Allergy can be divided into IgE (blood immunoglobulin E)-mediated, non-IgE-mediated and combined IgE-non-IgE-mediated types according to the different mechanisms of occurrence. (1) The IgE-mediated type has a rapid onset and develops within minutes to hours after encountering the allergen. The skin may show urticaria and angioneurotic edema; the respiratory system may show rhinitis, conjunctivitis, and asthma; the digestive system may show nausea, vomiting, and diarrhea. (2) The non-IgE-mediated type has a slow onset and develops 48 to 72 hours after encountering the allergen. The main manifestations of the digestive tract are similar to enteritis. (3) The combined IgE-non-IgE-mediated type sometimes has an acute onset, but in most cases it is slow and presents with atopic dermatitis (eczema) or gastrointestinal disease. Allergen testing, including skin prick testing and blood IgE (immunoglobulin E) testing, is usually mentioned for IgE-mediated allergies, so not all allergies can be identified by allergen testing. The speed and degree of disappearance of symptoms after the child’s reaction and avoidance after eating, touching or inhaling certain substances, as well as the speed and degree of reappearance of the same symptoms after eating, touching and inhaling again are the most accurate indicators for diagnosing allergies. 2. Three different stages of allergy: Allergy has three different stages of manifestation: skin and gastrointestinal tract, upper respiratory tract and lower respiratory tract. Allergy is the process of abnormal reaction of the body’s immune system to foreign substances, and it changes over time. Allergies manifest themselves in three different stages: skin and gastrointestinal tract, upper respiratory tract and lower respiratory tract. Allergies affect three major systems: skin, digestive system and respiratory system, with gastrointestinal and skin being the first to manifest. Vomiting (note that it is not milk spillage), diarrhea, constipation, especially alternating diarrhea and constipation, and severe abdominal colic after eating may be allergic manifestations. Allergies are commonly found in the skin. Acute allergy, i.e. IgE-mediated allergy, manifests as itchy skin, erythema, and local or generalized wind manifestations – acute urticaria. Acute angioneurotic edema of the lips, face and around the eyes is also an acute manifestation of allergy. Chronic skin allergy manifestations are mainly atopic dermatitis (eczema) in addition to pruritus and erythema. The purpose of knowing the acute and chronic manifestations is to find allergens from life as much as possible. After a long period of allergy, the respiratory tract can be attacked. The upper respiratory tract manifests itself like a “cold”, with recurrent runny nose, cough, enlarged tonsils, and enlarged adenoids. The upper respiratory symptoms of acute, IgE-mediated allergy include nasal itching, sneezing, runny or stuffy nose, and conjunctivitis; the lower respiratory symptoms include cough, chest tightness, wheezing, or shortness of breath. In the case of “recurrent” respiratory infections, it is important to distinguish whether they are immunocompromised or allergy-related. Do not use immune boosters without a conclusion, as allergies may worsen. Parents should not assume that allergies will automatically improve as the child grows up. Allergies will change over time and some conditions will become more difficult to treat as they develop. Parents can only prevent and treat allergies early if they understand the developmental changes and the seriousness of allergies. 3. How to find allergens? Never rely on allergen test results as the basis for choosing your child’s recipes. Many hospitals are now conducting allergy diagnosis, including skin prick tests and blood immunoglobulin E (IgE) tests. Although skin prick tests and blood immunoglobulin E (IgE) tests both test for IgE-mediated allergens and are routine tests, the testing mechanisms are different. The skin prick test involves the application of an allergen reagent to a pricked epidermis to observe the reaction. If you have taken anti-allergy medication before the test, it will definitely affect the test results. In contrast, the blood IgE test is a direct measurement and is not affected by medication. However, serum immunoglobulin E (IgE) can only be detected when it reaches a certain concentration in the body. Therefore, allergy symptoms often precede a positive IgE test result, so a positive IgE test may not always be available for infants and children within 1 year of age or with allergy symptoms shorter than 6 months of age. Both the skin prick test and the blood immunoglobulin E (IgE) test are for IgE-mediated acute allergies, and there are also non-IgE-mediated chronic allergies. A positive allergen test indicates that there must be an allergy, but a negative test does not indicate that there is no allergy either. Therefore, it is important to identify allergens by the tangible reactions of the child to food or the environment in life. When an allergy is suspected, the suspected food should be promptly removed or the environment should be kept away from the suspected environment. If the symptoms improve significantly, then consciously touch the suspected food or environment; if the allergic symptoms reappear, the allergy can be confirmed. If parents are unable to make an accurate judgment, they can consult a doctor. “Food avoidance + provocation” is the main method of allergy diagnosis, and blood tests and other means can only be used as an aid. Do not base your child’s recipe selection on allergen test results. 