Hello everyone, I am looking so forward to an opportunity of engaging with you around the issue of “Severe Allergic Disorder”. Although this disorder impacts adults, teenagers, children and infants, it is the moms’, the primary carers, who carry the greatest responsibility and concern. It is with this in mind that I want to introduce to you the suggested guidelines for possible prevention strategies.Severe allergic disorder, which includes the potential for Anaphylaxis (a potentially life threatening allergic reaction), is reaching epidemic proportions in South Africa. Would you believe that this has become the worlds’ most pervasive disorder as 20%-30% of the world’s population suffers from a form of allergic disease. The strange thing is that allergic disease is increasing with unprecedented complexity and severity. We want to focus on the escalation of food allergies. It’s difficult to imagine, but many children have multiple food allergies and often this coincides with asthma.Whilst this may be an overwhelming reality to live with, as children may react to tiny amounts of their allergen and may be very restricted in their dietary intake, it need not be. If parents or ‘parents to be’, are educated and aware, they can begin to make informed decisions in the best interests of their child and family, and link with others in this area for guidance and care.

Where to Begin

Firstly it may be useful to assess your family history. The Allergy Society of South Africa (ALLSA) has made it clear that a child without any family history of allergies is at 15% risk of developing an allergic condition in the first few years. A child where one parent has an allergic condition is at 40 to 50% risk, and if both parents have allergies the child is at 60 to 80% risk of developing an allergic condition.
Here are some guidelines given by the Allergy Society of South Africa (ALLSA) that aim to assist in prevention as much as possible.

Pregnancy:
During pregnancy one need not cut out food groups for the sake of allergy prevention. It is recommended that the pregnant mother eat two or more portions of oily fish a week. In the last trimester, if the baby is at risk of allergies, one may consider taking probiotics. Please hold in mind that this research is current and at the moment, which probiotic and how much remains uncertain. No smoking during pregnancy is advised.

Breast Feeding:
Breast feeding is recommended. The breast feeding mother need not avoid foods unless the infant has shown signs of allergies. Breast feeding over 6 months seems to show no allergy prevention properties but does have other benefits. In high risk babies, one may consider giving a probiotic and prebiotic, but please discuss this with your allergist. In high risk families, if the mother is not able to exclusively breastfeed during the first 4 months, ‘hypoallergenic’ formula may be considered, but the specific choice is to be made with your allergist or health care provider.

Solids:
If we think back, I am sure many of you can remember a particular medical perspective which advised moms to avoid the introduction of solids for as long as possible and especially to avoid introducing common allergenic food in the first year or two. There has been ground breaking international research called the LEAP study. The LEAP study recognises that we need to reassess the feeding policies of infants in an attempt to prevent what is called an ‘allergic march’ from reflux, to eczema, food allergies and asthma. The timing of introducing solids and the culture of avoiding potential food allergens until one or two years of age has been thrown into question.
Parents need to consult with paediatricians and allergists who are knowledgeable and steeped in understanding this research. International guidelines to assist parents and doctors are currently being processed. Making decisions on feeding prevention strategies is only to be done in consultation with a medical professional and is not for home experimentation.

Saying this, it is suggested that solids may be introduced when the child begins to show signs of readiness after 4 months of age. The idea is to begin with low allergenic foods like apples, pear, carrot, butternut, and sweet potato for the first few weeks. Thereafter it is no longer advised to hold back on any food group. In fact it is understood that if these food groups are introduced earlier, the immune system may be protected against the development of an allergenic system. However, if your baby is already showing signs of allergies; or if there is a strong family history of allergies, it is recommended that an allergist assess your baby between 4 to 6 months to guide the introduction of high allergy foods.

Healthy Skin:
Finally, keeping the child’s skin in a good condition may prevent eczema. Eczema is an allergic condition that can precede food allergies. So please use a daily emollient (a good balanced moisturiser with cetomacrogol or emulsifying base), rather than scented products or aqueous creams which are considered too harsh for sensitive skin.

You are Not Alone:
If you feel concerned, please remember that you are not alone. By being informed and prepared, you and your child can navigate through this and build strong healthy family and community bonds. We will continue to inform you about the many other issues related to this disorder and a caring society that is being created in South Africa.

For further information please contact allergyalive@gmail.com The Allergy Alive team will assist in directing, guiding and supporting social, emotional and practical concerns. In addition, Allergy Alive has a medical advisory board that is able to assist with medical guidance and referrals. You may also please join our Social Media community for tips, insightful articles and guidance: https://www.facebook.com/allergyalive/.

Hayley Katz
Director of Allergy Alive; Psychotherapist in Private Practice and Psychoanalytic Candidate.Important Links:
Allergy Alive Facebook Page: https://www.facebook.com/allergyalive/
ALLSA: http://www.allergysa.org/
The LEAP Study: http://www.leapstudy.co.uk/
The LEAP ON Study: http://allergicliving.com/2016/03/04/leap-on-study-shows-childrens-resistance-to-peanut-allergy-persists-without-consumption/