Adventures of an Allergist Mommy

We are learning more and more about how life in Mommy's womb affects our health later on in life. A recently published study in PLoS One has supported an association between maternal exposure to airborne byproducts of burning fuel (polycyclic aromatic hydrocarbons) and a parental report of asthma symptoms before age 5. Turns out that prenatal exposure to this type of air pollution is associated with an alteration of certain DNA sequences- which are, in turn, associated with higher odds of reported asthma symptoms. Although this study only shows an association, and does not confirm causality, it is very interesting. We already knew that air pollution is a key contributor to asthma exacerbations, but now we have evidence that traffic-related pollution may be contributing to the development of the disease itself. This may help explain why inner-city children have such high rates of asthma. In any case, we now have yet another reason to contact our state and federal representatives ...

Only an allergist would give her kid a stuffed dust mite to play with.

As a parent and pediatrician, I have considered acetaminophen (Tylenol) to be one of the medications I could pretty much always safely use for my children and patients. However, a new study published in the Annals of Allergy, Asthma & Immunology has raised some important concerns. 345 women were followed from early pregnancy through their child's first birthday. Associations between acetaminophen use during pregnancy and the development of wheezing during the first year of life were investigated. What was found is the following: Acetaminophen use during early pregnancy was unrelated to respiratory events during the first year of life. However, acetaminophen exposure during mid to late pregnancy was associated with nearly double the risk of wheezing (odds ratio 1.8) and slightly more than double the risk of wheezing that caused sleep disturbance (odds ratio 2.1) during the first year of life. Why might his be the case? Acetaminophen depletes an imprtant antioxidant (glutathi...

Son #2 did not sleep well last night- lots of whining and refusing to sleep anywhere but my lap... :( I initially couldn't figure out what the problem was, but it became clear when I switched on the light during a diaper change- little munchkin was covered in an itchy red bumpy rash ! He's had eczema and hives before, but it resolved completely with the elimination of strawberries from my diet almost 3 months ago (I'm still nursing, and he is allergic). This morning, after giving him a bath, lubing him up with hydrocortisone and petroleum jelly, and forcing some Zyrtec into his mouth, the detective work began. Hopefully, writing down my process here will help you understand how your allergist determines which exposures are most likely to be triggering allergic symptoms in you or your kids. Rash is generalized (on face and body)- so it could be either something ingested (food sensitivity) or something applied to the skin topically (lotion, detergent, etc...) Let's star...

Just returned from Son #2's 6 month check-up, where he received a couple of jabs to his chubby little thighs. (brave boy- hardly even cried!) I am often asked about the safety of vaccines by concerned parents who are frightened that they are putting their children at risk of adverse reactions by following the recommended immunization schedule. I fully understand the sentiment behind not wanting to take a risk (even if it is only a perceived risk) when the diseases we vaccinate against seem like ancient history. Let me put it plainly- the fact that these illnesses: polio, mumps, measles, diphtheria... seem like history is testament to the enormous public health success of immunizing children. Immunizations are the reason that we don't lose our precious children to horrible diseases like epiglottitis, meningitis, and measles at the alarming rates seen in previous generations. Let me use measles as an example, as the U.S. Court of Federal Claims recently delivered decisions on t...

According to a study recently published in Thorax , children born by caesarean section have a higher risk of asthma than those born by vaginal delivery, particularly children of allergic parents. The odds of having a diagnosis of asthma at 8 years of age was almost 1.8 times higher for children born by C-section than for children born by vaginal delivery. A proposed reason for this association is that babies who do not pass through the birth canal on their way into the world take longer to become colonized with the usual bacteria- or that, in essence, they are too clean. :) The bacteria are thought to keep the immune system geared in a non-allergic direction, and when you don't have the right balance of bacteria, your risk of allergic disease (like asthma) increases. This is the crux of the so-called "hygeine hypothesis", which seems to be garnering more and more support as the evidence accumulates. Guess who has two C-section babies? No asthma yet, but son #2 has w...