All About Babies and Allergies
- Do Babies Inherit Allergies?
- Does My Baby Have an Allergy?
- Does My Baby Have Allergy-Induced Asthma?
- Does My Baby Have Allergy-Induced Eczema?
- What Can I Do?
Allergies are not inherited, but the tendency to develop allergies is passed down through the genes, so if one or both parents have allergies, there is a 50 to 75% chance the baby will develop allergies. According to the Asthma and Allergy Foundation of America (AAFA), if one parent (or that parent's relatives) has allergies, the child is 50% more likely to develop an allergy (although not necessarily the same allergy as the parent). If both parents have allergies, the likelihood the child will develop allergies increases to 75%.
Even if both parents have allergies, a baby has to be exposed to the allergen many times in order to have an allergic reaction. It's called The Bucket Theory.
Some people have a big bucket, and may be exposed thousands of times without having an allergic reaction. Babies with allergic parents have smaller buckets, and don't require as many exposures to have a reaction. It is very rare for a baby to develop a seasonal allergy, such as to ragweed, before the age of 1 or 2 because it takes that long to have sufficient exposure. On the other hand, dust mite allergy, mold allergy, or pet dander allergy can appear at a very young age due to constant exposure indoors.
It can be difficult to tell the difference between a common cold and baby allergies. If the symptoms subside in a week or two, it was probably a cold. If the baby has a continuous runny nose, rash, stuffiness and/or watery eyes, or upset stomach, it could be an allergy. All babies are fussy at times ‒ however, if a baby is fussy all the time, the cause could be allergies.
Here are some questions from The Baby Center website to ask yourself. If the answer is yes to any of them, an allergy could be the culprit. Your doctor can tell you for sure.
- Does it seem like your baby always has a cold?
- Is your baby's nose continually stuffy or running?
- Is she constantly wiggling, wiping, or pushing her nose up in what doctors call the allergic salute (see baby at right)?
- Is the mucus that drains from her nose clear and thin (as opposed to yellow or greenish and thick)?
- Are her eyes itchy, red and watery?
- Does she seem to sneeze a lot?
- Does the skin under her eyes look dark or purple or blue ‒ what doctors call allergic shiners?
- Does she breathe through her mouth?
- Does she have a dry cough?
- Is her skin irritated or broken out in an itchy red rash?
The AAFA cites research that if a family has a history of asthma or allergies, if the mother smoked cigarettes during pregnancy, or if the child has allergies (about 80% of children with asthma have allergies), there is an increased likelihood that the child will develop asthma at an early age. The AAFA goes on to say that the symptoms listed below could indicate asthma. However, other conditions have many of these same symptoms, so only your doctor can tell for sure.
- Noisy breathing, or breathing increased 50 percent above these normal respiration rates:
- newborns 30-60 breaths per minute
- 1st year 20-40 breaths per minute
- 2nd year 20-30 breaths per minute
- Wheezing (whistling sounds when a child exhales) or panting with normal activities
- Lethargy, disinterest in normal or favorite activities
- Difficulty sucking or eating
- Softer or different crying sounds
The cause of asthma is not always known or understood. It may be that some children and adults have hypersensitive airways that are more likely to be irritated by certain known triggers. The American Lung Association identifies the following risk factors in infants and young children:
- allergies ‒ more than 80% of current asthma cases in the U.S. can be attributed to allergies
- exposure to secondhand smoke
- mother smoking during pregnancy
- outdoor air pollutants, including ozone, particulate matter, nitrogen dioxide, and sulfur dioxide
- respiratory infections and colds
- influenza (flu poses a greater health risk for children with asthma)
- exposure to cold air or sudden temperature change
- exposure to strong odors, such as from cleaning products, air fresheners, or scented candles
- excitement or stress
Atopic dermatitis is often called eczema. "Atopic" means that it is likely an inherited allergic reaction. Eczema is an allergic response that causes red, scaly, itchy patches ‒ most often on the face, hands, behind the knees, and on the outer thighs. Although it can look scary to others, the condition is not contagious. Sometimes it is difficult to tell if a rash is the result of extremely dry skin or if it is eczema. Eczema generally first appears during infancy, and will come and go as exposure to triggers fluctuates. If there is a family history of allergy, asthma or eczema or if the baby has an allergy or asthma, the rash you see is likely to be eczema. Your doctor can tell for sure.
