you react to and how strongly.
So if I'm allergic, do I have to spend the rest of my life inside?
No, but being aware of the risks and dangers associated with the
condition and managing them appropriately can improve your peace of
mind when you do go outside. Understanding the insects themselves
can also go a long way toward minimizing risk and staying safe.
For example, it's useful to be able to recognize the various critters
that can make trouble. Bees feed their young honey and pollen and only
use their stingers defensively. This means that bees are not likely to
sting unless they believe that their hive is threatened (the more
aggressive Africanized "killer" bees are an exception to this). Wasps,
hornets, and yellow jackets, however, use their stings to kill their
prey, so they are likely to be more aggressive.
Some bee species are social (honeybees and bumblebees) and will sting
to defend their colony. Other species are solitary (carpenter, miner,
mason, and cuckoo) and are less likely to sting in defense of one
another. Also the solitary bees usually have milder stings than
the social species. Bumblebees are less vicious and less organized
than honeybees and nest in the ground.
Wasps can be categorized as social and solitary as well. Hornets,
yellow jackets, and paper wasps are all social and very protective
of their nests -- they represent the most common wasp threats to
humans. Although these insects are predators, feeding on other
insects, they are also attracted to nectars and overripe fruit.
For this reason, it is recommended that you avoid wearing strong
perfumes when you go outside in the summer. Dark clothing also
seems to attract and provoke all the stinging insects.
It is believed that only two kinds of ants cause allergic
reactions -- harvester ants and fire ants. Both are highly social
and organized, living in mounds in the ground which are usually not
too difficult to avoid.
One easy way to avoid all these insects is to spend your time outside
in the fall, winter and spring when they are not active. This may not
always be practical, but be aware that most stings occur in the summer.
Finally, if you have (or should have) an emergency sting kit, carry it
with you!! It won't help if it's in the house and you get stung
outside! Don't count on having enough time to get to it!!
If I get stung, what should I do?
If you don't know whether you're allergic, remove any insect parts
left behind to eliminate excess venom or possibility of infection
as soon as possible. The site of the sting should be washed
thoroughly. Ice (*not* heat) may help with swelling and pain.
Analgesics like aspirin can help with this as well. Oral
antihistamine and calamine lotion can help control the itching.
Medical care is needed in the case of toxic or allergic reactions.
If you aren't sure what kind of reaction you're going to have, have
someone monitor your condition and be prepared to get you quickly
to a doctor or emergency room. You probably should *not* drive
yourself unless it's unavoidable since allergic reactions may
involve sudden unconsciousness.
If you've had an allergic reaction before, you should assume that
you will again. Wear a Medic Alert bracelet or medallion describing
your condition. If the sting is on an arm or leg, place a tourniquet
between it and the heart to keep the amount of venom in the blood as
low as possible. The tourniquet should be loosened every ten minutes
or so to allow circulation. If possible, apply a cold pack. Having
suffered an allergic reaction before, you should have your handy dandy
bee sting kit with you and should give yourself a shot of epinephrine
(adrenaline). Then call 911 and get yourself to the hospital
(the epinephrine wears off after 20 minutes or so).
Antihistamines can help deal with itching and other
symptoms after the victim's condition is stabilized, but are not an
effective emergency treatment. Other steps which may be necessary
(but should probably be administered by medical personnel) include
adrenal steroids (cortisones), intravenous fluids, oxygen, and even
a tracheotomy (an opening in the windpipe) in the case of acute shock
or airway closure.
If I'm allergic and I get stung, how soon should I get medical help?
Immediately. The speed of your reaction depends on your body, whether
you are able to get a dose of epenephrine immediately, how much of
the allergen is absorbed, and a few other variables and is therefore
unpredictable. The safest thing to do is to get medical attention as
quickly as possible.
Where can I get a Medic Alert medallion or bracelet?
You can order from Medic Alert Foundation, Box 1009, Turlock CA 95380.
Where can I get a bee sting kit to keep with me just in case?
Most drug stores have them by prescription. Any M.D. can write you a
Will a "bee sting" kit work if I'm allergic to wasps (hornets,
Yes. Epenephrine or adrenaline is usually effective at suppressing the
allergic reaction immediately, although severe reactions may require a
second dose. Later in the process, you may need an antihistamine
like Benadryl (the over-the-counter preparation may not be strong
enough). Your medical professional can help you in evaluating your
need for this and obtaining it.
Can an insect allergy be eliminated with desensitization therapy?
Venom therapy involves building up a tolerance to identified allergens
in insect venoms through gradually increasing doses of the specific
venom causing the allergy. The therapy is delivered by
injection and once tolerance is achieved, it must be maintained through
periodic (usually monthly) injections. Because of the frequency and
expense of repeated injections, most people will probably not find this
option feasible unless they work regularly around stinging insects.
I hope this information is helpful.
NIH Publication Number 82-1046
pamphlet prepared by
the National Institute of Allergy and Infectious Diseases
National Institutes of Health, Bethesda, MD 20205
5) Inhalant allergies (hayfever)
Contributor: firstname.lastname@example.org (Aiko Pinkoski)
The following text is from a brochure titled Hayfever I got at my HMO.
It says produced by Clinical Publication Program, HCHP, 10 Brookline
Place West, Brookline, MA 02146. Copyright HCHP, Inc. 1990. (a little
Hayfever is caused by allergy to pollens from trees, grasses, and
ragweed. Typical symptoms are itchy and watery eyes, runny nose, nasal
congestion, sneezing, itching of ears, nose and throat, respiratory
problems such as wheezing or asthma (occasionally).
