Allergies and asthma, which typically start in childhood, are the most common chronic diseases among children, but what is an allergy? An allergy is what happens when your immune system reacts abnormally to harmless substances in the environment. These substances are known as allergens. Some of these allergens include, dust mites, pollens, animal dander and foods.

The immune system has an important job: to defend and protect your body from invaders such as bacteria and viruses.  However, in certain cases the immune system will respond excessively and damagingly to a certain trigger, and leading to an allergic reaction

There are different types of allergies that all fall under three categories: respiratory allergies, skin allergies and food allergies.  This month the focus is on food allergies and the most common allergenic foods.

What usually happens when someone has a food allergy is that his or her body sort of misfires. Instead of treating the allergenic food like any regular food, the body reacts as if it is harmful. In an attempt to protect the body, the immune system produces antibodies (special proteins designed to fight infections) against that allergenic food.

A group of the eight major allergenic foods is often referred to as the Big-8 and comprises milk, eggs, peanuts, fish, crustacean shellfish, tree nuts, wheat and soybean. These foods account for about 90% of all food allergies. In this article, we will be talking about the 3 most common food allergies in children, which are, peanuts, milk & eggs allergies.

COMMON ALLERGIES

Peanuts

An allergic response to peanuts usually occurs within minutes after exposure.

Signs and symptoms can include:

• Diarrhea or vomiting
• Swollen lips and throat
• Sore, red and itchy eyes

Anaphylaxis: A Life-threatening Reaction

Peanut allergy is the most common cause of food-induced anaphylaxis

Anaphylaxis signs and symptoms can include:

• Constriction of airways
• Swelling of the throat that makes it difficult to breathe
• A severe drop in blood pressure (shock)
• Rapid pulse
• Dizziness, lightheadedness or loss of consciousness

Cow’s Milk

This is another common allergy in the pediatric population.  In some children the symptoms can be very obvious, however in certain cases the symptoms are less clear

Signs and symptoms of a cow’s milk protein allergy might include:

• Itchy skin rash, often around the mouth
• Colic, in babies
• Fussiness and irritability
• Bloating and gas
• Blood in the stool
• Diarrhea and vomiting
• Poor weight gain

It is also important to remember that all the signs and symptoms are not always present.  For this reason, at times, this can be a difficult diagnosis to make.

Eggs

Egg allergy symptoms usually occur a few minutes to a few hours after eating eggs or foods.

Reactions vary from one person to person and usually occur soon after exposure to eggs. Egg allergy symptoms can include:

• Skin inflammation or hives — the most common egg allergy reaction

PREVENTION

Food allergies can sometimes be prevented from the beginning by following some healthy lifestyle tips such as:

• Breastfeeding exclusively for the first four to six months may help prevent asthma, eczema, and certain food allergies.
• Introducing solid foods gradually between four to six months of age. Eggs, dairy, peanut, tree nuts, fish and shellfish can be gradually introduced after less allergenic foods have been tolerated. In fact, delaying the introduction of these foods may increase the baby’s risk of developing allergies.

Allergic children can have a very healthy and safe life, and the first step for that is to look out for any symptoms of allergies. In case you suspect that your child has any allergies, make sure to take him/her to a doctor to help diagnose the condition and give you the proper plan for managing the allergies.

This article was brought to you by Tabibi 24/7, Cairo’s leading family medicine & pediatrics group practice. Tabibi operates 24/7 and offers its services in the comfort of your own home or in one of its clinics.

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Family structure and domestic stability have always been important elements in Egyptian life, but as the pressures of today’s world builds up, unfortunately some marriages crack under the strain. When partners take the decision to move on and form a new union, the new domestic situation affects not only the adults, but the children, who have to adjust and cope as well. Cairo West Magazine went to leading psychologist Dr. Josette Abdalla from Oasis Clinics to get her input on this increasingly common situation.

CWM: Dr. Josette, is there an increase in remarriages nowadays?

JA: I do not have precise statistics, but based on what seems to be quite obvious or evident across the different strata in Egyptian society, there is a significant increase in second marriages.

Do you encounter people experiencing difficulties in creating a family bond with their new spouse’s children from the previous marriage?

