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Minimizing The Risk of Childhood Food Allergies

Dr. Eric Viegas, ND

Ottawa Holistic Wellness Centre

www.medicineismusic.ca

food allergies child peanut

Q: As a parent of a young child, what steps can I take to reduce the risk of childhood food allergies?

A:

  • Fish Oil consumption during pregnancy may cut the risk of childhood allergies by 30% (1). Researchers in London compiled data from women consuming a daily fish oil capsule from the 20th week of pregnancy until the first 3-4 months of breastfeeding. The consumption of fish oil cut the risk of childhood egg allergy by 30% (1).

 

fish oil food allergies child

 

  • Probiotics: eczema risk was cut by 22% in a group of mothers consuming a daily probiotic supplement between 36-38 weeks of pregnancy and the first 3-6 months of breastfeeding (1). However, probiotic supplementation did not appear to reduce the risk of childhood dairy allergy (1).

 

soap baby food allergies bath

 

  • Hygiene: Avoid overuse of “baby wipes” and make sure that soap is completely washed off of your baby’s skin. A recent study using mice suggests that disruption of our skin’s top lipid (fat) layer by soaps and allergens can contribute to the development of food allergies in young children with altered genetic mutations in their skin (2). Mice with genetic mutations in their skin barrier that were exposed to common food allergens (eg. peanuts) to their skin over 2 weeks were then fed these allergens by mouth. The mice developed allergic reactions in the intestines, on the exposed skin sites, and suffered anaphylaxis. More research is needed in this area to further clarify how these mechanisms affect humans. Unfortunately, skin barrier mutations are not visible in children until later in life, so minimizing your child’s exposure to harsh chemicals and allergens that may disrupt their skin barrier is a factor in reducing the risk of developing childhood food allergies.

 

 

Always consult with your doctor before beginning any new supplement or medication. For more information on the prevention and treatment of childhood allergies, consult with your local naturopathic doctor and/or functional medicine practitioner.

 

References:

 

  1. Garcia-Larsen V, Ierodiakonou D, Jarrold K, Cunha S, Chivinge J, et al. (2018) Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis. PLOS Medicine 15(2): e1002507. https://doi.org/10.1371/journal.pmed.1002507.
  2. Matthew T. Walker, Jeremy E. Green, Ryan P. Ferrie, Ashley M. Queener, Mark H. Kaplan, Joan M. Cook-Mills. Mechanism for initiation of food allergy: dependence on skin barrier mutations and environmental allergen costimulation. Journal of Allergy and Clinical Immunology, 2018, ISSN 0091-6749, https://doi.org/10.1016/j.jaci.2018.02.003.

10 Common Childhood Rashes and What You Should Know About Them

Dr. Eric Viegas, ND

rash child ottawa naturopath

There are many different types of rashes that children and their parents will encounter throughout their lives.

The following is a list of common rashes, their causes and symptoms, a description of their appearance, and what you can do about them.

 

 

  • Contact Dermatitis

 

Many causes including certain foods, body products, latex, jewelry and poison ivy.

 

Most incidents of contact dermatitis are mild, start around 48 hours after skin exposure, and resolve when the specific substance is prevented from contacting the skin. A mild reaction will usually result in small red bumps, while a more serious reaction can result in swelling and blisters.

 

  • Measles

 

A red, but not itchy, viral rash that is located over most of the child’s body. Children will usually complain of common cold symptoms: fever, sneezing, irritated throat, coughing, swollen glands, red eyes, and loss of appetite. Although preventable with the MMR (measles, mumps, rubella) vaccine, those who choose to forego immunization are at a higher risk of infection. If you believe your child has been infected with measles, please seek medical care immediately.

 

 

  • Scarlet Fever

 

Most common in children ages 2-10 (but infection can occur at any age). A scarlet fever rash is coarse to the touch, and red. It typically presents on the torso first, then spreads to other areas of the body over the course of a couple of days.

 

Children will typically present with a high fever followed by the rash 24 hours later.