There are 3 ways to control hayfever:
1. avoid exposure to pollens
2. take allergy medications
3. Undergo allergy injection therapy
Using an air conditioner and staying indoors ... is the best way to
avoid pollens. Most patients, however, don't find avoiding pollens to
be a practical solution.
The goal of allergy injection therapy (allergy shots) is to immunize a
patient to allergens and thereby reduce or eliminate the symptoms
produced by exposure to pollens. Although this kind of treatment can be
very effective, it is time-consuming and is generally considered only
after other methods fail to provide satisfactory relief. ......
Many patients find that hayfever symptoms can be treated satisfactorily
with allergy medications, which provide relief from symptoms but do not
cure the allergy. The most common medications are discussed below:
drugs are listed by familiar name (which are often brand names). Ask a
pharmacist about the availability of generic equivalents, which may be
less expensive and equally effective.
Antihistamines are the most widely used hayfever drugs because they
are safe and effective. They prevent the effects of histamine, the
substance released by the body during an allergic reaction.
Antihistamines reduce or control most hayfever symptoms, but can also
cause sleepiness. (Many patients adapt rapidly, and stop having this
reaction after just a short time of regular use.) Antihistamines can
provide dramatic relief and may make more complicated treatment
unnecessary. ... Well known examples include chlorpheniramine
(Chlor-Trimetron), brompheniramine (Dimetapp, Dimetane), and
Decongestants are helpful drugs that shrink swollen membranes, thereby
decreasing nasal congestion. They can cause mild stimulation
(nervousness, palpitations, insomnia), but most patients tolerate these
drugs quite well and often obtain relief with few side effects. The
most common decongestant is pseudoephedrine (Sudafed is one example).
Another is phenylpropanolamine. It is most commonly marketed as a diet
pill (Dietac, Dexatrim, etc.), but is quite effective as a
decongestant. (Caution: Neither pseudoephedrine nor
phenylpropanolamine should be taken regularly or over an extended
period of time without a clinician's supervision. This is particularly
important for people with high blood pressure, heart disease, diabetes,
an overactive thyroid, or glaucoma).
Combination drugs (antihistamines and decongestants) are formulated to
enhance the benefits and cancel out the respective side effects of
sedation (antihistamines) and stimulation (decongestants). This
combination has long been the cornerstone of allergy management and
many trade names have been given to the various common mixtures
(Dimetapp, Drixoral, Actifed, Allerest, ARM, Triaminic, etc). All of
these are available without a prescription and are very helpful for
many patients. Other preparations available by prescription
(Deconamine, Naldecon, Tavist-D, etc.) may offer advantages for some
Cortisone and its many derivatives are the most effective drugs
available for hayfever treatment, but they occasionally cause side
effects, particularly after oral treatment. Consequently these
medicines are used only when others have not been effective. In
recent years, topical cortisones (nasal sprays) have become available;
they can dramatically reduce symptoms. These topical drugs are highly
recommended and include Vancenase, Beconase, and Nasalide. They
usually require regular use for one or more days before benefits
Cromolyn is a unique drug which prevents the histamine release in
tissues following an allergic reactions. It is available in eye-drop
form (Opticrom), as a nose spray (Nasalcrom), and as an asthma inhaler
(Intal). One limit to cromolyn's usefulness is that it is not
immediately effective and requires regular and faithful use (often for
days) before relief can be expected. Side effects are minimal. (n.b.
Opticrom is not available at this time in the US, due to contamination
of supply several years ago)
Topical agents (antihistamine and decongestant nasal sprays and eye
drops) are almost immediately effective, but their benefits are
short-lasting. Many decongestant dye drops are available over the
counter, but the more effective combination (decongestant and
antihistamine) eye drops require a prescription. Non-prescription
nasal sprays (Afrin, Dristan, Newsynephrine) also offer immediate
relief, but can cause "rebound" irritation, whereby the symptoms they
are intended to relieve actually worsen. For this reason, they should
be used for only three days at a time, and are more helpful in the
treatment of colds than allergies. Cortisone-derivative and cromolyn
nasal sprays are generally preferable to non-prescription nasal sprays
for hayfever patients.
Side effects: Some people, especially young children and the elderly,
experience side effects when taking medication. Be sure to consult a
clinician if your hayfever medication causes you discomfort of any
Remember, do not take allergy medications without consulting a
clinician if you have:
high blood pressure
an overactive thyroid
Allergy medications may cause adverse reactions if they are taken in
combination with other drugs. Always consult a physician before taking
allergy medications if you are already taking another medication.
If you are pregnant or breastfeeding, consult and allergist or
obstetrician before taking any hayfever medication (over-the-counter
5.2 Dust Mite/ Mold Allergies
Contributor: Pete TerMaat( email@example.com)
The following is a collection of information on dust mite allergies
and their control. Please send email to firstname.lastname@example.org if you have any
comments or suggestions.
DUST MITE ALLERGIES
- Bachman, Judy, _Allergy Environment Guidebook: New Hope & Help for
Living & Working Allergy-Free_, c. 1990, Putnam Publishing Group,
257 pages. Information on allergies, effects of stress, advice on
building, decorating, remodeling and otherwise coping with
allergies. More depth and detail than most books on environmental
- Aslett, Don, _Make Your House Do The Housework_, c. 1986 Writer's
Digest Books, 201 pages. Tells you how to design and decorate a
house so that it requires a minimum of cleaning and maintenance.