4. How to deal with allergens? For allergies, many times parents are not necessarily unaware of allergens, but do not know how to face and deal with them. Since the immune system of infants and young children is still in the process of development, if allergens are found earlier and avoided early, allergies will become weaker and weaker as the immune system of infants and young children gradually matures, and even be completely eradicated. Removing allergens means avoiding allergy-causing foods and allergy-causing environments, which should be done at home. For example, for mite and dust allergies, you should remove carpets, tapestries, stuffed toys and other items that may be attached to these allergens; when scrubbing floors and desktops, try to use water and avoid using vacuum cleaners; for cow’s milk protein allergies, in addition to very decisive replacement with deeply hydrolyzed or amino acid formula powder, you should not eat any food or supplements containing cow’s milk, and do not consider continuing the trial or switching to soy milk or goat milk. For egg allergy, stop eating eggs and do not consume any food containing eggs; for mold allergy, in addition to avoiding humid environments, remove edible bacteria and fermented foods, including fermented foods. The same principle applies to other allergies. Many parents think that interrupting allergens is a very difficult task, but in fact, with patience and allergen testing, it is possible to find allergens in life. Once an allergen is found, avoid it strictly for at least 6 months, and the situation will naturally improve significantly. 5. Allergic treatment for allergies? The most symptomatic treatment is the one that targets the cause of the disease. To treat allergies symptomatically, we often use drugs. Allergy is related to a special immunoglobulin E in the body, which stimulates the mast cell membrane of the body to break down and release a substance, histamine, which causes redness, swelling, itching and other allergic symptoms. The most common antihistamines nowadays are called keratan, benadryl, and centrum. As for the well-known paracetamol, it is now rarely given to infants and children. When allergy symptoms occur, because a special type of cells in the body called mast cells release histamine, causing redness, swelling, itching and other symptoms, with this antihistamine drug, histamine will be reduced and the redness, swelling and itching will be reduced. The destruction of mast cells produces histamine. Although the use of antihistamine drugs can counteract the symptoms caused by histamine, they cannot stop the production of histamine at the root. Therefore, if you want to eliminate the symptoms for a long time, you must use antihistamines for a long time, but this will inevitably produce side effects. Another type of medication that stabilizes the mast cell membrane is hormones. Hormones are particularly common in the treatment of allergies, such as hydrocortisone, paregoric pine, etc. Hormones stabilize the mast cells and reduce or avoid the release of histamine. Although these two classes of drugs – antihistamines and hormones – are very common in the treatment process, neither is the drug to treat the cause of allergies. If allergies are viewed as a chain from beginning to end, then medications are only the last link in the treatment and are neither the best nor the most complete. The most symptomatic treatment is the one that targets the cause of the disease. 6. Allergy treatment: Before we start to consider allergy treatment, we first need to consider the cause of the allergy. For example, if the child has milk protein allergy, then we need to choose a special hydrolyzed milk protein preparation. What do we mean by “special”? A complete milk protein, to which the infant will be allergic, can be divided into many small parts. In this way, the nutritional value of the milk protein is preserved, and the allergenicity is significantly reduced or disappeared due to the incomplete biological structure. This technique of making the milk protein structure smaller is called hydrolysis, and the hydrolyzed protein is called hydrolyzed protein. Depending on the degree of hydrolysis, hydrolyzed proteins are classified as partially hydrolyzed, deeply hydrolyzed, and amino acid formulations. Since the smallest structural component of protein is amino acid, infants and children who are allergic to milk can only choose amino acid formula or deeply hydrolyzed formula. Of course, allergies are not only a type of milk protein allergy, it has many other allergens. For example, if an infant has a mite allergy, we use desensitization therapy. Desensitization therapy is the gradual stimulation of the child with special preparations, according to a special protocol, so that he eventually becomes desensitized. Generally, at the beginning, the child is stimulated with a particularly small amount of antigen, and then slowly and gradually increases, finally reaching the point where he is able to adapt himself to the large dose of antigen, i.e., he is not allergic to the thing anymore, i.e., he is tolerant. Since this is a special preparation, a preparation specially processed by medicine to give him desensitization therapy, this kind of desensitization therapy takes a little longer, usually in two to three years to do. Not a few injections can solve the problem, so if the child has desensitization indications, he needs to be given continuous use. 7. Probiotic therapy for allergies: Nowadays, more and more studies confirm that probiotic preparations can treat allergies. Therefore, while treating allergies, in addition to applying medications, hydrolyzed formula or desensitization therapy should be used along with probiotics. In addition to symptomatic treatment and allopathic treatment, there is a particularly common treatment for allergies – probiotic therapy. In fact, allergies mainly start with food allergies. Food allergy is the result of food being eaten in the stomach and absorbed without being digested well by the gastrointestinal tract, causing the body to be irritated by food components that have not been fully digested. Absorption without good digestion is due to a less healthy intestinal flora. Less healthy intestinal flora can cause food to be absorbed in a state that