Other symptoms include sore throat, difficulty swallowing, and white or yellow spots at the back of the throat; all related to a strep throat infection. If you suspect that your child has scarlet fever, seek medical attention immediately.

 

 

  • Chickenpox

 

Caused by the varicella zoster virus, this is a contagious and very itchy rash that affects the whole body. It may appear as red spots and/or blisters (pox). Each chickenpox red spot has a life cycle of 1-2 days; blistering, bursting, drying out, and crusting. New spots will appear daily for up to one week. This infection will stay dormant in nerves, and may result in an outbreak of shingles later in life.

 

An easy way to combat the itchiness of chickenpox is an oatmeal bath:

  • Using a mesh bag or cheesecloth, add 1 cup of uncooked oats and tie off one end.
  • Secure the oatmeal bag under your tub’s faucet and run under warm water, periodically squeezing the bag as the tub fills.
  • Once the bath is full, you can remove the bag from the faucet, letting it float in the bathwater. Continue to periodically squeeze the bag into the water.
  • Submerge affected areas in the bath for 20 mins.
  • You can also add calendula and lavender flowers to help soothe irritated skin.

 

 

  • Roseola

 

Appears around 3 days after a high fever caused by the roseola virus. This infection is usually mild, starting with a sudden high fever for 2-3 days and developing into a pink rash appearing on the torso, neck and arms once the fever begins to drop. Some children may experience seizures due to the sudden intensity of the fever, and the rash will last 1-2 days. This rash typically affects children aged 6 months to 2 years. Seek medical care if you suspect your child has roseola.

 

 

  • Fifth Disease

 

A “slapped cheek” facial rash that also has a lacy appearance on the torso, arms, legs, and buttocks.

This rash will follow sudden flu-like symptoms (fever, fatigue, aches, etc.), and children are most contagious 7 days before the onset of the rash.

 

Once the rash has appeared, children are no longer contagious. Hot temperatures and sunlight exposure may cause the rash to wax and wane over several weeks.

 

While the infection is mild for children, developing fetuses are at an increased risk when exposed to fifth disease. If you are pregnant and develop some of the signs and symptoms of fifth disease, seek medical attention immediately.

 

 

  • Heat Rash

 

Can happen to any baby exposed to hot weather or dressed too warmly. The rash looks like red or pink dots on the child’s head, neck, and/or shoulders.

Make sure your child is dressed lightly on hot days, covering their head and limbs, and do your best to avoid prolonged sun exposure.

 

 

  • Cradle Cap

 

Oily, yellow, scaly and/or crusting rash on a baby’s scalp. This rash is common and treatable, and its presence certainly does not mean parents are not caring for their baby.

Home treatment for cradle cap:

  • An hour before shampooing, rub your baby’s scalp with baby oil, or vaseline to help lift and loosen the crusts/ scales.
  • Wet your baby’s scalp then gently scrub the scalp with a soft-bristle brush (eg. a soft toothbrush or a fine-toothed comb) for a few minutes to remove the scales.
  • Wash the scalp with baby shampoo, rinse well, and gently towel dry.

 

 

  • Lyme Disease

 

Can be caused by bacteria that are carried by ticks. A Bullseye red rash at the site of the bite will expand, followed by flu-like symptoms, joint pain, and neurological problems.

 

In the case of lyme disease, see a doctor immediately.

 

 

  • Diaper Rash

 

Can be caused by urine/stool bacteria, moisture, heat, friction, or chemicals in a baby’s diaper. The rash has a red (may also appear burned/scalded) appearance, and affects the thighs, buttocks, genitals, or abdomen.

Sometimes, a yeast infection may be responsible for the rash, so always check with your doctor before using any medicated ointments for your child.

 

As with any skin issue, it is best to see your doctor when a rash presents so that you can get an accurate diagnosis and timely treatment. Some rashes require immediate antibiotics, while others tend to resolve on their own. I hope this quick guide to rashes will help ease the stress around skin issues for you and your children.

Eczema FAQs & How Naturopathic Medicine can help

eczema dr eric viegas

Dr. Eric Viegas, ND

 

Why do I have Eczema?