- Consumer Reports, Oct 1992, reviews a number of air purifiers.
Friedrich C90 is the top-rated model. 512-225-2000 is the Friedrich
number. A mail-order provider is S and S Buying Service,
- Consumer Reports, Feb 1993, reviews vacuum cleaners, including the
Nilfisk GS 90. They found it effective at filtering dust
particles. Suggested that the best solution for the severely
allergic may be to limit the use of carpeting.
- USENET misc.consumers.house archive on central vacuum cleaners,
available on the web at
- Allergy Control Products, 1-800-422-3878. Offer encasings made of
fabrics which they claim keep out dust mites while allowing water
vapor to pass through. Less clammy than the usual vinyl
encasings. Also filters, dust sealants, asthma supplies.
They offer a pamphlet, "Understanding Vacuum Cleaners, Vacuum
Exhaust and Allergen Containment." Separate catalogs for dust,
mold, and cat allergies.
- Bio-Tech Systems, 1-800-621-5545. A 17 page catalog containing
information and products related to dust allergies, mold allergies,
and asthma. Filters, masks, mattress and pillow encasings, dust
sealants, dust mite removers, mold preventers, nebulizers.
- Allergy and Asthma Products Company, 1-800-221-6483. A 5 page guide
to dust, mold, and asthma control, and 2 pages of products.
Filters, bedding protectors, sprays, masks.
- The AL-R-G Shoppe, Inc., 305-981-9182. A 17 page catalog. Lots of
cosmetics, jewelry, plus the usual filters and mattress encasings.
- Allergy Controlled Environments, 1-800-882-4110
- Allergy Relief Shop, 615-522-2795
2932 Middlebrook Pike, Knoxville, TE 37921
6) Contact allergies (contact dermatitis) and Chemical Sensitivities
The symptoms of contact allergies and chemical sensitivities vary
from person to person. A person can react upon exposure to a
particular substance, such as the metal nickel, wool, latex, rubber,
hair dyes (paraphenylene-diamine or PPDA), chromates (found in
cement, leather, matches, or paints) or household cleaners. A comman
example of contact dermatitis is poison ivy. Though these two terms
are not at all synonymous, the treatment is the same -- avoidance.
A person with a contact allergy will often notice redness, itching or
swelling when any part of the skin comes in contact with a substance
to which they are sensitive. The skin may form blisters that later
break. Clothing, blankets, carpeting and upholstry, or jewelry are
common culprits. Clothing can contain wool (a common allergen) or
chemicals used in processing the fibers, such as dyes, finishes or
sizers. Washing all clothing before wearing helps, but that may not
be sufficient to remove all the allergen. Obviously, this won't help
someone with an allergy to wool!
Jewelry often contains nickel as part of alloy or in electroplating.
Wearing no jewelry or only jewelry of 18 carat gold may help. Also
watch for buttons and other fasteners that may contain metal. Be
aware of keys, kitchen utensils, tools, door knobs, and other metal
objects. Look for clothing with non-metal fasteners, or coat the
parts that may touch the skin with clear nail polish or other
covering. Buy tools and utensils that have handles of wood, plastic,
stainless steel, or aluminum.
Many other possible allergens can be found in cosmetics, toiletries and
perfumes, household cleaners, and latex.
An allergist can perform a one of several tests to determine the exact
allergen. One test is a patch test -- a small amount of a suspected allergen
is placed on the skin for a period of time and then checked for a reaction.
See Contact Allergy and
Information on Common Skin Diseases
for more complete information.
Chemical sensitivities are not allergies, in the accepted definition
of an allergy as an antibody response by the immune system, but they
can have many of the same outward symptoms such as lightheadedness,
fatigue, headaches, and recurrent illnesses that have no other
explanation. Reactions vary widely from person to person, but the
treatment is the same: avoidance. Chemical sensitivities do not
require contact with the substance to cause a reaction. Fumes or
residues on surfaces may be enough to trigger a reaction. This type
of sensitivity can be hard to pin down, as it sometimes requires a
lot of observation to make the connection. Possible sources of
irritants can be anywhere -- carpets, laser printer toners, housing
insulation, household cleaners, etc. These sensitivities can be quite
serious, requiring complete avoidance of many common substances.
For more information on multiple chemical sensitivities (MCS)
The Human Ecology Action League (HEAL)
PO Box 29629
Atlanta, GA 30359-1126
or The American Environmental Health Foundation
or The Environmental Hypersensitivity Association of Ontario
There is a mailing list
for people with chemical sensitivities called mcs-immune-neuro.
On asthma: Not all people with asthma have allergies.
Roughly 5% of the population lives with asthma.
A generally accepted definition of asthma is that it is a
disease that is charaterized by increased responsiveness
of the trachea (windpipe) and bronchi (main airway) to
sometype of trigger that causes widespread narrowing of
the airways that changes in severity either as a result
of treatment, or spontaneously.
The major features of asthma include:
1. Hyper-responsiveness of the airways to a specific
trigger or group of triggers.
2. Obstruction caused by one or more of the following:
a. bronchospasm (contraction of the smooth bronchial
b. mucus formation
d. edema (swollen lung tissue)
3. Reversibility: The changes in the lungs that occur as a
result of an asthma attack are not permanent, and will
resolve either spontaneously, or with treatment.
Asthma triggers can include but are not limited to:
allergens (pollen, dust, animal dander or foods)
smoke (environmental or cigarette)
Many people with asthma find that strong emotions, stress or
anxiety can make symptoms of asthma worse, especially during
a severe attack. Sometimes asthma symptoms appear for no
There are two types of asthma, acute and chronic.