Here are some tips from the American Academy of Pediatrics (AAP) and the American Academy of Dermatology (AAD) to prevent flare-ups if your baby develops eczema that is triggered by exposure to certain allergens:
- Ask your doctor if your baby has allergies. If so, avoid any triggers, such as giving baby foods that cause an allergic reaction.
- Keep baby's skin well moisturized:
- Make moisturizing part of baby's daily skin treatment regimen.
- Apply moisturizer at least once a day to baby's face and entire body.
- Choose fragrance-free moisturizers, ideally those formulated for sensitive skin.
- Choose thick creams and ointments over lotion.
- Consider using a fast-acting, fragrance-free eczema cream to relieve and heal skin irritated by eczema.
- Tips for bathing:
- Use cleansers only when needed, and use only a mild, fragrance-free cleanser, ideally one that is hypoallergenic.
- Bar soaps should also be mild, unscented and hypoallergenic. Avoid any soaps containing harsh perfumes and deodorants.
- Do not use bubble bath, and avoid antibacterial products.
- Give baby shorter baths (5-10 minutes) in lukewarm (not hot) water.
- Gently pat the skin, instead of rubbing dry after the shower or bath to avoid irritating the baby's skin.
- Apply moisturizer while skin is still damp.
- Tips for clothes and laundering
- Choose soft clothing, such as 100% cotton, rather than rough scratchy clothing, such as wool.
- Don't buy clothing with sewn-in tags, as these can irritate baby's skin.
- Always thoroughly wash and rinse new clothes and bedding prior to use.
- Use laundry products made for sensitive skin that are free of dyes and perfumes.
- Do not use more than the recommended amount of laundry detergent.
- Do not use fabric softening sheets in the dryer.
- Other tips to prevent discomfort and flare-ups:
- Keep baby's fingernails short and smooth to help prevent nighttime scratching.
- Keep temperature and humidity levels constant. A humidity and temperature monitor can give you instant and accurate readings. Air that is extremely dry or where your child sweats and overheats can trigger the itch/scratch cycle.
- Avoid sudden changes in temperature or humidity.
- In the winter, keep dry air in your home moist by using a humidifier or vaporizer, or by placing pans of water on the radiator.
Limiting your baby's exposure to allergens is the best way to prevent or control allergies. According to The American Lung Association (ALA):
“Children spend more than 90 percent of their time indoors. Young people are particularly susceptible to indoor air pollution because their bodies are continuing to develop. Because children breathe in 50 percent more air per pound than adults, if indoor air quality is poor, they inhale and absorb a greater volume of contaminants into the lungs.”
The American Academy of Allergy, Asthma & Immunology (AAAAI) says "Since some airborne substances may trigger allergy or asthma symptoms, reducing contact with these substances early in life may delay or prevent allergy or asthma symptoms. Research for this is clearest with dust mites. If your child is at high risk of developing allergies, there are steps you can take to control dust mites." The most prevalent indoor allergens are dust mite, pollen, pet, and mold. Following are steps you can take to avoid each one.
How to Avoid Dust Mite Allergen
- Use zippered allergen-proof covers on all bedding where baby sleeps – your bed, too, if baby sleeps with you.
- Any bedding, curtains, dust ruffles, or stuffed animals that cannot be covered should be washed every 1-2 weeks in very hot water (130 degrees), or alternatively with a special, all-temperature laundry additive or laundry detergent that will either kill dust mites or neutralize their allergen so that it is not irritating to baby.
- Keep relative humidity below 50% since dust mites thrive in a moist environment. A humidity gauge can help monitor humidity. If it is consistently high, a dehumidifier may be needed in your home.
- If possible, remove carpet from baby's room (and your room if baby sleeps with you). Second to bedding, carpets are the next most popular place for dust mites to live. If carpet removal is not feasible, use dust mite carpet treatments that either kill dust mites or neutralize their allergen.
- Remove upholstered furniture from baby's nursery because it, too, harbors dust mites. Instead, choose leather or wood furniture. Treat upholstery and soft furnishings around the rest of your home to kill dust mites or neutralize their allergen.
- NO SMOKING in your home or around baby or while mom is pregnant.