  • Partly due to genetics, immune dysregulation causing allergic inflammation, and environmental factors.
  • If you have a family history of eczema you are more likely to develop it. Environmental factors like bacterial (staphylococcus aureus) colonization of damaged skin, and chronic phthalate exposure (found in textiles, food products, and plastics) contribute to inflammation and immune dysregulation.
  • There is some evidence that the presence of helicobacter pylori, a bacteria commonly known for causing stomach ulcers, can also contribute to immune dysregulation and inflammation of the skin barrier.
  • Food triggers are also an important contributor to eczema. Increased intestinal permeability contributes to allergen sensitization, so chances are good that your digestive system needs some help. A naturopathic doctor can work with you to establish which foods may be contributing to your eczema.
  • If you have endocrine problems like thyroid disease it is best to take your medication and be well managed, as worsening hypothyroidism may also worsen the severity of your eczema.

 

What is the best treatment for Eczema?

  • A combination of dietary management, skin care, and stress management will help to control the chronic symptoms of eczema and address the underlying causes.

 

Can diet affect Eczema?

  • Eggs, wheat, dairy, soy, peanuts, tomatoes, and artificial colours & preservatives have been implicated as triggers in a large percentage of eczema cases. Elimination of these offending foods has been shown to restore normal intestinal function and reduce the progression of new food allergies. Avoidance of these foods may be continued for up to one year to achieve the best results.
  • There is also a growing body of evidence to support histamine intolerance in the development and severity of eczema. In histamine intolerance, ingestion of histamine-rich foods (think red wine, aged cheeses, cured meats) overwhelms your gut’s ability to breakdown this inflammatory molecule. Overtime, more systemic signs of histamine intolerance (rashes, heart palpitations, irritable bowel syndrome, and allergies) develop.
  • Eating more fatty fish (eg. salmon, herring) in pregnancy, lactation, infancy and childhood has shown protective effects against eczema in epidemiologic studies.

 

What lifestyle behaviours can help with my eczema?

  • First, stop scratching. Scratching will break the skin barrier and allow for bacterial colonization.
  • In terms of keeping clean, baths are more beneficial than showers as long as you remember to “soak and smear”; bathe, pat yourself dry, and then apply a very generous amount of moisturizer to the skin. For added benefit, soak oatmeal in a clean cloth bag in your bath to soothe your skin.
  • People suffering from the itchiness of eczema tend to have more anxiety, and feel more stressed out. Finding an outlet for your stress and keeping your anxiety at a manageable level will help to benefit your outlook and the severity of your eczema. A naturopathic doctor has many tools to address high stress and anxiety.

 

What are natural topical remedies for Eczema?

  • Seabuckthorn oil, castor oil, olive oil, coconut oil, calendula oil, chickweed cream, and moisturizers containing beeswax can all help to moisturize the skin and maintain its barrier. It is also important to use a mild pH-neutral soap free of any perfumes or fragrances to avoid any unwanted skin irritation.

 

What Supplements are good for Eczema?

  • Daily fish oil supplementation and use of the probiotic strains lactobacillus acidophilus and bifidobacterium bifidum are two supplements with good evidence for use in eczema.
  • However, you should always consult your doctor before starting any new medication or supplement. A naturopathic doctor will take a thorough health history to determine any other health concerns that should be addressed along with your skin health and come up with a comprehensive treatment plan. It is not uncommon for people with eczema to also experience digestive issues, allergic rhinitis (seasonal allergies), and asthma.