Acute asthma is what we generally refer to as an asthma
attack. The bronchial tubes suddenly narrow, and the person
is acutely short of breath, and (sometimes) wheezes. An
acute attack may require medical stabalization in a hospital
setting; unless special equipment, medication, and help is
available in the home.
Chronic asthma produces symptoms on a continual basis,
and is characterized by persistent, often severe symptoms,
requiring regular oral steroid use in addition to multiple
On doctor's: Allergists are not the only physicians who
treat asthma. Pulmonologists are also medically specialized
physicians who treat many people who have asthma.
This was written with a view towards children, but also applies
to adults as well.
The environmental approach can be a real pain and a real expense,
but it does help - if you do it effectively. It does not help your
child to dust his/her room if you let him/her sleep with stuffed
animals, on an unsealed down pillow, on an unsealed mattress, in a
carpeted room, etc. It can do your allergic child harm if you vacuum
the house while he/she is around, or if he/she returns shortly after
vacuuming. We knew that these steps would help us, but never did
anything. When our kids developed severe problems, we didn't hesitate
to take drastic action, especially if it meant that we were able to
reduce their discomfort, the number of trips to the emergency room, or
the amount of medication that they were required to take.
This is what we did for our little asthmatics:
We started on their bedroom, where they spend aprox. 50% of their time:
- removed all stuffed animals
- removed all books
- sealed their mattresses and pillows in high-quality
- removed the carpeting
- removed all draperies and curtains
- removed upholstered furniture
- moved most of their dust-collecting toys and furniture into
- purchased an HEPA air filter
For the rest of the house, we:
- found new homes for our cats and dogs. Besides eliminating
the animal dander, there's far less skin and hair for the
mites to thrive in.
- removed all carpeting except on the stairs, where it
cushions their all-to-frequent falls
- removed upholstered furniture
- removed all draperies and curtains
Since we have hot-water heat, we didn't need to deal with the dust
problem associated with hot air systems. You'd be amazed at how much
dust collects in the ducts of a hot air system!
We vacuum only when the kids are away for a couple of hours (a real
pain!). After this, we damp-mop the floors and damp-dust
the furniture and woodwork in order to reduce the amount of dust.
On cat allergies specifically: Bathing cats can remove the dander,
which is the promary allergen. Cats deal best with baths if the
practice is started when they are still kittens. The catalog from
Allergy Control Products, 1-800-422-3878, has very useful
instructions for making cat-bathing easier.
One reference for cat dander, carpeting, and cat bathing is in the
journal American Review of Respiratory Disease, 1991, volume 143, pp.
1334-9: "Airborne cat allergen (Fel d I). Environmental control with
the cat in situ".
For more information on asthma, see
Alt.support.asthma FAQ and the
Alt.support.asthma Asthma Medications FAQ .
8) Specific advice on allergies and asthma in children
Amy Uhrbach (email@example.com)
Eileen Kupstas Soo (firstname.lastname@example.org)
Andrea Kwiatkowski (email@example.com)
Mark Feblowitz (mdf0@shemesh.GTE.com)
Lynn Short (firstname.lastname@example.org)
Allergies can show themselves in a number of ways -- runny noses,
ear infections, digestive disorders, irritability, hyper- and hypo-
activity, and such. Adults are often more sensitive to "not feeling
right" than children are, so look for indicators such as changes in
behavior or chronic or repeated sickness the corelates to exposure
to various substances (foods, air-borne particles, chemicals, etc.).
Recurrent stomach aches, never-ending ear infections, or changes
in bowel habits may indicate that an allergy is present. In infants,
colic, formula intolerance, frequent spitting up, and
low-grade fevers can be signs of allergies. Note that allergies
may not show up at the first exposure to the allergen. Some
allergies may take repeated exposures to develop.
During pregnancy, it is possible for the mother's antibodies,
produced against allergens, to be passed in utero. This can
unknowingly sensitize the child to the mother's allergens. Though the
allergies weren't inherited, they are still "familial". As always, a
doctor's advice should be obtained as to whether or not the mother
should avoid particular foods; however, avoiding known allergens
would seem like a prudent thing to do.
For infants, breastmilk is the safest food, in terms of allergies.
Some children are allergic to cow's milk, soy formulas, and such. The
best advice is to experiment until you find what works for your
child. Some mothers report that the mother's consumption of cow's
milk will cause a reaction in a breastfed child; this has
been confirmed by medical experts, so you may need to check this if
your child is being breastfed. References for this and other issues
concerning infants are cited at the end of this section.
When a child is born, the intestinal track is not fully
developed. Some foods may cause a reaction in babies that will be
outgrown as the child matures. The safest course is to introduce new
foods one at a time over an extended period (say, one food per week)
and see if the child has an allergic reaction. Postponing the
introduction of common allergens (wheat, cow's milk, corn, eggs) and
favoring the introduction of almost-always-safe foods (rice, apples,
bananas) is one sensible approach.
Children with allergies face the same social difficulties that
grown-ups do, but with less maturity and emotional resources to
deal with them. Children find that they cannot eat what their
friends eat or cannot play outside during some seasons. Until
a child is mature enough to understand why s/he cannot do
whatever, the parent must be extra careful to help the child
through the difficulties. Start teaching your child early on
what s/he cannot eat; you will not always be able to monitor everything.
