Allergies in children have become a widespread problem. More and more children are allergic to house dust mites, plant pollen, chemicals, and animal fur. Unfortunately, allergy problems are often hereditary. The likelihood of a child developing an allergy is higher if one or both parents suffer from allergies. If both the father and mother are allergy sufferers, there is a 75% chance that their child will also struggle with an allergy. If one parent has an allergy, the risk of the child developing one is 50%. Studies show that the type of a parent’s allergy influences the type of allergy their child develops. Asthma, hay fever, rhinitis, and eczema are considered hereditary.
Young allergy sufferers
The most difficult task is making the correct diagnosis. Identifying allergies in children aged 3–6 is difficult because they often suffer from various illnesses during this period. Allergy symptoms can therefore be confused with infections—this is discussed in the video “Can allergies in children be confused with other diseases?” by Zygmunt Nowacki, MD, PhD, an allergist from Kraków. According to him, a primary care doctor cannot diagnose an allergic disease on their own. That is why it is worth consulting a specialist.
Allergists often diagnose allergies indirectly, by ruling out other diseases that have symptoms similar to those of allergies or asthma. Allergy diagnostics, meaning tests, are used. However, it is important to remember that these tests do not determine the diagnosis; they only suggest that the child is predisposed to allergies.
Correct and early diagnosis of allergies in a child is very important—it may protect the child from other diseases in the future. In the video “Children with atopic dermatitis are at risk of bronchial asthma” Dr Monika Kapińska-Mrowiecka, a dermatologist and allergist from Kraków, explains that attention should be paid to the early manifestations of atopic dermatitis in children because the risk of developing bronchial asthma in such cases is very high.
Allergist or pulmonologist?
It is best to consult a specialist in the following cases:
- the primary care doctor is uncertain about the diagnosis,
- the family doctor is unable to control the child’s symptoms,
- the allergy symptoms are moderate or severe and require specialist advice,
- additional consultation is needed.
The young patient may receive a referral to an allergist or pulmonologist. It is important to understand the differences between these specialties.
An allergist is an expert in determining the causes of allergic reactions. They perform allergy tests, provide advice on measures that can help reduce exposure to allergens in the environment, and can also conduct immunotherapy (treating the child with desensitization vaccines).
A pulmonologist is a diagnostician who generally treats children suffering from rarer respiratory conditions. They are prepared to answer questions such as: Why does the child cough when the prescribed medicines are not working effectively? What has been overlooked in a child who continues to suffer from persistent symptoms? A pulmonologist is also an expert in interpreting various tests assessing lung function, which may be useful.
Pediatric pulmonology is considered a relatively new branch of medicine. Allergology is an older specialty, and consulting an allergist is often a good choice. The roles of allergology and pulmonology do not exclude one another, so children may receive care from doctors in both specialties simultaneously. It is important that the doctor be an expert in selecting medicines and safely controlling children’s symptoms.
A Child’s First Doctor’s Appointment
If a child experiences symptoms suggestive of an allergy or asthma, the first step should be an appointment with a primary care or family doctor. The advantage of a family doctor is that they consider the child’s entire body. An additional benefit may be that they know the young patient, which makes working with the child easier. If an allergic disease or asthma is suspected, the family doctor will issue a referral to an allergist or pulmonologist.
The child’s parents should prepare properly for the doctor’s appointment. The first step is to observe the child and write down one’s observations. It is important to know what symptoms the child has and under what circumstances they occur, such as sneezing during a spring walk in the park. If the child takes medicines, the doctor should be told about them—what they were prescribed for and in what doses they are administered. It is best to bring the medicine packages to the appointment.
During the appointment, parents should not hesitate to ask questions. What can they ask the doctor?
- Does the child have an allergy or asthma?
- Is there any other health problem besides the allergy or asthma?
- What factors trigger the child’s allergic symptoms?
- Does the child need to undergo allergy tests?
- Should the child see a specialist, and if so, should it be an allergist or a pulmonologist?
- What besides allergies can trigger asthma attacks in the child?
- How can the child’s contact with allergens be reduced?
- Should the child receive desensitization vaccines?
- How often should follow-up appointments take place?
- Does the child need medication all the time, or only when symptoms occur?
- Can side effects occur after taking the medicines?
- What is the safest way to treat the child?
- What should be done if the prescribed medicines do not work?
- Who should be contacted in urgent situations?
The Role of Parents
It is important to realize that parents are also part of the diagnostic team because they describe the symptoms and illnesses the child has experienced. These are key elements of examining a young patient, so during a specialist appointment it is best for both parents to be present, especially at the first visit. The better prepared parents are for the meeting with the doctor, the more benefits they will gain from the appointment.
It is also important that children be able to do what they want—to participate fully in all kinds of activities and not feel restricted by their allergy.
information Anna Włoszek, Dariusz Młynarczyk
The series “Everything You Want to Know About Allergies” is published in cooperation with the video portal www.JaAlergik.pl.