 

References:

 

Kido M., Tanaka J., Aoki N., et al: Helicobacter pylori promotes the production of thymic stromal lymphopoietin by gastric epithelial cells and induces dendritic cell-mediated inflammatory Th2 responses. Infect Immun 2010 Jan; 78: pp. 108-114

 

Elias P.M., and Schmuth M.: Abnormal skin barrier in the etiopathogenesis of atopic dermatitis. Curr Opin Allergy Clin Immunol 2009 Oct; 9: pp. 437-446

 

de Maat-Bleeker F., and Bruijnzeel-Koomen C.: Food allergy in adults with atopic dermatitis. Monogr Allergy 1996; 32: pp. 157-163

 

Agata H., Kondo N., Fukutomi O., et al: Effect of elimination on food-specific IgE antibodies and lymphocyte proliferative responses to food antigens in atopic dermatitis patients exhibiting sensitivity to food allergens. J Allergy Clin Immunol 1993; 91: pp. 668-679

 

Kremmyda L.S., Vlachava M., Noakes P.S., et al: Atopy risk in infants and children in relation to early exposure to fish, oily fish, or long-chain omega-3 fatty acids: a systematic review. Clin Rev Allergy Immunol 2011 Aug; 41: pp. 36-66

 

Barnes B.: Thyroid therapy in dermatology. Cutis 1971; 8: pp. 581-583

 

Maintz, L., et al. “Evidence for a reduced histamine degradation capacity in a subgroup of patients with atopic eczema.” The Journal of Allergy and Clinical Immunology. Vol. 117, No. 5 (2006): 1106–1112.

 

Worm, M., et al. “Exogenous histamine aggravates eczema in a subgroup of patients with atopic dermatitis.” Acta Dermato-Venereologica. Vol. 89, No. 1 (2009): 52–56.

 

Gesundheit! Seasonal Allergies and Asthma: Histamine Part 2

Allergies Asthma Dr. Eric Viegas Naturopathic Medicine Ottawa

Gesundheit! Seasonal Allergies and Asthma: Histamine Part 2

 

Dr. Eric Viegas, ND

 

With spring (hopefully) around the corner, warmer weather is a cause for celebration. However, for the 20-25% of Canadians suffering from seasonal allergic rhinoconjunctivitis (aka seasonal allergies) the thought of going outside in the spring, summer, and fall months causes significant stress. Sniffling, sneezing, itchy watery eyes, and rashes are all common symptoms of seasonal allergies. In order to feel better, allergy sufferers typically reach for diphenhydramine (aka Benadryl) and other over the counter antihistamines like Claritin, Aerius, Allegra, etc. Benadryl acts on H1 (histamine) receptors and can reduce sneezing, itchy eyes, and itchy runny nose(1). While antihistamines directly blunt the effects of histamine in the body, they do not stop mast cells from releasing histamine (1). Thus, both Benadryl and the newer class of antihistamines have little effect on nasal congestion, and cause significant drowsiness(1). Antihistamines can be effective in the short term, but it is possible to build a tolerance to them, which is why many doctors recommend that patients cycle between different brands. Another option for allergy sufferers is to get “allergy shots”; subcutaneous injections of allergens in increasing amounts over a period of months to years. These shots are given to discourage the immune system from activating mast cells, and an ensuing allergic response, by producing different antibodies.

 

So, what can be done if you either do not want to take antihistamine medications and “allergy shots”, or find that these therapies do little to quell your sniffles?

To understand what your body needs to deter an allergic response, first you need to take a look at the cascade of reactions that cause it. When an allergen is inhaled, your body relies on IgE antibodies to capture them and signal mast cells or basophils to release histamine and other inflammatory intermediates. These other inflammatory intermediates include free radicals and are therefore susceptible to being quenched by antioxidants. A “mediterranean” diet rich in fruits, vegetables, lean meats (fish, chicken), nuts, seeds, and low in refined carbohydrates, has been associated with lower rates of childhood asthma and allergy (2,4). In a 2005 study, Mao et al. demonstrated that daily consumption of a spirulina supplement reduced inflammatory intermediates in allergic rhinitis patients by as much as 32% (3). Quercetin is an antioxidant found in onions, broccoli, asparagus, green peppers, tomatoes, red leaf lettuce, black & oolong teas, grapes, apples, berries, and wine (5). Known for scavenging free radicals during an allergic reaction, quercetin also: promotes a healthy immune response, has antiviral activity, and stops histamine release from mast cells (5). In 2004, a 21 day study conducted by Takano et al. established that the use of rosemary extract in patients with mild seasonal allergies improved symptoms of itchy nose, and itchy watery eyes(6).

