Prof Hugo Van Bever Professor in Paediatrics, National University Singapore
“Do you know that in the past, many years ago, when I was young and handsome, they said that having a big head at birth increased your risk of allergy?”
Amused laughter greeted Prof Hugo Van Bever as he took the stage for a talk during the recent "Gut Microbiata Modulation: From Insights to Clinical Practice" session. Organised by the Obstetrical & Gynaecological Society (OGSM) and the Malaysian Paediatric Association (MPA), the session enabled Prof Hugo to share his insight into the latest approaches adopted by the medical community to address allergies in children, especially food allergy.
Prof Hugo, who is currently a Senior Consultant with the Division of Paediatric Allergy, Immunology & Rheumatology in the National University Singapore, pointed out that the rate of allergy among children has been rising over the last 30 years. While the cases of respiratory allergy (allergic rhinitis) has plateaued (although still high), the last 5 years saw a huge increase in the number of children with food allergy.
Just a little bit
Treatments of allergy can involve the exposure of allergens through carefully controlled doses to the allergic person, until the person’s body becomes accustomed to the exposure and their symptoms eventually get better over time. This process is called desensitisation, and we may apply a similar process to infants so we can reduce their risk of certain food allergies when they are older.
Food that makes little ones go, “Aargh!”
- According to Prof Hugo:
- The most common food allergy in infants and toddlers is egg allergy.
- In pre-schoolers, peanut allergy is the most common.
- Seafood allergy is the most common food allergy among older children.
Prof Hugo brought our attention to the Learning Early About Peanuts (LEAP) study in the UK, in which researchers found that infants who were given peanut-containing foods had as much as 80% lower risk of developing peanut allergy by the time they turned 5. This finding led the American Academy of Physicians (AAP) to recommend offering peanut food products (such as peanut butter) to children who are at risk of peanut allergy from a young age.
Prof Hugo speculated that, as we continue to conduct research into this area, it is possible that we would one day have nutritional guidelines to help parents minimise their children’s risk of allergies from an early age.
5 tips for parents
- Let the child play outdoors more. Most parents worry that their children would suffer allergic reactions when these children are let loose into the wilderness, but Prof Hugo stated that this is far from the case. Allergens such as house dust mites gather in greater concentration indoors, especially in the bedrooms, so the more time children spend in there, the greater is their exposure to allergens. “The bedroom is the zoo of the house dust mite,” Prof Hugo remarked. “Don’t let your child live in there!”
- Keep clean, but not too clean. Keeping the child’s environment totally sterile actually increases the risk of developing an allergy, Prof Hugo said, as the body never gets a chance to become desensitised to allergens. It may be fine to keep a pet, or to let the house get a little “messy” now and then.
- Breast is best. “Breast milk is a living milk,” Prof Hugo stated. No other milk in nature is as good as a mother’s milk. A mother’s milk is complete when it comes to nutrition, and, unlike any other milk, it contain antibodies from the mother to support an infant’s immune system.
- Keep good bacteria around. “Bacteria are our friends,” Prof Hugo declared, “so don’t kill our friends!” Our gut is the natural home for many types of helpful bacteria that support the immune system. Dosing a child with too many antibiotics at an early age, therefore, may kill these helpful bacteria before they have a chance to settle down in the gut. Prof Hugo recommended prebiotics as a means to help children who may need some extra help in maintaining a healthy population of useful bacteria in the gut.
- Use moisturiser. Research shows that children with eczema face a higher risk of developing food allergy. Moisturising the baby’s skin from birth can reduce this risk by as much as 50%, as the moisturiser can act as an extra barrier of protection. “Any moisturiser will do,” clarified Prof Hugo.