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Allergy alert

ALLERGY has risen dramatically in recent years. The siren is beginning to sound in many countries across the world. Indeed, allergy is one of the chronic diseases most frequently suffered by infants and children in industrialised countries, where one out of every three or four children is affected.

On the global scene, it is estimated that asthma, a form of airway allergy, affects as many as 300 million people with another 100 million expected in 2025.

Allergy seldom kills or maims. Life does go on for allergy sufferers, but unless you have an allergy yourself or live with someone who has it, you will never fully understand the impact of allergy on the quality of life. The physical suffering, the mental torment, the emotional struggles, the financial strain and the endless limitations in many aspects of life, ranging from food to sports or vacation to vocation. In a nutshell, allergy rarely kills but often steals your zest for life.

As 60% of all allergies appear during the first year of life, it is only logical for allergy prevention to be focused on infants and young children. In fact, it is estimated that 35% of children are affected by allergy.

The most common manifestations of allergy in children are food allergy, atopic dermatitis, asthma and allergic rhinitis/conjunctivitis.

As if the misery of one form of allergy, say dermatitis, is not enough, allergies may come in a series called the "allergy march". Leading this march is atopic dermatitis which is often accompanied by food allergy. A large proportion of children with atopic dermatitis then progress to rhinitis or asthma later in life. Thus, the development of allergic diseases can be life-long.

Up till now, there is still no cure for allergy and prevention remains the only way to stop the allergy march. But before we can put the brakes on allergy, we must know what drives it.

Genetic link

Allergic diseases run in families. If you and your spouse both suffer from allergies, your children will have a 40-60% risk of developing allergies. If only one of you is allergic, then the risk falls to 20-40%.

However, even if both parents are allergy-free, the offspring will still run a 5-15% risk. So, allergy prevention is justified for all infants.

Environmental factors

Besides genes, environmental factors also contribute to the development of allergy. At present, genetic and environmental factors each account for 50% of allergic diseases (Host 2001).

The major environmental risk factor is exposure to foreign food proteins in early life and the main culprit is cow's milk protein. In unmodified cow's milk, there are more than 32 types of proteins with great potential to trigger food allergy.

Similarly, plant proteins, like soy protein, also possess the potential to spark off food allergy. While any food can cause food allergy, the more potent ones are eggs, milk, peanuts, tree nuts (for example, almond, walnut, cashew, hazelnut, etc), fish, shellfish and soya beans. The state of the digestive tract and age of the child when first exposed to the offensive food are equally important.

Halting the allergy march

If we cannot change our genes, we have to change the environmental factors. Here are some measures that can help halt the allergy march:

Exclusively breastfeed your child for at least the first six months of life. Breast milk proteins are not considered as foreign proteins by your child's immune system. In fact, breast milk has a long-term preventive effect against non-food allergies. However, nursing mothers are advised to abstain from highly allergenic foods themselves as traces of offending proteins from these foods may reach the breast milk.

If you are unable to breastfeed due to medical reasons, use a scientifically proven hypoallergenic formula that helps to prevent the development of allergy. Although this formula contains cow's milk, the proteins have been modified with gentle heat and enzymatic treatment so that they are now safe and do not trigger allergies.

However, if your child has already been confirmed with cow's milk protein allergy (CMPA), he would need another type of hypoallergenic formula, which is specifically designed for treating allergy.

Do not use goat's milk or similar milks as the proteins are very closely related to cow's milk and as such may provoke allergic reactions. Soy protein formulas have no role in the prevention of allergic diseases, so do not use them for prevention. Moreover, 15-50% of infants who are allergic to cow's milk are also allergic to soya milk.

Delay the introduction of solid foods until your baby is at least six months old, when his digestive tract and immune system are better developed. Stay away from highly allergenic foods like shellfish, eggs and nuts during the first year. Introduce only one new food at a time to allow any adverse reactions to be traced easily.

Stop smoking during pregnancy as it may have adverse effects on infant lung development. Children should also not be exposed to cigarette smoke at all, especially in con- fined spaces.

Parents should make every effort to prevent allergy in their children because once triggered, the allergy march might just go on, and adversely affect your quality of life.


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