Health and medical information

As pure cotton, and in blends with synthetics, cotton is very widely used. Allergy to cotton is very rare, despite its wide exposure. It is a cellulose fibre, not a protein fibre like wool, and is hence less likely to provoke an allergic reaction. However, if a reaction does occur, it is the cotton flock – the small particles given off from the fibre – which causes reactions when inhaled. Some people allergic to cotton find they can tolerate it if they avoid very fibrous cotton, such as towelling, knitted cotton or cotton wadding.

When people react to cotton fabrics, it is often found that they are sensitive to resins applied to the fabric to give easy-care properties, rather than to the cotton itself. If you follow the guidelines for testing cotton in the Pillow Test, resins should not interfere with the test. They are not applied to cotton towels or blankets; and they are rarely or lightly applied to T-shirts and pillowcases. They are also usually washed out after several washes, so using a well-washed cloth for testing should prevent problems for even those highly sensitive to resins.

Always wash clothes or fabrics well before using. It may prevent any problem with chemical treatments unless you are highly sensitive.

Fabric resins are applied to furnishing fabrics as well as to clothing fabrics. In addition, pure cotton furnishing fabrics are often treated with fire-retardant chemicals to meet with fire regulations, and some have stain-protection chemicals applied as well. These chemicals may be responsible for apparent reactions to cotton.

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Certain allergens or substances are more likely to cause cross-reaction than others. Moulds, for instance, have a high degree of cross-reactivity and if you react to one particular mould, you are more likely to react to other moulds or yeasts. Grass pollens cross-react with other grass pollens. Foods are also prone to cause cross-reaction, especially between closely related foods within the same biological cl; Certain chemicals, natural and synthetic, are known to with other chemicals, drugs or foods – the active chemical in aspim, a specific example.

Some pollens cause cross-reaction to nuts and fruits that are related to them, but, by and large, if you react to one species of pollen, there is no reason why you should cross-react to other pollens. Being allergic to grass pollen, for instance, does not pre-dispose you to react to tree pollens, say, or any other species of pollen. Similarly, being allergic to one species of animal should not make you cross-react to another species of animal, though you can react to related animals; people known to be allergic to horses have cross-reacted to donkeys, mules and zebras, which are of the same species.

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Try and make a special diet as flexible and normal as you can. Have the confidence to ignore any pressure from family or friends to conform or not to give unusual foods – if the child is well on his or her special diet, that is your justification.

One of the most difficult areas is to establish rules on things that a child can or cannot do – especially things to eat and drink. If you operate a total ban on some things (e.g. playing with friends’ pets, buying sweets, eating ice creams, going swimming or eating biscuits) then you have to trust the child to observe them when out of your sight.

If you are fairly sure that the child is breaking the ban but lying about it, it may be better not to have an absolute prohibition. One option is to allow treats or outings at regular intervals, so that there is less emotional friction around the issue. Although the child may be doing things that

upset him or her, at least you know the extent of the damage and the child is sharing in the responsibility for his or her actions.

Food fads can also be tricky to handle. Food sensitive children often have strong food cravings or obsessions, and aversions to other foods. Craving, addiction or aversion to a food is often an indicator of allergy or intolerance. However, food faddiness is also common to many children – most children have periods of strong preference and aversion, and go through phases in which they will only eat certain things, or phases in which they use refusal of food you offer as an emotional tool. Managing food fads can be exhausting at the best of times, without adding to it the need to stop a child eating a food that clearly does him or her harm.

Again, there is no easy solution, except that if you decide that your child must stop eating a particular food in the interests of health, then you will have to carry it through firmly and take the storms that will follow. If you are concerned that your child does not eat enough or has the wrong balance of nutrients, be reassured that studies have shown that children left to themselves to choose what they eat select foods which give them a proper balance of nutrients – even if they only eat one food for a day or more.

A child who is hungry will eventually eat, and although you may have to endure two or three (or more) terrible days when you first take out a loved food out of a child’s diet, a child will eventually co-operate if you are firm and do not weaken.

It helps a great deal if other family members do not eat the deprived food in front of the child (and do not tease him or her about it). But often this cannot be managed and you will have to sit things out.