I do. As a clinical psychologist much of my work is in the domain of parenting and counselling with parents, in general, as well as with youngsters, to help them cope with emotional issues related to second marriages.

It is often difficult for the step-dad or mom to bond with the spouse’s children from a previous marriage, even if the relationship between them before the actual marriage (or announcement of the marriage decision) was a happy and interactive one.

What are the main issues that arise?

Among the numerous issues that may arise are:

• The child resents the fact that the step-parent will be present in the house permanently and will be sharing the parent’s room and bed.
• The child may feel that he/she will come second to the step-parent and a lot of jealousy may be felt.
• The child’s sense of security or stability is affected, especially if both natural parents are or are getting remarried. He/she may feel lost and uncertain as to where he/she will be in the household.
• The parent may spoil the child in order to compensate for having remarried, or may become unduly sharp or harsh when there is difficulty as a result of the situation.
• If the new spouse has children; living permanently with him/her or visiting temporarily.
• Disciplining the child (by parent or step parent) and extent of authority of step-parent and/or subservience/passivity of parent.
• The attitude of the previous spouse with regards to the step parent and handling holidays as well as finances and responsibilities.

What steps do you recommend to avoid problems?

• Careful consideration of all the possible problems that might arise.
• Consultation with a psychologist about the best approach with which to handle each of these possible problems.
• Involvement of all adults involved in the child’s life and clear outlining of each person’s responsibility. The role of the grandparents has to be clearly outlined.
• Be on the alert for signs of worry or anxiety such as enuresis, undue irritability or withdrawal.
• Making sure that the child will feel secure and part of a family, and have a firm attitude when he/she tests boundaries (which is something that will certainly be attempted).
• Have logical and age-appropriate consequences to actions.
• Have a clear system with responsibilities that the child can accomplish so as to ensure that the child can give as well as take, and that the child does not stop at being a recipient who is uninvolved and simply reacts whichever way he/she feels.
• The parent of the child is to be the ultimate decision taker and the step-parent’s role is to be clearly outlined from the start so that there is no conflict of authority and both have the child’s respect.
• Avoid over-talking or having very lengthy repetitive discussions with the child. It is very important that any questions asked by the child be answered (in an age-appropriate, objective and very clear and simple manner), but repetition or redundancy should be avoided.
• Any parent needs to think in advance of possible problematic issues, and be prepared with the alternatives or best approaches to face them when they occur.
• Immediately acknowledge any positive behavior/endeavor/achievement the child demonstrates without exaggeration.

How can a good relationship be built when merging families?

Understanding the child’s emotional, social, physical and developmental milestones is a must, and on this basis, know how to handle the child. For example, informing the child of the parents’ divorce, or possible remarriage of either or both parents when the child is an infant is totally different from when the child is below six or above six or is a teenager.

What should the two partners in the new marriage avoid doing?

• Exposing the child to unexpected and major upheavals without sufficient preparation.
• Taking the child’s permission or whims with too much seriousness or involvement.
• Being harsh is as bad as being apologetic.
• Not having a regular, predictable and age-appropriate routine including responsibilities and obligations.
• Expressing any worries/apprehensions/dissents in front of the child.
• Disciplining techniques should be immediate, clear and short. It is important to avoid lengthy or ridiculous forms of deprivation or punishment.

What should the children be encouraged to do?

• Be assigned and expected to fulfil age-appropriate tasks and responsibilities
• Have some form of diary/ten-minute discussion with the parent or other trustworthy adult, in which the child expresses his/her feelings (both positive and negative), innermost apprehensions and any other emotion or thought eliciting situations and ensure that the parent find a way to discuss these with the child.
• Verbalize his/her feelings rather than act out or internalize issues.
• Bear consequences to actions.

The choice of right second partner is very important. Choice is in terms of ensuring that this partner accepts the fact that there is a child or children involved, and that the mental and emotional well being of these children is of primary priority. At the same time, parents are entitled to having a private life and being happy.

The timing, choice of partner, and how to tell the child and how to handle the related issues all need to be carefully thought out before taking the final decision and informing the child.