is not fully digested. Since the involvement of intestinal bacteria is required in the digestion and absorption of food, bacteria are said to be a particularly important part of digestion and absorption. If the intestinal bacteria are not well established, the food will not be digested well and absorbed, which will naturally cause allergic reactions in the body. Probiotic therapy is the gradual restoration of healthy intestinal flora, which can promote intestinal maturation by stimulating immune cells such as dendritic cells and antigen-presenting cells among intestinal cells, and at the same time stimulate the maturation of the whole body immune system. This process resists exactly the pathways that lead to the appearance of allergies. All bacteria in our gut are foreign, entering the digestive tract through the medium of food, contacts, etc. None of the gut bacteria are produced intrinsically, so parents do not have to worry that taking probiotics will cause the intrinsic bacteria in the gut to be damaged. In fact, taking probiotics removes unhealthy bacteria from the intestinal tract and preserves healthy bacteria. This allows for a healthier gut and better digestion and absorption of food to avoid allergies, which is a particularly important way to treat allergies from the root. Why do children have unhealthy intestinal flora? It has to do with two factors: first, the home is too clean. Too clean, less bacteria in the contacts, less bacteria in the food, resulting in less opportunity for the child to eat the bacteria. Second, disinfectants are used too often, leading to an increased chance of eating them. I want to tell you that we don’t need disinfectants at home because we don’t need to be sterile at home, we just need to be clean. Clean is the method and state of scrubbing by water to keep clean. The misuse of disinfectants, together with the misuse of antibiotics, can destroy the normal flora of the intestinal tract and lead to an unhealthy intestinal tract. More and more studies are now confirming that probiotic preparations are available to treat allergies. So while treating allergies, in addition to applying medication, hydrolyzed formula or desensitization therapy should be used, along with probiotics. 8.How to prevent pediatric allergy? Prevention of infant allergy should be prepared from the mother-to-be during her pregnancy. The health and nutritional status of the mother-to-be and the early sucking of the child at the mother’s breast for the first breastfeeding after birth are the keys to prevent allergy. During pregnancy, attention should be paid to nutrition, especially to the intestinal and immune status. If food allergy occurs before or during pregnancy, avoid allergic foods as much as possible; if infection occurs during pregnancy, use antibiotics wisely; if intestinal discomfort occurs, use active probiotics. Some studies have shown that probiotics taken in the last 3 months of pregnancy can prevent infant allergies thereafter. In addition, studies have shown that more and more allergy sufferers are inseparably related to their lifestyle habits. Premature addition of powdered formula, frequent use of antibiotics, and over-reliance on disinfectants are all triggers for allergies. Infant allergies start with food, mainly milk and eggs. The early addition of milk after birth, the over-reliance on egg yolks, and the increasingly “sterile” environment are all factors that contribute to the growing number of allergies. While treating allergies is important, preventing them is the top priority. It is important to suckle at the breast as soon as possible after birth to help and promote the establishment of intestinal flora; to remove disinfectants from your life; to insist on exclusive breastfeeding; to use antibiotics as little as possible; and to get vaccinations on time. Allergy is an overreaction of the body’s immune system to natural harmless substances. There is no panacea that can cure allergy quickly, so only avoid allergens as much as possible, while taking active probiotics to correct the immune system, and insist on at least 3 to 6 months to see the first results. 9. What is a food allergy? Food allergy is an abnormal reaction of the body’s immune system after repeated exposure to a certain food. Not all foods entering the body will cause an abnormal reaction, but only infants with immature immune systems or after the immune system has been damaged (such as repeated use of antibiotics, etc.) may develop allergies. The first and most common manifestation of food allergy is digestive symptoms. Rapid onset of angioneurotic edema of the lips, tongue and palate, manifesting as marked oral pruritus or nausea, acute cramp-like abdominal pain, vomiting and diarrhea after ingestion of a food should be considered as food allergy. These manifestations are IgE-mediated allergy, or acute allergy. In such cases, it is important to stop the suspected food and take anti-allergy medication. Food-induced allergies often manifest as chronic symptoms, such as gastroesophageal reflux that does not respond to treatment, dilute watery stools with increased frequency of bowel movements, blood and/or mucus in stools, frequent unexplained abdominal pain, infantile colic that does not respond to treatment, refusal to eat or anorexia, persistent constipation, perianal redness and swelling, pale skin and frequent fatigue. When you encounter these conditions, consult your doctor and consider whether they are related to food allergies. Food allergies should be considered if a child is found to have slow growth with eczema and at least one gastrointestinal symptom, including gastroesophageal reflux disease, loose watery stools with increased frequency of bowel movements, blood and/or mucus in the stool, abdominal pain, colic in infants, refusal or anorexia of food, constipation, and perianal redness. Parents should consult an experienced pediatrician if they are unable to make a definitive diagnosis.