1 in 5. In Singapore, allergies like atopic dermatitis (eczema) now affect around. Read on to find out more about allergies.

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1 In Singapore, allergies like atopic dermatitis (eczema) now affect around 1 in 5 1 Read on to find out more about allergies. Reviewed by Reference: 1. Tan T, et al. Prevalence of allergy-related symptoms in Singaporean children in the second year of life. Pediatr Allergy Immunol 2005: 16: ASTHMA & ALLERGY ASSOCIATION

2 What is allergy? An allergy is a reaction by the immune system to a substance that is harmless to others. Allergies can cause swelling, itching, rashes, runny nose, or wheezing. 1,2 These symptoms are related to allergic diseases such as food allergies, eczema, asthma and allergic rhinitis. A family history of allergies is the single most important factor that puts you at risk. Click and find out which allergic diseases the images below are related to. Red, dry and itchy skin Red R chy itc t i nd h heezi Wheezing ezing Sneezing, runny nose Sn S n runny lips Swollen lips Reference: 1. Allergy. Medline Plus US National Library of Medicine 7Jan Available from [14 Jan 2014] 2. Allergic Reactions: Tips to Remember. American Academy of Allergy, Asthma & Immunology Available from [14 Jan 2014] 2

3 Red, dry and itchy skin R d chy itc t i nd Eczema is a chronic skin condition that results in red, dry and itchy skin. It is also called atopic dermatitis. It can be caused by other diseases, irritating substances, allergies and is related to your genetic makeup. The most common type of eczema is atopic dermatitis - an allergic condition that is most common in infants and children. Children with atopic dermatitis tend to develop other allergic diseases such as asthma, rhinitis or food allergies. Reference: 1. Eczema. Medline Plus US National Library of Medicine 27 Dec Available from [14 Jan 2014] 3

4 ezi Wheezing ezing Asthma is a chronic lung disease characterised by coughing, chest tightness, shortness of breath and wheezing. The role of allergy in asthma is greater in children than in adults. When children experience asthma symptoms, inflamed airways become narrowed, making it more difficult to breathe. Asthma exacerbations may be triggered by viral respiratory tract infections or exposure to irritants like tobacco smoke. Reference: 1. Allergic Reactions: Tips to Remember. American Academy of Allergy, Asthma & Immunology Available from [14 Jan 2014] 4

5 Sneezing, runny nose S n runny Allergic rhinitis may be seasonal or year-round. This seasonal allergy is often called hay fever. In the tropics, where there are no pollen seasons, symptoms are year-round. They may be caused by exposure to indoor allergens such as dust mites, indoor molds or pets. The symptoms include sneezing, stuffy or runny nose and itching in the nose, eyes or on the roof of the mouth. Reference: 1. Allergic Reactions: Tips to Remember. American Academy of Allergy, Asthma & Immunology Available from at-a-glance/allergic-reactions.aspx [14 Jan 2014] 5

6 lips Swollen lips Food allergies is an abnormal response to a food allergen triggered by the body s immune system. In infants and young children, some common food allergens are cow s milk, eggs, peanuts, tree nuts, soybeans and wheat. Food allergy symptoms include itching or swelling in your mouth, vomiting, diarrhea, or abdominal cramps and pain, eczema and tightening of throat. In severe cases, it can result in life-threatening reactions. Reference: 1. Food Allergy. Medline Plus US National Library of Medicine 8 Jan Available from [14 Jan 2014] 6

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8 Family history has been found to be important in determining allergy risk. Babies are more likely to develop allergies if there s a history of eczema, asthma, hay fever or food allergies (known together as atopy) in the family. B Both oth p parents arents a are re n non-allergic on-allllergic* F a tthe he er/ r/m Mothe o t he he err w with i tth ha atttopy op py y Allergy gy risk Allergy gy risk B Both o t h par pare ent n ttss w with ith a att o op p py y Allergy gy risk * Not medically diagnosed with any form of allergic diease Adapted from: Van Bever H: General Introduction: Disease in Children Allergic The Science, the Superstition and the Stories. World Scientific, Mainland Press, 2009, ppxvi 8

9 Primary prevention of allergies has been extensively studied with a goal to prevent the onset of allergic diseases in newborns. These measures are recommended for families with atopy, however, the reality is that despite parents efforts to diligently follow the recommendations, children could still develop allergies. Check out what the experts agreed based on the current understanding. 9

