| Excite Host: |
Hello chatters, thanks for coming! We'll
get started in a few minutes. Welcome to Excite Canada's
Allergy Awareness chat with Dr. Paul. Excite Canada is pleased
to have pediatrician, Dr Paul Roumeliotis, with us today
to take questions on children's allergies and asthma. Dr.
Paul is a firm believer in patient education and is the
founder and former director of the Montreal Children's Hospital
Asthma and Pediatric Consultation Centres. It's great to
have you with us today Dr Paul! |
| Dr. Paul: |
Thank you very much.
I'm glad to be here for my first chat. |
| Excite Host: |
Let's start out with a basic definition.
What is an allergy? |
| Dr. Paul: |
An allergy develops when
a person's body has a bad reaction to a particular substance
or product that's normally harmless, such as pollen or a
food such as milk. The substance that causes the allergic
reaction is called an allergen. Allergens can enter the
body when they're eaten, touched, inhaled or breathed in.
When the body perceives the allergen as something harmful,
it tries to protect itself by attacking the allergen. In
the process, the person experiences various symptoms that
can range from mild to severe. |
| Excite Host: |
Question from Host-Bradley: Is there any
way of telling the difference of a cold from allergies? |
| Dr. Paul: |
In general, colds last
maximum a week. Allergies tend to last for longer periods
of time, ranging from several weeks to months depending
on what is causing the allergy. One important feature of
allergies is that there is no fever. If a child has symptoms
and a fever, it is unlikely it is allergies. An example
of a child who has allergies may be the child who always
seems to have a cold. Again, duration of symptoms is important. |
| Excite Host: |
Anonymous Question: What is the youngest
age which you feel reliable allergy tests can be conducted
on children? One year? |
| Dr. Paul: |
That depends on what
you're testing. If you're testing food such as milk, it
can be done earlier than that. If you are testing respiratory
allergies, we generally feel they are most reliable after
the age of 4 or 5. |
| Excite Host: |
Anonymous Question: What is the latest
research on peanut allergies? How many people actually have
a peanut allergy? Is it true children can actually grow
out of them and if so, how does that happen? |
| Dr. Paul: |
Very pertinent question
as there have been a few studies recently that have shed
some light into those issues. First of all, it's hard to
pinpoint the percentage of people who are allergic to peanuts.
However, we have the sense that it is increasing. The latest
studies have actually made the outlook of peanut allergies
a bit brighter. It seems that, contrary to what we believe,
about 20% of people or children with peanut allergies will
outgrow their allergy. We do not completely understand why
some people outgrow an allergy and specifically a peanut
allergy. However, it is not the first circumstance in which
we see children outgrowing a specific or certain food allergy.
For example, most children with milk allergy do outgrow
it within the first few years of life. |
| Excite Host: |
Anonymous Question: My son will be two
next month. So far he has had bronchiolitis three times
each time requiring puffers and once prednisone. Is my son
now more prone to developing asthma? |
| Dr. Paul: |
I will answer you simply
by giving you the definition of asthma today. Asthma is
defined as a condition where a child has recurrent or repeated
episodes of cough and/or shortness of breath, and/or wheezing,
yet is otherwise normal, growing well and has no other underlying
lung problems. If you look at these symptoms, presuming
your child is well, it sounds as if your child fits the
definition. If there is a family history of asthma or allergies,
then my suspicion is even higher. Of course, the individual
specifics of your son's case should be assessed by your
son's doctor. |
| Excite Host: |
Anonymous Question: Dr. Paul, our son is
six years old. Does the extended use of inhalers pose any
danger and should they be used for occasional cough, he
seems to have in the morning, especially this time of year. |
| Dr. Paul: |
I'm very happy you asked
this question because people tend to oversimplify or overuse
the term inhalers. Inhalers are devices that help spray
medication into a child's lungs. Which medication in the
inhaler is the question. And there are two categories of
medications. One is the bronchodiolators such as Ventolin
or Brycanil and the other category are the anti-inflammatory
medications, which include steroid-based preparations such
as Flovent and Pulmicort, and the non-steroid preparations.
The bronchodialators are used to relieve immediate symptoms.
The bronchodialators are used only when needed. The anti-inflammatory
medications are considered to be preventative medications.
Therefore, are given on a regular basis, the duration of
which depends on the individual situation. |
| Excite Host: |
Anonymous Question: My 23-month-old has
had a cough for about 8 weeks - my Doctor says she thinks
that it is an asthmatic cough and would recommend I try
him on a puffer however, he is not wheezing. Any thoughts? |
| Dr. Paul: |
Excellent question because
it allows me to discuss the fact that five per cent of asthmatic
children will have cough as their one and only symptom.