 

In my last blog post about Histamine Intolerance (HIT), I discussed some of the health consequences and what you can do to help your body with an increased histamine burden. Histamine release is increased by your body when you are dehydrated, hypoglycemic, and stressed. So to properly manage your response to seasonal allergens this spring, make sure to stay hydrated. If you rely on sugary snacks and coffee to get you through your day, then you may notice blood sugar crashes make you groggy. Blood sugar crashes can worsen your response to histamine release, so pair your snacks and meals with a handful of nuts, some avocado, or a serving of protein to promote stable blood sugar. Finally, if you are having trouble managing the stressful factors in your life, consider seeing a Naturopathic Doctor. NDs have an excellent knack for stress management and can get you back on the right track. Gesundheit.

 

References:

 

  1. Guilliams TG. “Allergies: the natural approach.” The Standard. May 1998; 1(2): 1-8.
  2. Ulugbek Nurmatov, Graham Devereux, Aziz Sheikh. “Nutrients and foods for the primary prevention of asthma and allergy: systematic review and meta-analysis”. Journal of Allergy and Clinical Immunology. March 2011; 127(3): 724-733.
  3. T.K. Mao, J. Van de Water, and M.E. Gershwin. “Effects of a spirulina based dietary supplement on cytokine production from allergic rhinitis patients.” Journal of Medicinal Food. April 2005; 8(1): 27-30.
  4. Chatzi L, Apostolaki G, Bibakis I, et al. “Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete.” Thorax 2007; 62:677-683.
  5. Mlcek J, Jurikova T, Skrovankova S, Sochor J. “Quercetin and its anti-allergic immune response.” Molecules 2016; 21(5): 623-638.
  6. Takano H, Osakabe N, Sanbongi C, Yanagisawa R, Inoue K, Yasuda A, Natsume M, Baba S, Ichiishi E, Yoshikawa T. “Extract of perilla frutescens enriched for rosmarinic acid, a polyphenolic phytochemical, inhibits seasonal allergic rhinoconjunctivitis in humans.” Society for experimental biology and medicine. March 2004; 229(3).

 

Histamine Intolerance: More Than Just Seasonal Allergies

histamine intolerance Dr. Eric Viegas Naturopathic medicine Ottawa

Histamine Intolerance: More Than Just Seasonal Allergies

Dr. Eric Viegas, ND

 

Histamine is an important inflammatory molecule used by your immune system. Seasonal allergies and asthma are both affected by histamine release in your body, but did you know that gut issues and pain are also affected? In a healthy gut, histamine is produced in large amounts, but your gut cells also do a great job of producing diamine oxidase (DAO) to breakdown histamine. If your gut is inflamed from a chronic digestive issue, your gut cells–called enterocytes–have a limited ability to produce DAO. When the production of histamine outpaces your body’s ability to break it down, histamine can spread from the gut to other parts of your body. Flushing, headaches, rashes, diarrhea and abdominal pain can all result from an imbalance in the breakdown of histamine; this is called histamine intolerance (HIT). HIT has been implicated in anxiety, depression, chronic pain, estrogen dominance, interstitial cystitis, urinary tract infections, IBS, and IBD. Certain medications can also affect HIT.

Children with a history of chronic abdominal pain may benefit from a diet low in the amino acid histidine, and foods that free histamine in your body. Histidine is converted to histamine through a series of steps in your gut. Aged cheeses, red wine, yeast products, and cured meats have all been identified as ‘histamine-rich’ foods; those that can add more histamine to your system. Citrus fruits, while not histamine-rich, have been implicated as a histamine liberator. If DAO is not being produced in sufficient quantities, both histamine-rich foods and histamine liberators can worsen HIT.

Your doctor may be able to test for blood levels of DAO, but unfortunately low DAO blood levels are not always a reliable way to predict HIT. If avoidance of histamine-rich foods improves your symptoms, chances are good that HIT is the culprit. Working with your doctor to strengthen your digestion, immunity, and response to stressors is what will ultimately provide meaningful change in HIT.