Nursing

ALLERGIES AFFECT more than 73,000 children in the U.S., and are the third-most common cause of chronic diseases in children younger than 18.¹ Among the most prevalent childhood allergies are allergic rhinitis, food allergies, and atopic dermatitis.² Implications toward allergy development include a complex relationship between genetics, immune system dysfunction, and environmental factors. Tendencies toward developing allergies increases by 70% or more when both parents are allergy-prone. Genetic connections probably exist but have no impact on specific types of allergies children may develop.³

The immune system protects the body from allergens through an inflammatory process, and is programmed to launch immediate attacks against these antigens by producing an immunoglobulin E (IgE) antibody response. IgE molecules are present in body fluids and circulate throughout the blood stream. They locate and attach themselves to mast-cell surfaces because these cells do not circulate in the blood and basophils.⁴ Mast cells originate in the bone marrow and are found in connective tissue throughout the body in the dermis, lungs, and linings of the nose and intestinal tract. IgE produces immune-mediating chemicals, like histamine, and releases them into the blood stream and surrounding tissues. Mediating chemicals produce allergic responses in sensitized individuals: from rashes and hives to anaphylaxis and possible death. Individuals sensitive to particular allergens do not have allergic reactions from their first exposure because the sensitivity process occurs over time, as allergic responses increase in strength and duration. Well-known allergens include pollen, dust, mold, animal and human dander, latex rubber, food, vaccines, and venom from insect bites.⁴

ATOPIC DERMATITIS (eczema) is a skin disease that affects 10% of infants and children. It occurs due to an IgE response in skin cells that cause inflammation. Eczema's signature symptom is an itchy rash that starts on the face and continues over elbows and knees and may spread to other body parts. Rashes may begin to appear when infants are six weeks old.⁵

Emotional triggers such as fear, anger, and frustration worsen symptoms, and are exacerbated when colds or other bacterial-related infections are present. Stressful events during childhood are suspect causes of allergic dermatitis during later years due to a stress-related peptide, vasoactive intestinal polypeptide (VIP), released in the blood stream in situations when children are separated from their parents due to death or divorce, or when they move from one residence to another.⁷

ALLERGIC RHINITIS (hay fever) is a common problem in infants and may affect more than 10,000 school-aged children exposed to air pollution, secondhand smoke, and pets.⁸ Hay fever is caused when an IgE-mediated response causes an inflammation due to extrinsic protein allergens that affect nasal membranes, eyes, ears, sinuses, and throat. Sneezing, conjunctivitis, and itchy sensations in the palate, nose, and ears are among its symptoms.⁹ Children aged 10 to 17 years are three times more likely to have hay fever than children aged zero to four years.¹

FOOD ALLERGIES affect one in 17 children under the age of three, and 2.2 million school-aged children have one or more food allergies. Food allergies have increased during the past decade by 18% among children under 18 months of age. Children with food allergies are two to four times more likely to have asthma or other allergies.¹⁰

Eight food types account for more than 90% of allergic reactions: milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat.
Reactions range from mild to severe. Severe life-threatening reactions occur most often after eating peanuts and tree nuts. Allergies to milk, egg, wheat, and soybean are often outgrown by about school age. However, peanut, tree nut, fish, and shellfish allergies are likely to continue throughout adulthood.^11,12