Join paediatric allergy specialist Dr Adam Fox for a childhood allergies webchat 12.30-1.30pm on Monday October 5th.

Hi,
My lo was diagnosed by pediatric dietician at 4m as being lactose intollerant. she has always been very low on the centile chart and used to scream at the very sight of her bottle. She was put on nutramigen and that seemed to help. We were told to re-introduce cows milk at 12m but when we did this she developed skin problems, further suggesting lactose intollerence. She is now 19m and are scared to try cows milk again. Is it likely she will never grow out of this?

hiya

I have an allergy to nuts and have had a severe reaction in the past.

My son is now 2 but has never been in contact with nuts. Should they be introduced to his diet?

He is well and eats a varied diet with no sign of allergies.

Thank you Anna

Babyexpert.com welcomes paediatric allergy specialist, Dr Adam Fox, who will be answering your questions from 12.30pm for one hour today...

Dear Mrs Blue,
This is always a worry when there is a family history to nuts. Fortunately, one doesn't pass down specific allergies eg to nuts, just the tendency to allergic problems eg asthma, eczema, food allergy or hayfever. Having a sibling with a nut allergy does make nut allergy more likely and thus we always recommend testing before introduction. With a history of peanut in a child this is not really necessary (although many parents feel better having this done first). One thing we do know now is that there is no benefit in delaying the introduction of nuts so you should just get on with it. If your child has a history of eczema, I would just make sdure you try peanut butter when other family members are around and you have access to a bottle of piriton. Rub in on their lips , wait a few minutes and if nothing has happened, let them eat it. If there is no history of eczema in your child (this is the major risk factor for nut allergy) I would just get on and let them have it
Adam

Thanks IMT. It sounds like you are describing a milk, not a lactose, intolerance. Milk intolerance is a bit of an old fashioned term for what we now know is a delayed allergy (as opposed to the immediate sort that cause hives, swelling and anaphylaxis) to milk. Allergy involves the immune system which reacts to proteins in the food. It is commonly confused with lactose intolerance (where the sugar is the problem and the immune system is not involved - this can be easily overcome by using lactose free milks). Fortunately, delayed milk allergies (most often treated with special milks like nutramigen) do have a good prognosis and most kids outgrow them in early childhood. Your specialist will guide you as to when to try reintroducing milk - maybe every 6 months or a year and may use a special patch test to guide this,
Adam

thank you very much Adam

Hi Dr Fox.
My two year old daughter has always had mild eczema which comes and goes and I wouldn't say is really severe enough for prescription drugs or creams, we have however been through a huge array of over the counter creams and body-washes. Are there any particular ones on the market that you can particularly recommend? Also as it comes and goes can it be related to either seasons or diet?

thanks eileenteo, it would be really difficult to tell without allergy tests but a food/rash diary may help. Allergies are very consistent - they will happen every time you have the [problem food. If you have a big portion o fsomething and nothing happens, an allergy is very unlikely. If your child has ecamea, lots of acidy foods eg tomato, citrus etc may cause redness but this is just due to the sensitive nature of eczema skin

thanks homey-uk
despite what the manufacturers may claim, there is no 'best' one for everybody. In my practice we offer parents a load of different small tester posts so they can see which one suits them best. I do have a favourite though - doublebase - which is gloopy enough to moisturize effectively,but doesn't feel too greasy. Remeber, moisturisers only help with the dry bits of skin, not the sore red bits which need an anti inflammatory such as a week steroid (or related creams).

homey -uk, most eczema is not related to food. The earlier it started and the more severe it is though, the more likely diet may be involved. If the eczema is mild and if there have been periods when it has been pretty clear (despite the suspected foods being eaten) it makes food allergy very unlikely. If you still have a suspicion, try keeping a food diary to see if there is a consistent relationship between a certain food and flare ups of the eczema. If so, it may be wrth a trial exclusion diet which will get to the bottom of t but you should only try this will help from either a doctor used to dealing in this area or a dietician

Can babies suffer from hay fever? My son in the summer was very bunged up and sneezed a lot during the day. He had no other -cold symptoms' as such. I thought it might have been my cat and was contemplating having my mum adopt him (the cat that is!) but now its got later in the year it seems to have cleared up and Archie hasn't had to move out, which is why I'm thinking hayfever. If this is the case what can I treat him with next year if it happens again - he'll be around 18 months by then.

Thanks, it's never got bad enough to be sores so maybe it's just dry skin rather than actual eczema. I'll also do the diary. Thanks for the advice

thanks little-el. allergies to pollens and other inhaled allergens eg cat, don't tend to develop until later in life so hayfever is very unusual in infants. If symptoms do return next spring/summer though, you should consider the possibility. One option would be allergy testing but this is often negative is kids this age (when testing for pollens) so it may be sensible just to try a small dose of antihistmaine which should help. Go for a long acting, non sedating one like cetirizine and not piriton.

Thanks for the reply. Does it make sense if it is a milk allergy rather than a lactose intollerence that my lo has no problems with yougurt and cheese e.t.c. just the milk? Hope that makes sense!

hi, my 6 month old son has been diagnosed with milk intolerance/ allergies and was put on wysoy by the gp at 4 and a half months and changed to a completely different baby and became very contented and happy. however he then developed an intolerance to that too (apparantly this is quite common in babies under 6 months) so they then put him on nutrimagen but this only made his vomiting and cramps worse, we finally saw a paedeatrician last week who said to keep him off dairy, but to continue with the wysoy as he's now a bit older that intolerance should wear off now??? not quite sure how that works but anyway, i was just wondering as there is no 'baby' soya yoghurts/ cheeses in the supermarkets and i don't know if it's ok to give him the 'adult' soya products as with normal dairy there are special childrens ones.. or are there brands of soya yogurt etc that i should avoid? just gebnerally wondering how to go about giving him dairy alternatives as we're well under way with weaning and not really sure what i can and can't feed him in the way of dairy alternatives. thanks

Is there a proper definition for 'dry' or 'wet' eczema. In my experience treating 'wet' bubbly eczema with moisturiser makes the eczema worse?

lmt -thanks. tolerating cheese etc can fit for both delayed milk allergy or lactose intolerance. Lactose intolerance does not give skin symptoms but bloating, tummy ache and diarrhoea. Nutramigen would be a very bizarre choice of formula if he thought this was LI. Delayed milk allergy can cause tummy symptoms and skin symptoms that would resolve with nutramigen. However, as he outgrows the allergy he may tolerate milk based products. However, if he is having lots, without any problem it may well be time to try plain milk agian - ask your doctor!

franticmum - eczema has two components - diffue dry skin (needs moisturisers) and the sore inflamed bits (need antiinflammatories). Wet and red eczema is v possibly infected and needs antibiotics and welll as careful steroid use. Moisturisers do nothing for this,

Thanks again for your advice.