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If reducing the level of any food has little effect, you should go further and leave the chosen food totally out of your diet totally. If you do this for common foods, such as cow’s milk, wheat, eggs, yeast, com and soya, it can mean drastic changes to your diet and usually entails leaving out most processed and manufactured foods.

There is also advice on what substitutes to use, on nutritional balance and precautions to take against new sensitivities developing in the baby.

Babies with a tendency to food sensitivity can become sensitive to foods that are introduced into a breastfeeding mother’s diet as substitutes (e.g. to goat’s milk or soya milk used as an alternative to cow’s milk) and you need to take care not to binge on or overuse any foods you use as substitutes in case this happens. So, even if a mother is not food-sensitive herself, she needs to observe the preventative guidelines.

If leaving out these foods seems hard at first, an easier route, and one that women sometimes try before they turn to total exclusion of cow’s milk, etc., is to leave out some common culprits which are less fundamental parts of the diet, and see if baby improves. You could choose one of these food groups at a time and leave it out for two to four days to see what happens. Move on to another if you get no response. Try leaving out one of the following groups at a time:

• Tea, coffee, cocoa and chocolate

• Alcohol

• All sweet and fizzy drinks, sugar, sweets, biscuits and bakery

• Orange, grapefruit, lemon and other citrus fruits and juice

• Onions, garlic, leeks, spring onions

• Spices (NB curry)

• Cabbage, broccoli, sprouts, cauliflower, kale, spring greens

Some babies are sensitive to chlorine and other chemicals from tapwa-ter passing in breastmilk. The mother could try as an alternative using filtered or bottled water (Evian, Buxton or Malvern for preference). Use the chosen water for drinking, making hot drinks and soups, and for all cooking purposes. For more information on water.

A breastfeeding mother needs to take care of her own diet. Consult your doctor about any intentions you have to leave out common foods, and about the need for any vitamin and mineral supplements.

It can sometimes take several days for the benefits of exclusion to be seen on a breastfeeding baby. So give each food (or group of foods) time to show results.

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There are some things you can do specifically to help babies and young children who have house dust mite allergy, or to prevent it developing. Add these to any of the other measures you carry out.

Take Care with Soft Toys

Soft toys snuggled in bed are frequently a prime source of house dust mites for allergic children. To avoid such problems, buy washable toys and wash them frequently to remove the faecal pellets. Then hang outside to dry in the sun, vacuum them, or air and dry them, to remove the mites themselves. Buy a duplicate favourite toy if necessary, to substitute while washing is done.

Some parents report success in killing mites by freezing the soft toy after washing. (Poor Teddy!) Remember, if you do this, make sure the toy is thoroughly dry after defrosting.

Bunk Beds

It is better for an allergic child to sleep in the top bed rather than the bottom, if this is feasible. House dust mites are scattered from the top mattress as the inhabitant turns and moves during the night.

Childminders and Nurseries

If your child seems fine at home, but gets worse after going to a childminder’s or nursery, the cause can be, amongst others, house dust mites – particularly in a warm, damp, carpeted environment. If this is worth taking action over, either look for a childcare place where the environment is more favourable – for instance, uncar-peted and well ventilated – or see if you can lend the childminder or nursery a filtered vacuum cleaner to see if things improve. Be tactful.

Take Care with Young Babies

If you have a history of any allergy in the family, it can help to take avoidance measures with young babies, to prevent them developing house dust mite allergy. Remember that very small babies spend much of their time with their noses stuffed into the very surfaces that harbour dust mites – carpets, bedding and furniture. They have a much more intense exposure to house dust mites than older children or adults have.

So do what you can with all the basic and other measures suggested to reduce the level of mites around a baby or young child. In particular, use washable bedding, especially using cotton blankets (washable at high temperatures) rather than duvets. Keep bedding and insulation around a baby to a minimum – avoiding cot bumpers and pram ‘nests’ if possible, or washing and airing them frequently. Air mattresses and keep them dry.

Pay particular attention to carpets and rugs where the baby plays, crawls or rubs its nose a great deal. Vacuum with niters, or wash if possible. Keep these mite-free if you can. Prevent pets sleeping on beds or cots, or where a baby or young child plays a great deal. Warmth, damp and animal skin scales encourage mites to grow.

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