Some parents have found that by volunteering to bring food to certain
events, they can provide food the child can have. (In one book, a
mother suggested bringing an alternate birthday cake/cupcakes/treat to
a birthday party if the child is allergic to wheat, chocolate or other
common cake ingredients.) If the allergy is life threatening, the
parent must take special care to warn all adults that care for the
child about the problem. For example, peanut allergies can be quite
severe; a caretaker or neighbor could innocently offer a peanut butter
sandwich to the child without realizing the consequences. Other
allergic reactions are merely uncomfortable; in this case, the parent
and child will have to weigh the consequences of eating any particular
food vs. the freedom to do whatever.
Some parents find that it is easier to feed the whole family
the same meals, planned around the child's allergies. This
can require some initial adjustments to learn new recipes,
but then the ease of preparing only one dinner is there. Other
benefits are that the child doesn't feel isolated from the
rest of the family by a special diet.
Allergic reactions to foods can include stomach upset or
digestive upset. Children sometimes balk at eating anything
that has caused an upset. This may be a clue to the parent to
check for allergies. The parent will have to judge whether
the child is allergic, just doesn't like the food, or is
rejecting the food for any of the million reasons children
reject foods :-) As the child matures, s/he will be better
able to judge the reaction to foods as well as monitor their
food intake away from home.
From Andrea Kwiatkowski:
One child and I have asthma and both children and I have food allergies
and are on special diets right now. One child and I are receiving
allergy shots. One suggestion that I have deals with the section about the
benefits of a pediatric/regular allergist. My 6 year old and I go to the
same one together. It was strongly suggested by my allergist to
reevaluate myself since allergies change and the shots have gotten much
better than when we were children. It REALLY HELPED Sarah to have mom
get tested and shots with her. All three of us get our flu shots
together at the pediatrician's office.
A great book on this topic and many others dealing with allergy in
children is "Is this Your Child" by Dr. Doris Rapp. She deals with common
allergy problems, providing pictures of symptoms and more controversial
ideas such as allergy control to improve behavior (dramatically improved
in my children), deal with ADD, epilepsy, etc.
From Heather Madrone (email@example.com)
From _Counseling the Nursing Mother_ by Lauwers and Woessner:
"The most common food allergen in infancy is cow's milk, with three-fourths
of such allergies beginning the first one to two months of life. Cow's milk
formulas do not contain the antibodies necessary to protect the infant's
intestines and for sensitive infants, the foreign protein of cow's milk
passes through the intestinal wall causing allergic reactions. These
reactions may manifest themselves as colic, diarrhea, vomiting, malabsoption,
eczema, ear infections or asthma. Symptoms of allergy are seven times
more prevalent in formula-fed infants than in breastfed infants, presumably
because of cow's milk. There is also the possibility that other food
antigens cause allergy responses in these infants, since solids are frequently
started at an earlier age in formula-fed infants.
"There are almost no antibodies in the immature intestine of a newborn infant,
leaving the wall of the intestine susceptible to invasion by foreign
proteins. Human milk contains a high level of antibodies, especially IgA,
which are thought to provide an anti-absorptive protection on the lining
of the infant's intestine, shielding the surface from the absorption of
foreign proteins as well as from bacterial infections.
"For any infant, with or without allergic tendencies, breast milk is
best able to protect him until his intestinal tract and immune system
mature. In one study, babies who were exclusively breastfed for
six months were no longer susceptible to eczema, food allergy or
asthma, despite an hereditary risk of such ailments. Breastfeeding
will not totally eliminate food allergies; however, it will greatly
reduce their incidence or delay their onset."
For a good discussion of allergies in children, see George Wootan's
_Take Charge of Your Child's Health_.
Anecdotally, in 3+ years as a breastfeeding counselor, I've noted that
children weaned before six months often have a very high incidence of
illness (particularly ear infections) and allergic reactions. Children
nursed longer than 18 months tend to be ill less frequently, have few
or no secondary infections (such as ear or sinus) and exhibit few signs
of allergy. Our pediatrician concurs in this and claims that the longer
a child nurses, the healthier the child.
From Kate Gregory ( firstname.lastname@example.org)
[maintainer: brackets indicate an edit]
[on how to avoid wheat, berry-fruits, citrus fruits, fish, dairy
products, chocolate, eggs, honey and nuts for the baby's first year]
We have a number of allergies on my husband's side of the family
and we followed this regimen for my son's first year (my daughter's
first year ended five years ago today and I can't remember what
she ate when.)
The hardest thing to avoid was wheat. We found many wheat-free cold
breakfast cereals and they made excellent finger foods. We used rice
and oat mush too. Cooked rice in place of pasta, that sort of thing.
We have anothr family member with a wheat allergy (and a niece who
gained ONE POUND between 12 and 24 months because of multiple food
allergies) so we already know what has wheat and what doesn't,
automatically. [Some brands are wheat-free; you need to look for the
brands that are sold in your area. Be sure to check biscuits, cakes,
bread-products, crackers, pasta and semolina. Be wary of anything
with flour or just "starch".] I wouldn't get all het-up about one
bite of something thickened with a teeny bit of starch. But anyway,
we fed mostly single-ingredient stuff. (Eg a jar of baby peaches:
[On avoiding citrus fruit (orange, grapefruit, lemon) and citric acid;
specifically on avoiding Vitamin C]
That's probably taking it too far, and besides I don't recall seeing
any baby food every with added Vitamin C. Don't give citrus juice,
pieces of citrus fruit to eat, or lemon sauces.
Note to UK readers: The above is US. One reader UK states :" Large
numbers of varieties contain vitamin C, lemon juice or ascorbic acid.