10 Eat a healthy balanced diet with plentiful fluid (8-10 glasses). Avoidance of highly allergenic food in pregnancy is not recommended as a measure for preventing allergic disease because it has not been shown to be useful and may be detrimental as it has the potential to compromise the nutrition of both the mother and fetus. REFERENCE Maternal smoking in pregnancy is highly discouraged as it affects the lung development of the fetus. Avoidance of environmental house dust mite exposure in pregnancy has not been shown to be useful. If you want to get more information on allergies, please log-on to the Asthma & Allergy Association [ Reviewed by ASTHMA & ALLERGY ASSOCIATION 10

11 References: 1. Health Promotion Board March Health Start for Your Pregnancy- Healthier Child, Brighter Future. Singapore. Also available from HOPPortal/health-article/ Ministry of Health 2010 Management of Food Allergy MOH-AMS Clinical Practice Guidelines 2/2010, Singapore. Also available from moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical/2010/cpgmed_ management_food_allergy.html REFERENCE Prescott S, Tang MLK. Position Statement The Australasian Society of Clinical Immunology and Allergy position statement: summary of allergy prevention in children. Med J Aust 2005; 182(9): Also available from com.au/journal/2005/182/9/australasian-society-clinical immunology-and-allergy position-statement-summary ASCIA Infant Feeding Advice. The Australasian Society of Clinical Immunology and Allergy (ASCIA) September Available from healthprofessionals/papers/ascia-infant-feeding-advice 14 Jan Greer FR, Sicherer SH et al. American Academy of Pediatrics Committee on Nutrition : Americal Academy of Pediatrics Section on Allergy and Immunology. 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 food, and hydrolyzed formulas. Pediatrics 2008;12(1): If you want to get more information on allergies, please log-on to the Asthma & Allergy Association [ Reviewed by ASTHMA & ALLERGY ASSOCIATION 11

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13 Primary prevention of allergies has been extensively studied with a goal to prevent the onset of allergic diseases in newborns. These measures are recommended for families with atopy, however, the reality is that despite parents efforts to diligently follow the recommendations, children could still develop allergies. Check out what the experts agreed based on the current understanding. 13

14 Breastfeeding is recommended for at least 6 months for many reasons and is encouraged to continue it for as long as possible. If infant formula is required in the first months of life before solid foods are introduced, there is some evidence that hypoallergenic formulas, otherwise known as partially hydrolysed formula*, may reduce the risk of eczema in high risk infants. REFERENCE Weaning to semisolids should be delayed until at least 4 months and commenced by 6 months of age. Parental smoking is discouraged because of the potential harm of secondary smoke. Avoid exposing your child to cigarette smoke in confined spaces and indoor air pollutants. It is unnecessary to remove or avoid pets for preventing allergic disease. *Partially hydrolysed formula is not suitable for baby who is diagnosed with cow s milk protein allergy If you want to get more information on allergies, please log-on to the Asthma & Allergy Association [ Reviewed by ASTHMA & ALLERGY ASSOCIATION 14

15 References: Exclusive breastfeeding for six months best for babies everywhere. Jan 2011 Available from ASCIA Infant Feeding Advice. The Australasian Society of Clinical Immunology and Allergy (ASCIA) September Available from professionals/papers/ascia-infant-feeding-advice 14 Jan 2014 Ministry of Health 2010 Management of Food Allergy MOH-AMS Clinical Practice Guidelines 2/2010, Singapore. Also available from moh_web/healthprofessionalsportal/doctors/guidelines/cpgmedical/2010/cpgmed_ management_food_allergy.html 14 Jan 2014 REFERENCE 4. Greer FR, Sicherer SH et al. American Academy of Pediatrics Committee on Nutrition : Americal Academy of Pediatrics Section on Allergy and Immunology. 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 food, and hydrolyzed formulas. Pediatrics 2008;12(1): David M. Fleischer, Jonathan M. Spergel et al. Primary Prevention of Allergic Disease Through Nutritional Interventions. J Allergy Clin Immunol: In Practice 2013 January. Also available from: PDF%20Documents/Practice%20and%20Parameters/Primary-prevention-allergicdisease-through-nutrition.pdf Prescott S, Tang MLK. Position Statement The Australasian Society of Clinical Immunology and Allergy position statement: summary of allergy prevention in children. Med J Aust 2005; 182(9): Also available from: com.au/journal/2005/182/9/australasian-society-clinical-immunology-and-allergyposition-statement-summary If you want to get more information on allergies, please log-on to the Asthma & Allergy Association [ Reviewed by ASTHMA & ALLERGY ASSOCIATION 15

16 Acknowledgement: With thanks to Asthma & Allergy Association for their contribution in this publication. Educational material brought to you by: Nestlé Start Healthy Stay Healthy as part of their First 1000 Days Nutrition Program. This material is not intended as a substitute for professional care Reviewed by Brought to you by: ASTHMA & ALLERGY ASSOCIATION