Webchat with consultant paediatric allergist Dr Adam Fox, Tues 18 Nov, 12.45pm

[GeraldineMumsnet]

We're delighted that top children's allergist Dr Adam Fox has agreed to come on to Mumsnet to answer queries about all things allergic. Please post any advance questions here, particularly if you're not able to make it on the day.

[DrAdamFox]

vvq - most common is enzyme deficiency eg lactose intol due to losing the enzyme to break down lactsoe (as most people do)

[ukrainianmum]

Dear Dr Fox

My daughter has been caughing for like over two months now. And recently she developed this stange habbit like clearing up the throat. Not cough itself but this very particualr sound that she is irritated in her throat. Her lungs,throat, everything is clear,blood and urine tests all good.

Could it be the sign of any allergy?

thank you
P.S. we live in Ukraine.

[DrAdamFox]

Dear athomeagain - i would really recommend you ask for a referral to an allergy clinic as i am a bit worried about the advice you have been given. Food allergy should not have this sort of impact on your life. We simply do not see nasty reactions to casual contact, only really through eating the allergen. A nice american study shown only 30% of patients with severe peanut allergy reacted even to patch or peanut butter stuck to their skin and even then only had mild skin reactions. Please also ask to see a paediatric dietician (should be avaialble in the allergy clinic)

[VeniVidiVickiQV]

So it's purely a digestive thing then? Right! That makes more sense.

[MmeLindt]

Thankyou for your answer, Dr Fox. We will have her tested as soon as possible.

[DrAdamFox]

dear ukranian mum - has somebody ooked up the nose! this is the most likely place to be causing problems - an allergic rhinitis wouldgive these symptoms.

[VeniVidiVickiQV]

Oh, and lastly, how would we arrange to get a referral for DD to see you?

[DrAdamFox]

Dear Tatt - i have never heard peadiatricians arguing against the need for allergists (although may be they stop saying it when I am around). I would argue that the best people to manage children's allergies are paediatric allergists (but i would, wouldn't i).
GP training in allergies is getting better all the time, thankfully.

[DrAdamFox]

Dear silverfrog - Sorry to hear about the difficulties you?re having. Most families of kids with autism get a pretty crappy deal from the health services. Regarding your eldest, there are (as I suspect you know) no decent tests for these sorts of intolerances so your only option is an exclusion diet followed by reintroduction to see what effect is has. As your daughter is already on multiple exclusions you have to be really careful here as you could cause real nutritional compromise. The answer is a careful supervised exclusion
done together with a paediatric dietician for say 4-6 weeks. Your GP will be able to refer you to one but even better if there is one attached to the community paeds who see her about her autism. The important thing is to keep an open mind and even if it seems to help, make sure you still reintroduce the corn to see if it makes things worse again. If you don't see a clear effect on exclusion, reintroduction and again on further exclusion it is very unlikely the food is really playing a role. I see so many kids who had a food excluded, no clear difference was seen but they were just kept of the food anyway. Regarding your youngest, it is hard to comment but the persistent loose stools are a worry. I would suggest you discuss your concerns with your paediatrician and ask them about other possible diagnoses that were considered and how the conclusions were reached. If you are not happy you could ask your gp for referral to a paediatric gastroenterologist.

[DrAdamFox]

Dear crybabybunting - I think somebody certainly needs to look at your baby?s airways as it does sound like she has either big adenoids or inflamed nasal lining, which is stopping her breathing through her nose. The association with milk is very controversial and certainly shouldn?t be considered until the common causes have been properly considered. I really wouldn?t go down the route of dietary exclusions for nasal problems as it is profoundly unlikely to be helpful. If you are determined to do so, go for a
complete milk exclusion for 2-3 weeks and see if the problem goes away but still make sure you reintroduce it to see if things really get worse. If you are strict and do this probably I?d be really surprised if you found an effect (but please let me know if you do!)

[GeraldineMumsnet]

Five-minute warning - Dr Fox has to leave at 1.45pm to get back to work. Think you'll agree he's answered tons of questions and we're very grateful to him for coming on

[VeniVidiVickiQV]

My experience of paediatric dietitions is very limited.

We struggled to get assistance in terms of dietary advice when we first discovered DD had a cows milk protein allergy. There was no follow up either.

Obviously, reading food packets becomes a habit/talent pretty quickly, but in terms of replacing what you are excluding to provide the right amount of nutrients/vitamins we felt it was, well, crap. Besides, have you ever tried to get a toddler to eat leafy green veg?

[rootie2]

please coul you tell me if you think there is a relationship between the lymphatic system and allergies. i posted earlier and have come back as i'm desperate for help with my 1 year old who had a lymphatic malformation in his mesentery (abdomen). half was removed a month ago, but he still is very rashy at times and has loose stools up tp 6 times a day. couldhe have developed a lactose intolerance, could a blockage to the lympahtic system cause immune/allergy issues? plaese help!

[DrAdamFox]

Dear ggirl ? they do!

[cmotdibbler]

Any answer for me and my wheezer ?

[VeniVidiVickiQV]

awwww. Come back again soon!!!

[twocutedarlings]

any answer for me and my DD Re possible allergy to prawns

Thankyou

[DrAdamFox]

dear cmotdibbler - not all asthma/wheeze is related to allergy but negative allergy test early in live doesn't rule out a possible role. Respiratory allergies develop over childhood (in contrast to food allergies that predominate in early life) and thus if things aren't better then testing again at some point may reveal somehting useful

[bythepowerofgreyskull]

thanks for your time.

[VeniVidiVickiQV]

lymphatic question is an interesting one....please answer.

[cmotdibbler]

Thank you !

[DarrellRivers]

What year did you qualify from UCL? [nosy}

[silverfrog]

thank you for taking the time to talk to us

[DrAdamFox]

Dear 2cutedarlings - this better be my last post as clinic awaits (and I wouldn't dare be late!). I definitely agree with your decision, it is very likely there would be another reaction and possibly a more severe one. Testing would confirm the diagnosis and also allow you to look for allergies to molluscs (rahter than just crustaceans) and other common allergens they may not have eaten yet eg nuts hence avoiding reacions.

[DrAdamFox]

darrell rivers - left in 96 but was only there from 93. Do i know you?!?