The 'natural' brands tended to use lemon juice, the cheaper brands
vitamin C. Heinz 'Pure Fruit Banana and Apple' is the most annoying -
I discovered it contains lemon juice as a bleaching agent, but you'd
only know that by reading the *tiny* ingredients list."
[On fish and seafood products]
If you must ignore one of these categories, pick this one. Soft
white fish is a nice high protein soft food. Also canned tuna is
a major treat for my kids and has been for a long time.
[On dairy products, including milk, cheese, yogurt, lactic acid, lactose,
casein, skimmed milk powder]
Read baby cereal boxes carefully to check for formula added. Some
families do yogurt at 9 months, but since my kids react with colic to
dairy in *my* diet in the early months, I stayed clear of dairy the
full 12 months.
Note to UK readers: The above is US. One reader UK states :"Skimmed
milk powder is one of the number one food additives in 80% of baby
food I looked at. Nearly all baby cereals, except Baby Organix (one
of the most expensive) contained skimmed milk powder. Even a 'Fruit
and Soya' dessert I discovered contained lactose!"
[On nuts and nut oils]
High quality peanut (groundnut) oil doesn't have the protein
in it. It's the cheap stuff that does. Some peanut allergies are fatal
and typically it's from something like "peanut oil in the cake
icing" where the victim could never have known.
Note to UK readers: The above is US. One reader UK states :"The
problem is, you don't know what quality of oil the food manufacturer
used when he says 'groundnut oil'. In this country, it does not even
have to be labelled if it is below a certain proportion."
No exception on this one. Infant botulism is bad bad news. I rather
doubt people are selling baby products sweetened with honey, still.
... my kids started eating completely different from us, then moved
slowly towards what we ate. By about 15 months the meals consisted
entirely of "family food". My kids still (6 today and 2 today!)
eat 3 extra snacks a day and those are usually high fat because
little ones need more fat.
At 6 months, its baby mush (rice or oat) made with expressed
milk, and some veggies or fruit from a jar. At eight or nine
months the jar mush has been replaced with soft (cooked if
necessary) fruit or veg, cut into tiny pieces, and the baby
mush supplemented with cold breakfast cereal such as Oatios
(Cheerios have a little wheat starch.) If we're having rice
or mashed potato, some for the baby. If we're having a cooked
veg, some for the baby. Also at about 9 months, soft fish
(but no shrimp etc because I'm allergic) and cooked (very
well cooked) ground beef.
At 11 months or so it's tiny shreds of meat from our plates,
veggies, whatever wheat-free starch we're eating. If we're
having spaghetti (no tomatoes for us before a year) then
baby has a separate meal. By 12 months whatever we're having,
baby has, and we gain crackers, toast, scrambled egg, yogurt,
cheese etc as snack items. Introduced one a a time of course.
The big convenience is when you decide a store-bought
cookie, from the bag, is OK.
Sure it's a huge hassle for those 6 months. But I assure
you from this long perspective that it fades to part of
that first-year blur. And the theory goes that this
will prevent food allergies (though not all: I certainly
didn't have any shrimp in my first year) and I can assure
you that dealing with a life long allergy is far more of
a pain. At least an eight month old doesn't come home from
school in tears (or covered in hives) because of feeling
pressure to eat what others eat.
[On the risk of a nutritionally imbalanced diet during the
first year, if all possible allergens are avoided]
I would ask your doctor to expand on this. What is nutritionally
risky about this if the child is still taking breastmilk? What
nutrients should you worry about? There is Vitamin C in potatoes,
calcium in broccoli, iron in raisins...
8.3 References on breastfeeding and baby allergies
Contributor: Paula Burch (email@example.com)
AN 91179769. 91000.
AU Haschke-F. Pietschnig-B. Bock-A. Huemer-C. Vanura-H.
IN Universitats-Kinderklinik Wien.
TI `Does breast feeding protect from atopic diseases?:.
SO Padiatr-Padol. 1990. 25(6). P 415-20.
JT PADIATRIE UND PADOLOGIE.
PT JOURNAL-ARTICLE (ART). REVIEW (REV). REVIEW-TUTORIAL (TUT).
AB It is well established that food antigens can pass from mothers to
infants via the breast milk. Bovine-beta-lactoglobulin has been
detected in several breast milk samples from mothers with regular
intake of *cow's* milk. Healthy *breastfed* infants can produce IgG
antibodies against *cow's* milk protein and in infants at risk for
atopic disease specific IgE antibodies were found before *cow's* milk
based infant formula was introduced into the diet. However, several
clinical studies in infants at risk for atopic disease indicate that
exclusive breastfeeding decreases the incidence of atopic disease.
The protective effect of breastfeeding is only relative and it is
uncertain, how long protection lasts. Sensitization to food antigens
may occur already in utero, because infants whose mothers avoid
common allergenic foods during the whole pregnancy and then during
the lactation period have a lower incidence of atopic eczema than
infants whose mothers are on an unrestricted diet. Avoidance of
common allergenic foods only during the last trimester of pregnancy
had no effect, because the fetus is capable of forming IgE immune
response. Author-abstract. 17 Refs.
AN 88217424. 88000.
IN Division of Gastroenterology and Nutrition, Children's Hospital of
TI Parental counseling compared with elimination of *cow's* milk or soy
milk protein for the treatment of infant *colic* syndrome: a randomized
SO Pediatrics. 1988 Jun. 81(6). P 756-61.
