Allergies in a child - "treat" or "cure"?

The relevance of the topic "allergy in children" is evidenced not only by the abundance of information materials, but also by the persistence of certain myths and misconceptions. Yes, yes! Despite thousands of articles devoted to the problem of allergies, many people for years remain true to beliefs that do not quite correspond to reality. Let's check whether we are also supporters of erroneous judgments?

Myth 1: Allergies in children are the result of parents’ mistakes

Many true words have been said about the relationship between nutrition and allergies. Today, many people know that the errors in the diet of a future mother can be connected with the baby's tendency to diathesis, and the wrong menu of a child whose cheeks "bloom" every now and then can provoke a real allergic reaction ⁷. Modern parents also know about the delicacy of children's skin, the care of which does not involve the use of "adult" hygiene products, and that "cleanliness is the key to health..." and much more.

However, such a wave of thematic information also has a downside. Many of its consumers believe that the assumption that children of parents who carefully adhere to the principles of hypoallergenic nutrition, vigilantly maintain body and home hygiene, and generally follow useful recommendations, should not suffer from allergies seems logical.

But this is a misconception! Allergy sufferers often appear in families that carefully follow all the rules of allergy safety. Simply because the list of allergens is so wide that it is impossible to avoid meeting a potential source of problems.

Therefore, by the way, parents who are convinced that in their family the baby’s contact with food and household allergens is reduced to a minimum are advised not to be offended by friends (or the doctor) for “unfair suspicions”, but to focus on what is important – i.e. on finding out the events that preceded the appearance of alarming symptoms in the child.

Myth 2: Allergies in children are primarily a rash

Rashes are indeed more common in babies than in adults8. It is also true that rashes, itching and redness of the skin are symptoms of an allergy called ^urticaria3.

But not every rash is a sign of urticaria! Skin rash in children can be a manifestation of more than a hundred! Different diseases. ¹⁴ Causes of rash in children can be not only allergic reactions, but also infectious and parasitic diseases, blood and vascular diseases, as well as lack of proper hygiene ^9-10. Therefore, to determine the causes of a rash in a child, it is better to consult a doctor.

Myth 3: Allergies in a child are a sign of a weakened immune system

This is not true. Since allergies are hypersensitivity to substances to which most people are indifferent, they should rather be considered a sign of the peculiarities of the immune system ¹¹.

By the way, it is for this reason that more and more doctors are coming to the conclusion that the prescription of “immunity” medications should be approached very, very carefully. Especially if the child is constantly showing symptoms of ARVI ¹¹.

Myth 4: The safest way to treat a child's allergies is with "good old remedies"

It is stupid to refute the postulate that “medicines are pure chemistry.” At least because even ordinary water is a chemical compound with the formula H2O! But it is not worth agreeing with the widespread opinion that medicinal compounds that have existed on the pharmaceutical market for several decades are safer than modern drugs.

Let's take, for example, antihistamines, which probably no allergy sufferer can do without.

One of the oldest representatives of this group is mebhydrolin ^13. This "patriarch" is now approved for use in children from 3 years of age, provided that they do not have inflammatory diseases of the gastrointestinal tract and strict adherence to dosage recommendations (psychomotor agitation is possible). It is prescribed up to 3 times a day. ¹⁵

At the same time, one of the most modern antihistamines, desloratadine, can be prescribed to children from 6 months ¹. “This drug also has no contraindications that limit the range of potential patients (except for individual sensitivity to desloratadine or individual components of the drug). The conclusions are self-evident…

Myth 5: Treatment for allergies consists only of taking antihistamines

This is not true, although antihistamines do play an important role in eliminating allergy symptoms. After all, the task of these drugs is to block receptors sensitive to the effects of histamine as one of the most active substances involved in the development of allergic inflammation ¹².

However, the benefit of taking a drug that "turns off" only the histamine component of an allergic reaction may be less effective than using a drug with additional antiallergic and anti-inflammatory properties. That is why desloratadine, which has such characteristics, is actively prescribed to eliminate symptoms associated with allergic rhinitis (sneezing, rhinorrhea, itching, swelling of the mucous membrane and nasal congestion, itching in the eyes, lacrimation and hyperemia of the conjunctiva, itching in the palate and cough) and urticaria (itching, redness, rash) ^3-6.

The key to success in treating allergies is eliminating their causes, i.e. eliminating hypersensitivity to the allergen. But this is a strictly individual and rather complex therapy (allergen-specific immunotherapy - ASIT), so the decision on its appropriateness can only be made by an experienced allergist based on laboratory data obtained during the examination.

References

1. Pediatr Asthma Allergy Immunol 19(2): 91-99 2006.
2. Instructions for the drug Erius.
3. WAO Book on Allergy 2013.
4. Geha, R. S., Meltzer E. O. Desloratadine: A new, nonsedating, oral antihistamine. J Allergy Clin Immunol 107(4):752–62 (2001 Apr).
5. Ring J, Hein R, Gauger A. Desloratadine in the treatment of chronic idiopathic urticaria. Allergy 56(Suppl 65):28–32 (2001).
6. Monroe EW, Finn A, Patel P, et al. Efficacy and safety of desloratadine 5 mg once daily in the treatment of chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial. 2002 Submitted for publication.
7. Greer, FR, Sicherer, SH, Burks, WA, and the Committee on Nutrition and Section on Allergy and Immunology. (2008). Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas. Pediatrics. 121(1), 183-91.
8. Zitelli KB, Cordoro KM. Evidence-based evaluation and management of chronic urticaria in children. Pediatric Dermatology. 2011 Nov-Dec;28(6):629-39.
9. Napoli DC1, Freeman TM. Autoimmunity in chronic urticaria and urticarial vasculitis. Curr Allergy Asthma Rep. 2001 Jul;1(4):329-36.
10. Mathur AN1, Mathes EF. Urticaria mimickers in children. Dermatologic Therapy. 2013 Nov-Dec;26(6):467-75.
11. Drannik G.N. Clinical immunology and allergology Kyiv, 1999
12. Kreutner W, Hey JA, Anthes Preclinical pharmacology of desloratadine, a selective and nonsedating histamine H1 receptor antagonist. 1st communication: receptor selectivity, antihistaminic activity, and antiallergenic effects. Arzneimittelforschung 50(4):345–52 (2000 Apr).
13. Franks HM, Lawrie M, Schabinsky VV, Starmer GA, Teo RK. Interaction between ethanol and antihistamines The Medical Journal of Australia. — 1981. — Vol. 2. — № 9. — P. 477-479. 14. Color Atlas & Synopsis Of Pediatric Dermatology, Kay Shu-Mei Kane, Alexander J. Stratigos, Peter A. Lio, R. Johnson, Panfilov Publishing House, Binom. Knowledge Laboratory; 2011 15. Smirnova GI Antihistamines in the treatment of allergic diseases in children. – M, 2004. – 64 p.