Baby allergies

By Rafael Castillo, MD
Philippine Daily Inquirer

ALLERGY for adults is a source of much concern; and it becomes more so in babies and young children. Yes, allergy is not a problem only found in adults – a popular misconception. So babies with puffy eyes and runny nose may already be suffering from allergy. Initially they may present with symptoms such as recurrent abdominal colic or regurgitation of milk, which neither the parents nor the doctor may attribute to allergy.

Dr. Peter Smith, a pediatrician-allergologist from Griffith and Bond University in Australia, was recently in the country to lecture on the various causes of allergy in infants and the steps that could protect an infant from the discomfort and danger that allergies could bring.

Dr. Smith defines allergy as “an abnormal response of the body to a foreign protein, which can be something we breathe in, something we eat, or something we’re stung with, like an insect sting.”

Food allergies, in particular, affect anywhere from 5 to 8 percent of infants, and health experts are alarmed that the rates have been rising in recent years. Cow’s milk protein is often the first and major cause of food allergy during infancy, Dr. Smith says. As the child grows and is given more solid foods as complementary feeding, allergies to eggs, nuts and seafood may also be fairly common.

Allergy symptoms

The symptoms of allergy can be relatively mild initially such as upset stomachs or regurgitation but it can also be potentially life-threatening in some cases. There have been reports of occasional anaphylactic shock in babies causing constriction of airways and difficulty of breathing. The baby with anaphylactic shock can just suddenly turn blue, due to lack of oxygen.

So babies of parents with serious allergic histories should be considered at risk of developing allergic problems also. Dr. Smith explained that if neither parent was allergic, the chance that infant would have allergies was only about 15 percent. An infant with an allergic parent has 40 to 60 percent risk of developing allergy, and if both parents have allergies, the risk goes all the way to 80 percent.

Also an interesting hypothesis (hygiene hypothesis) proposes that limited exposure to bacteria, especially in early life, due to extremely sterile surroundings may also increase the risk of allergy. So, clean environment for the baby is good, but “sterile” rooms –supposed to be a privilege of urban affluence – may deprive the babies the chance to develop the babies’ immune system.

A little bit of bacteria and other allergens may positively stimulate the immune response with antibodies being formed by the body itself. This is why some experts including Dr. Smith label some bacteria as “good bacteria.” In fact, I believe some milk preparations have already incorporated in their formula some of these good bacteria such as bifidobacteria.

‘Allergic match’

There is also such a thing as an “allergic march” in infants and children, such that the allergic manifestations may become worse as the child grows. It triggers a cascade of other troublesome allergic problems involving the stomach (gastrointestinal tract), skin, nose and lung airways. Cross allergy to various substances can also occur.

For example, 95 percent of those who have egg allergy also develop dust mite allergy. And dust mite is practically present everywhere. Egg allergy is also known to increase the risk of developing skin allergies or eczema which in turn may also lead to allergic rhinitis, so the child always have runny nose, sneezing and teary eyes.

Dietary protection vs allergy

The risk of allergy from milk preparations is one strong argument for breastfeeding. Dr. Smith stresses that it still remains as the best and earliest step that can be taken for dietary protection against allergy, regardless of family history. He explained that breast milk provided a naturally hypoallergenic milk protein that significantly reduces the risk of allergy. Also, breast milk contains antibodies and probiotics (live, good bacteria) like bifidobacteria that help strengthen the infant’s immune system.

So, unless other medical conditions in the mother and child make breastfeeding not possible, breast milk remains the best source of nutrition for the baby for as long as possible, especially during the first year. When breastfeeding is not possible, pediatricians may consider prescribing an infant formula that is hypoallergenic. Such preparations contain hydrolyzed whey (H.W.) formulas, because the process of hydrolysis makes milk proteins less allergenic. Hydrolysis is a technical process that breaks down cow’s milk protein into smaller, gentle particles that are regarded as harmless by the immune system. Hence, it helps reduce the risk of allergy.

In addition to hydrolyzed whey, introducing probiotics to an infant’s diet can also significantly decrease the risk for allergy, Dr. Smith suggests. He presented a paper explaining the benefits of probiotics in food allergy prevention. These probiotics can help alleviate the tendency of the infant’s immune system to react abnormally to proteins in food and thus help reduce the potential of developing food allergies. Specifically, probiotics have been reported to decrease the chances of developing eczema, which in turn decreases the likelihood of other forms of allergies.

Allergy prevention

Soy formula or alternative animal formulas like goat, sheep, or mare, have also been proposed for allergy prevention in infants and babies; but currently, there is no good evidence showing that they can prevent the development of allergies.

Omega 3 fatty acids (fish oil) have been shown in some studies to suppress the inflammatory mechanisms associated with allergies; and nutritional supplementation in the mother has been associated with reduced allergy risk such as wheezing in infancy. However, this protective effect dissipated by three years of age. Folate is also another nutritional supplement now being studied in the prevention of allergy.

Babies, whose parents have significant histories of allergy, should be evaluated already as early as possible if they have inherited their parents’ allergy-prone genes. There are now blood tests using a few cc’s of blood to find out the baby’s allergic risk. In fact, blood from the infant’s umbilical cord can already be sent for testing, so right on day 1, the infant’s allergic risk is known.

Allergy is always bad news at any age. Let our infants and babies be spared from it.