PT CLINICAL-TRIAL (CTR). JOURNAL-ARTICLE (ART).
AB Treating the infant *colic* syndrome by counseling the parents
concerning more effective responses to the infant crying is compared
to the elimination of soy or *cow's* milk protein from the infant's
diet in a randomized clinical trial. Because symptoms of vomiting
and diarrhea are not part of the infant *colic* syndrome, infants with
these gastrointestinal symptoms were excluded from the study.
Dietary changes were accomplished by either feeding the infants a
hydrolyzed casein formula or by requiring mothers to eliminate milk
from their diets. In phase 1 of the study, the group receiving
counseling (n = 10) had a decrease in crying from 3.21 +/- 1.10 h/d
to 1.08 +/- 0.70 h/d (P = .001). The crying in the group that
received dietary changes (n = 10) decreased from 3.19 +/- 0.69 h/d to
2.03 +/- 1.07 h/d (P = .01), a level still greater than twice normal.
AN 89189856. 89000.
TI *Cow's* milk allergy in the first year of life. An Italian
SO Acta-Paediatr-Scand-Suppl. 1988. 348. P 1-14.
JT ACTA PAEDIATRICA SCANDINAVICA. SUPPLEMENT.
PT CLINICAL-TRIAL (CTR). JOURNAL-ARTICLE (ART). MULTICENTER-STUDY
AB The diagnosis of *Cow's* Milk Protein Allergy was considered in 303
infants aged less than 1 year, who presented with one or more of the
following symptoms: acute reaction related to *cow's* milk proteins
(CMP) ingestion, severe *colics,* persisting vomiting, protracted
diarrhea with or without blood and mucus, failure to thrive, eczema,
respiratory symptoms, such as chronic rhinitis and wheezing. A
diagnosis of CMPA was confirmed in 148 cases (60%): 125 relapsed on
milk challenge, 23 were not challenged because of acute reactions at
onset, presence of specific IgE (RAST and prick), and improvement on
milk free diet. Familial atopy, familial history of CMPA and
previous acute gastroenteritis were significantly more frequent in
cases than in 191 age matched controls. Breast feeding was not more
common or of longer duration in controls, compared to cases. Mean
IgE serum levels were higher (46.3 U/ml) in cases than in controls
(17 U/ml), while specific *Cow's* Milk Protein IgE were found in 71/148
cases (48%). 15 infants entered the study while on breast milk,
because of the confirmed relation between their symptoms and CMP on
the maternal diet. These infants had a higher prevalence of IgE
mediated problems. All cases improved on a milk free diet but in 26
(17.8%) a further modification of the diet was required after the
first prescription. Milk challenge was monitored by simple
laboratory tests: all cases who had symptoms on challenge showed at
least one test modification. Six infants, with no history of acute
reaction, showed severe self-limited clinical symptoms at challenge.
Key words: *cow's* milk allergy, milk, allergy, prick test, eczema,
AN 91187523. 91000.
AU Clyne-P-S. Kulczycki-A Jr.
IN Washington University School of Medicine, St Louis, Missouri.
TI Human breast milk contains bovine IgG. Relationship to infant *colic?*
SO Pediatrics. 1991 Apr. 87(4). P 439-44.
PT JOURNAL-ARTICLE (ART).
AB Previous studies have suggested that an unidentified *cow's* milk
protein, other than beta-lactoglobulin and casein, might play a
pathogenetic role in infant *colic.* Therefore, a radioimmunoassay was
used to analyze human breast milk and infant formula samples for the
presence of bovine IgG. Milk samples from 88 of the 97 mothers
tested contained greater than 0.1 micrograms/mL of bovine IgG. In a
study group of 59 mothers with infants in the *colic-prone* 2- to
17-week age group, the 29 mothers of colicky infants had higher
levels of bovine IgG in their breast milk (median 0.42 micrograms/mL)
than the 30 mothers of noncolicky infants (median 0.32 micrograms/mL)
(P less than .02). The highest concentrations of bovine IgG observed
in human milk were 8.5 and 8.2 micrograms/mL. Most *cow's* milk-based
infant formulas contained 0.6 to 6.4 micrograms/mL of bovine IgG, a
concentration comparable with levels found in many human milk
samples. The results suggest that appreciable quantities of bovine
IgG are commonly present in human milk, that significantly higher
levels are present in milk from mothers of colicky infants, and that
bovine IgG may possibly be involved in the pathogenesis of infant
9) Allergies in relation to ADD and autism
Contributor: Don Wiss (firstname.lastname@example.org)
Here's some quotes on attention-deficit which elicited a lot of interest in
parents of ADD kids (and they brought to the celiac list a parent that tried
the diet herself, and is so ecstatic with the results she doesn't care if
she has not been tested for the condition first). Note only some are
relevant to kids.
(1) The following is taken from the "Celiac Sprue" flyer from CSA/USA (Box
31700, Omaha, NE 68131 402-558-0600): "...; personality changes (especially
common in children with sprue; they become unable to concentrate, are
irritable, cranky, and have difficulties with mental alertness and memory
function); can also occur in adults; ..."
(2) The following is from the February 1995 Sprue-nik Press newsletter. It
included Misc. Highlights from the 1994 American Celiac Society Conference.
"Question (to Alessio Fasano, Pediatric Gastroenterologist, University of
Maryland): Is there an association between celiac disease and attention
deficit or hyperactivity in children? Yes, but only for untreated celiacs.