If you remember my definition of asthma, it describes cough
and/or wheezing and/or shortness of breath as symptoms of
asthma. This form of asthma is called cough manifest asthma. |
| Excite Host: |
Question from luther_21: My son has terrible
allergies to pollen and certain grasses. Should I stay away
from hanging his bedding and clothes outside? He tested
for many of these. |
| Dr. Paul: |
The answer generally
is yes. If you hang bedding outside, the pollen will be
introduced into the home. However, it depends on which pollen
he is allergic to. For example, if he is only allergic to
ragweed, then you should be careful during ragweed season,
which usually occurs towards the end of the summer. On the
other hand, some people don't have dryers and they have
no choice but to hang clothes outside, I would recommend
to do it towards the end of the day as pollen counts in
the air are usually higher in the morning. |
| Excite Host: |
Anonymous Question: can home air purifiers
help reduce the incidence of bronchial problems? |
| Dr. Paul: |
Many children are allergic
to dust mites and molds at home. There are also pet allergies
and one of the most important irritants but not really an
allergy but still important to bronchial allergies is cigarette
smoke. While air purifiers may get rid of larger particles,
they tend not to be effective in removing dust mites and
other small particles such as cigarette smoke chemicals.
I think that although air purifiers have been promoted as
being "good for allergies" the main emphasis, especially
in dust mite sensitive people is to make sure we decrease
as much as possible, contact with dust mites that for the
most part are found in mattresses, carpets, pillows, and
stuffed toys, all of which are not affected by air purifiers. |
| Excite Host: |
Anonymous Question: What is your opinion
on Singulair for a 6-year-old girl? She is taking Ventolin
as needed and Flovent 50, 2 puffs twice a day. Her doctor
is watching her dosage. We are looking for options. |
| Dr. Paul: |
Singulair is a type of
anti-inflammatory medication. However, it is not a steroid.
Thanks to research, we have now been able to pinpoint very
specific areas of where asthma occurs within a child's airway.
Singulair, and another similiar medication called Accolate,
are a new category of anti-inflammatory medications called
anti-leukotrines. They also differ from the steroid medications
in that they are available in oral pill form. I believe
that although there are limited studies in children. Certainly
in the milder asthmatic situations we would like to decrease
Flovent (inhaled steroid) use, and these medications offer
a potentially practical alternative. Although Singulair
seems to be a new medication, it has been around for at
least four years, but only recently licensed for use in
young children. |
| Excite Host: |
Anonymous Question: I am curious to know
what age is safe to introduce peanut products to children |
| Dr. Paul: |
The answer is not clear.
The logic behind it is the younger a child is exposed to
a potentially allergy causing substance, the higher the
chances are that he or she will develop an allergy. Coupling
that with the presence of a family history of peanut allergy,
most experts recommend not giving these children who come
from peanut allergy prone family backgrounds for the first
four years of life. |
| Excite Host: |
Anonymous Question: My 5-year-old son has
a peanut/nut allergy. Recently he ate some soup with green
peas in it. He said his throat felt funny and then he vomited
a few minutes later. Could this become anaphylactic? |
| Dr. Paul: |
Yes, because what people
do not realize is that peanuts are not nuts. They are legumes,
part of the bean and pea family. So children who are allergic
to peanuts have a higher chance of developing an allergy
to related legumes such as peas. Your child should be evaluated
for this. |
| Excite Host: |
Anonymous Question: Why are there so many
more peanut allergies in children, and as a breastfeeding
mother should I avoid eating peanuts/peanut butter (my daughter
is two months)? |
| Dr. Paul: |
Very good question. I
believe that the same number of people are born with a tendency
to develop a peanut allergy as opposed to 20-30 years ago.
But today, we are being exposed to peanuts much more frequently.
People are more health conscious and therefore, are eating
more nuts, vegetables and fruits. We're also cooking with
peanut oil. And I do believe that because of the increase
of peanuts in a lot of what we're eating, children tend
to become more sensitized. A recent study has isolated peanut
protein passed through mothers in breast milk. Therefore,
the thinking is the younger a child who is prone is allergies
is exposed to peanuts, the higher the chance he or she will
develop it. From this study, the recommendation is that
if there is no family history of peanut allergy, there should
be no restriction in mother's diet with regard to peanuts.
However, if there is a family history of peanut allergy,
most experts now recommend that mothers do not eat peanuts
or peanut butter while they are breastfeeding. Again, this
is applicable only to children who are at high risk of developing
a peanut allergy, i.e. those with a family history. |
| Excite Host: |
Question from Host-Mel: Should allergy
medication be taken all through the spring/summer or only
on a day that you need it? Do you build a tolerance to it? |
| Dr. Paul: |
This depends on the individual
situation and on which medication we're talking about. In
mild forms, we take the over the counter medications only
as needed. In other situations where the symptoms persist,
these may be needed on a daily basis during the pollen season.
If this is the case, this should be discussed with your
doctor. The other forms of allergy medications are the nasal
sprays which contain corticosteriods, such as Flonase. These
medications are generally prescribed for at least a 4 to
6 week period. They're not given as needed. They're only
effective if used regularly for a certain period of time.
When we test a child for allergies, specifically pollens,
knowing which pollen they are allergic to will help us guide
the timing of when to begin and stop these medications.
I do not believe you can build a tolerance to any of these
medications. However, if despite taking these regularly
there is no improvement, this should be discussed with your
doctor. |
| Excite Host: |
Thanks Dr Paul for being with us today. |
| Dr. Paul: |
It was my pleasure. |
| Excite Host: |
Please look for our next Dr Paul chat on
www.excite.ca during the last week of May. Thanks to all
of you chatters for your excellent questions. We hope to
see you again soon! |
