Allergies: An interview with Pediatrician Tina Feeley

By Adem Lewis / in , , , , , , /

Today’s topic that we’re
talking to Dr. Tina Feeley about is allergies and intolerances. So can you tell us what the difference is between an allergy and an intolerance. Tina: Absolutely. It’s a great question. So an allergy is something
that is going to cause issues in your body that can
be potentially life-threatening but also harmful to your body, in general, especially over a long period of time. So there is different types of allergies, they’re the food allergies you think of, where you need your
EpiPen, where it causes the hives, and the wheezing,
and the vomiting, diarrhea, and just a lot of almost instant reaction within like a half hour to
an hour of eating that food. And then there’s other allergies like celiac disease or milk protein allergy that can cause your body
to have bloody poop, and to not be able to digest
food well and things like that. So they are things that
cause you to have ultimate harm to yourself. An intolerance is something
that makes you feel kind of lousy, but it
doesn’t actually cause any damaging effects to you in
general, beside the fact that you feel kind of
lousy but it won’t cause ultimate harm or potentially
kill you or things like that. So those are kind of the
major differences just from how we separate them in terms
of how we think and then the ultimate difference
comes down to biology, which we don’t need to get into right now. But it comes down to the
actual reactions that are happening within your
body when you’re exposed to the foods, as well. Amanda: Right. And so what are the most common
allergies and intolerances that you see in children and babies? Tina: Yes, so it really
depends on the age. So by and large, in the newborn
period until a baby eats solid foods, the number
one allergy is usually milk protein allergy. So milk protein allergy
is something, that, the baby actually has
an allergy to the milk, but it’s not an allergy that
you think of with getting hives and trouble breathing
and things like that. It actually affects your gut,
and the major symptom with it that we use to diagnose
is having bloody stool. So having bloody poop,
but also they’re generally vomiting, refusing bottles,
very fussy, uncomfortable, but the major hallmark is the bloody poop. With that also sometimes
babies that have milk protein allergy also have a soy
allergy because the soy protein and milk proteins are very
similar to each other, so they can kind of mimic
each other, so some parents will switch from a milk
formula to a soy formula and not see any difference,
and that’s the reason ’cause they could kind of be
similar allergies in that. Once the baby gets older, when
they’re starting solid food, then we think also, they could
still have the milk protein allergy, but we could
also think of allergies, the typical allergies you
think of that cause the wheezing, and the hives,
and things like that. Those allergens are
typically peanuts, tree nuts, so tree nuts are things like
almonds, pecans and like that, shellfish, finfish, dairy,
eggs, wheat and soy. And then in terms of
intolerances, the two that I think we talk about most common
are lactose intolerance. That is actually, it’s
different than the milk protein allergy, lactose intolerance
means that you have trouble breaking down the sugar
in the milk itself, and that we generally don’t see in babies. That’s usually more toddlers and above. Usually not, you don’t see it
before the age of 2 typically. And then also, there’s right
now a lot of talk about gluten intolerance, as well. Again not something we
typically see with babies but it’s usually older children. Amanda: Right. How do you know if a baby has
an allergy or an intolerance? What are some of the signs
that you would typically see? Tina: So this is
definitely something where, especially when it comes to
like milk protein allergy, or if you’re concerned
that you’re child is having issue with dairy or milk
protein, I would say go to your pediatrician,
or go to your doctor right away and talk about it
because it can actually be, especially in the newborns
and younger infants, it can be kind of tricky
to hash out what is an allergy versus what is an intolerance. Part of that is because a good
amount of babies with reflux will actually respond to a milk-free diet. So it’s not that they are
actually having a milk protein allergy, it might be the milk protein, more like intolerance, but
it’s making the reflux worse, so although it’s not having
those harmful effects of like what we’re talking
about before, like a true allergy where it can cause
you to have ultimate harm in your body, and baby not gain
weight and things like that, it can make them fussy and
irritable and make the reflux worse, so sometimes we’ll
actually recommend a milk-free formula or a
milk-free, or mom to go on a dairy-free diet if she’s nursing. For the reflux, that’s not
actually a milk protein allergy. So in terms of, that’s
why I say definitely, if you’re concerned about it,
definitely go to your doctor so that we can kind of
discuss your specific baby and their specific
symptoms because it can be a little bit of an
overlap in that age group. But the hallmark, again,
of a milk protein allergy would definitely be if they
are vomiting after each feed, and vomiting, I mean like very profusely, not just spit up and moving around. I mean, you know, forceful vomiting. If they’re having any bloody stool but those are definitely hallmarks
of a milk protein allergy but sometimes there’s a little
bit of interaction between the two, it definitely takes
a little more discussion with you and your doctor
to hash out what’s what. Amanda: And this is something
that I see commonly around some of my own friends, is that
other mothers have suggested going off milk or changing the baby from cow’s milk formula, is this something, this is something that should really only be
recommended by a pediatrician or a doctor rather than
just hear from friends? Tina: Absolutely, absolutely. I can’t emphasize that enough. If you’re going to make any
changes to your baby’s diet, then I would definitely
recommend talking to your doctor, talk to your
pediatrician, talk to your GP about it prior to making that change, because A, especially, so with
my own daughter had reflux that was responsive to a milk-free diet, and I can tell you as a
nursing mom, a dairy-free diet is not easy to do So before you put yourself
through that, you might wanna also make sure that that’s
something that would be helpful, but also any time you make a
change to your baby’s diet, it’s going to ultimately
change what they’ll take in the future, when you’re gonna
introduce different solids to them, and I would definitely
recommend talking to your doctor before making any dietary changes because it can be really
eye-opening depending, again there’s a lot of overlap
between things and what works for one baby might not
work for another, so depending on the specifics
of the situation. Amanda: I couldn’t agree more, definitely. And so can allergies or
intolerances ever be confused with anything else? Tina: Definitely. So a lot of times, especially
around the six week mark, parents will come and talk
about their baby being really fussy, and so allergies and
intolerances can definitely be confused with reflux, but
around the six week mark, it also could just be colic,
which generally around the four to six week time,
baby end up stooling less, so parents will think
that they’re constipated, even though a lot of times,
the stooling patterns can be completely normal for
a four to six week old. Also colicky babies, we don’t
really know what causes colic, but sometimes parents will come and say, “It must be the milk.” And they’ve come in at six
weeks and they’ve tried eight different formulas
and nothing’s making any difference, and they’ve tried
each one for a couple days here or there, and it’s
not making a difference and it turns out that it’s
actually because of colic, which is frustrating, because
there’s not much you can do for it, but at least it’s
reassuring that you don’t have to take something out of their
diet and things like that. There are definitely overlap
between multiple diagnoses especially in the younger
babies, and again just a fussy infant, in general, can often be attributed to multiple
different things, but oftentimes it gets attributed to
problems with the formula, problems with the milk, problems
with reflux or constipation and it may not be any of them. Amanda: It may be that they
need more sleep, for example. I know a lot of babies
get diagnosed with colic when it’s actually just that they have only had three 20-minute
sleeps throughout the day, that they just need to sleep. They’re fussy because they need to sleep Tina: Absolutely, absolutely. Amanda: Yeah, definitely. Okay, well thank you so much
for chatting about allergies and intolerances, it’s
been really informative. Thank you very much, Tina. Tina: Thank you.

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