Once the child goes on a gluten-free diet, these problems tend to
disappear. A related question: Is there a link between behavioral problems
and celiac disease in children? Once again, the answer is yes, but only for
untreated celiacs. It is the malnutrition that leads to the problem."
(3) From Gluten Intolerance Group - "Gluten-Sensitive Enteropathy: Up-Date
for Health Care Professionals" May, 1992:
"Behavioral changes - such as irritability and inability to concentrate,
may be reported in undiagnosed children. Adults often relate difficulties
in short-term memory and concentration...."
(4) From Coeliac Disease, by Michael Marsh, Blackwell Scientific
Publications, November 1992. - Chapter 2 (by Jacques Schmitz) - p.30 - "The
effects of the gluten-free diet are most often spectacular, particularly in
toddlers. Behavioural disorders are the first to subside..."
(5) Marsh's book again - Chapter 3 - on CD in adults, written by Peter
Howdle and Monty S. Losowsky. p. 55 - "Psychological changes have also been
widely investigated, but are difficult to quantify. Many patients appear
to be depressed, while others are irritable, morose or difficult to relate
to... Nevertheless, in some case reports, treatment with a gluten-free diet
has resulted in spectacular improvements in mental function."
(6) Lisa Lewis, PhD, has put up an excellent web page on diet and autism.
Explains what is happening with intestinal permeability, etc. It is 46K of
info and I can e-mail if one doesn't have web access.
10) Personal stories:
From: email@example.com (Aiko Pinkoski)
I have had seasonal hayfever starting about 8 years ago,
usually pretty severely the last 5 years. I basically just
pray for an easy spring :-) I have not seriously considered shots due
to inconvenience and my phobia of needles. Now I've learnt to
recognize the early symptoms and start my "preventive maintenance"
drugs early, esp. since some of them do not start working right away
And if I wait too long (I did this a couple of years since I don't
usually like medication) I'll end up with asthma.
Our 3 year old seems to be getting hayfever symptoms for the
first time. She complains of itchy eyes, has a clear runny
nose, and coughs a lot *at night* (probably because of post nasal drip,
I have to sleep sitting up at the height of allergy season). I just
spoke to our pediatric RN & she said for young children they will try
to medicate as little as possible as long as there is no fever, she is
eating, and not having trouble breathing. The recommended treatment is
a small dose of Dimetapp or Triaminic (combination drugs below) at
bedtime & naps). I am hoping that it might still just be a cold since
apparently 3 is rather young to get hayfever ...
But her father, my husband, only has mild pollen allergies now
but apparently was allergic to EVERYTHING (except food) as he
was growing up from a very young age. His eyes would be glued shut in
the mornings and his mother would steam them open with hot towels. He
had a series of shots and that may have helped, or he just outgrew them
naturally--he is not sure himself if the shots really worked.
Also an interesting fact I just found out--a food allergy is
not "having a badly upset stomach and intestinal pains when you
eat X"--at least one allergist nurse I spoke with (about possibly
getting tested for food allergies) said that I probably wouldn't test
positive to the allergy tests if I did not get hives or swelling.... I
am just "intolerant" and was just told not to eat X. Avoidance is also
the only "treatment" if they positively identify X but avoiding
something is more difficult when you suspect what X is but am not
really sure, which is my situation :-(
This is a bit of my experience, to give you a bit of hope..
light at the end of the tunnel and all.
I have been tested several times for allergies. All my doctors have
been careful to tell me that the results are NOT conclusive
evidence that one is allergic to a substance, just that one
MAY be allergic to it. I have been tested as sensitive to:
tomatoes, eggs, all molds in any form (air, food, etc.),
bell peppers, carrots, lettuce, colas, chocolate, caramel coloring,
wheat, oranges, potatoes, etc. (I just forget the rest... it's
quite a list.) I am (or was) somewhat sensitive to all these at
one point. I find now, after 10 years, I am less sensitive to
some of these, more sensitive to new things. The list keeps
changing. What is encouraging is that, after avoiding the food
for awhile, I find I am able to tolerate it in small quantities.
Now, I can have one serving of wheat a day (two average slices
of bread) without a hassle, as long as I don't have other foods
I am sensitive to that day. On great days, I can have spaghetti
in tomato sauce with no reaction. The orange allergy seems to be
bogus, as does the potato allergy. No problems yet with them. So,
check with your allergist, but you may find that the test results
are not 100% accurate. An elimination diet can test this out. (No
fun, but a great way to start eating a healthy diet and lose a
bit of weight, if you're so inclined.) I find the best indicator
is my stress level -- if it's high, avoid everything suspect. If
it's low, go ahead and try the foods. NOTE: this all assumes that
your reactions are not life-threatening or too severe. DO NOT
eat anything that is likely to cause severe reactions without
your doctor's consent.
Two other helps for me are allergy desensitization shots for
the mold allergies and a good antihistamine. The shots have
brought my mold allergies down to tolerable levels, so I can
eat cultered and fermented things again. The reduction in the
mold allergy also lets me eat some of the other suspect things
a bit more freely, since the total dose of allergens for the
day is lower. Also, if you can tolerate them, antihistamines
can help a lot when you know your going to be eating things
you aren't supposed to (like Christmas time, etc -- hard not
to have at least one cookie, a bit of something else..) Again,
this is only if the reaction is not too severe or life-threatening.
Some people find antihistamines make them quite drowsy; I don't
have this problem (or the reduction in allergy symptoms over-
shadows the little bit of drowsy..)
Not that this is much hope, either, but allergies may become less
severe after menopause ( a bit far off for me, but I can hope..)