- Remove as many dust-catching knick-knacks as possible because one component of house dust is dust mite allergen. Dusting often helps too, especially with a fragrance-free, allergen polish or a special dust grabbing cloth or an anti-allergen dusting spray.
- Vacuum often to capture allergens that have settled on the floor and surfaces. Use a HEPA-filtered vacuum so the particles don't escape back into the room with the exhausted air.
- The AAAAI recommends breast feeding exclusively for the first 4-6 months (or use a hypoallergenic formula) to help strengthen the baby's immune system. If baby is at risk of developing a food allergy (and you do not exclusively breast feed), the AAAAI recommends using an hydrolyzed infant formula, rather than a cow's milk formula.
The AAAAI also points out that "Infections that start in the lungs are common triggers of asthma. Since breast-feeding for at least four to six months strengthens a child's immune system, it is helpful in avoiding these infections and, in the long term, asthma."
- To prevent asthma, the AAAAI also advises it is best to avoid group day care for very young children to reduce their exposure to respiratory infections that can trigger asthma. The AAAAI states "Healthy preschool children in day care can have up to eight viral respiratory infections with a cough every year, each lasting about 10 days." The National Institutes of Health (NIH) cites a study by the National Center for Biotechnology Information (NCBI) concluding that "Infants attending DCCs (day care centers) will suffer ARI (acute respiratory infection) more frequently than children cared for at home."
How To Avoid Pollen
- Keep baby indoors when pollen counts are high and keep windows closed. You can check the pollen levels in your area online or watch weather reports that include a pollen index.
- Use a HEPA air purifier especially in baby's room to capture airborne pollen and other allergens.
- Have the family change clothes immediately when coming inside.
- Wipe off the cat or dog when it comes inside because pollen sticks to everything.
How To Avoid Mold
- Fix water leaks immediately.
- Keep relative humidity under 50%. Using your air conditioning may be enough, and a humidity gauge can help you maintain proper humidity. If humidity is continuously high, you may need a dehumidifier.
- Watch for mold in damp areas like bathrooms, basements, and around windows where condensation may occur. Clean mold away quickly if found.
- Prevent the growth or regrowth of mold by applying a protective layer that keeps mold away for months.
- Test for mold to learn what type(s) of mold you have and their concentration levels. Also helpful to test if you believe you have a mold problem, but you cannot see it.
- For larger problems, remediate mold and mildew yourself or call a professional.
- Silently eliminate airborne mold spores with a heat convection device or air purifier.
How To Avoid Pet Dander
- The best and most obvious way is to not have a pet.
- However, if you already have a pet, keep the pet outdoors if possible. At the very least, keep the pet out of the baby's room.
- Bathe the pet regularly in an anti-allergen pet shampoo.
- Moisturize the pet's coat and skin to reduce dander.
- Use pet wipes regularly to remove dander and other allergens, while conditioning your pet's skin and coat.
|A Word of Note on Pets and Allergies:
In 2014, the AAAAI says the relationship of pets and the development of asthma and allergies in children has become somewhat confused. They say that previous evidence suggested exposure by children to animals early in life could lead to the development of allergies or asthma. More recent research shows, however, that early exposure to animals (cats and dogs in particular) may actually protect children from developing these diseases. You may want to talk to your doctor about how this might pertain to your child.
If your baby's pediatrician confirms allergies, then in addition to making the above changes, the doctor may recommend medicine. If the doctor diagnoses asthma, an inhaled medication that reaches the lungs quickly may be prescribed. This is often administered with a compressor/nebulizer. Sometimes your doctor may prescribe what is called a "spacer" or "holding chamber" that allows the child to breathe in the medication from the chamber (see illustration at left). Your doctor may also recommend the use of a peak flow meter to tell the speed at which air can be expelled from the lungs to monitor and adjust the need for medication.
Allergies are no fun at any age, but it is always distressing to see a miserable baby. Using environmental controls like the ones above will definitely help reduce the indoor triggers of allergies, asthma, and eczema. Making changes in your home early may prevent or delay the onset of allergies or asthma, and will also help to lessen the symptoms caused by known allergies. It's a process. Start with the easiest changes first, and just keep at it until your baby's room and your home are allergy-safe zones.