Paula McQueen’s talk is called The Allergic Child. If you’re a parent with concerns, it’s one you won’t want to miss. The UK specialist will share “recent developments in paediatric food allergy” at a free presentation by asthma charity Open Airways tomorrow. Learn more below ...

Q: What’s your background as an allergy specialist?

A: I work as a GP at the Royal Surrey County Hospital, what is called a district general hospital, in Guildford, Surrey.

But my special interest is in allergy. There’s so much going around in the UK; it’s similar in most of Europe, and Australia is pretty bad.

Most allergies develop in childhood and so most of my patients are preschool age. I see quite a lot of children with bad eczema and these are the ones who tend to develop food allergies and, as they get older, asthma and hay fever tend to come along.

Q: Are you seeing allergy in greater numbers or is the incidence fairly stable?

A: Allergy wasn’t really much of a problem 30 years ago, but it’s expanding everywhere.

I think people who didn’t see it before will now come across it. In the UK, one in four GP consultations is allergy-related, which is pretty huge. But 30, 40 years ago, it was definitely not as high as it is now. There have been some very good studies published [showing that] eczema, food allergies, hay fever have increased dramatically. And it’s not that it was not recognised, it wasn’t there.

Q: Why do you think there has been an increase?

A: There’s a lot of research going into that at the moment; there are lots of theories.

There’s a genetic component, but it’s also environmental and definitely a problem in the west rather than in developing countries. The exact reason why, we don’t know; nothing has been completely proven yet. What’s quite interesting is, when you look at big countries like China where the cities are modern and there are rural areas similar to developing countries, in the cities [the allergy incidence is] similar to in the west and in the rural areas it’s similar to developing countries.

Q: Is there something we should be doing that we aren’t?

A: I think allergy can definitely be managed a lot better than it is. More teaching and more sharing would allow bases to be covered better in the UK. I don’t know what happens [in Bermuda] but in the UK system it’s sometimes not dealt with very well.

Q: How/when do the allergies usually manifest themselves?

A: We see food allergy and eczema when children are very young, less than a year. As they get older, we see hay fever and eczema and allergies to dust and pollens.

We get lots of babies with cows’ milk allergies. They present early on and the reaction can be immediate, with hives and swelling or anaphyletic, or [there can be] delayed allergies with gastrointestinal symptoms. We see a lot of children like that and we see a lot that have eaten a certain food, such as a peanut, for the first time and had an immediate reaction.

Q: Why do peanuts, in particular, get such a bad rap?

A: There are about ten different foods that cause over 90 per cent of food allergies.

Peanuts, cows’ milk, sesame, egg, wheat, soya, fish and shellfish are [among] the most common that we see although it varies slightly, country to country.

There have also been studies done looking at death from anaphylactic reaction to peanuts, so I think that’s why peanuts get a bad rap.

Q: Once an allergy is there, is it there for life?

A: A lot of children outgrow their allergy. We will bring them into the hospital and challenge them with the food they used to be allergic to to see if they’ve outgrown it. I’ve had children with ten allergies and reduced them to about five. It makes a big difference to a family if they can eat things together such as eggs and wheat.

Q: I read somewhere that there are allergies that can be prevented. Is that true?

A: I think certain studies are showing [that giving peanuts, for example, early, can prove of] enormous benefit in preventing allergy in high-risk children.

The LEAP study, of babies from four to 11 months most with severe eczema, gave half of them peanuts three times per week and the others avoided peanuts completely. The difference was huge. The group that consumed peanuts had little allergy; in the group that didn’t consume peanuts, a huge percentage developed allergy.

Q: What should parents do if they think their child has an allergy?

A: I think it’s important to be tested properly. A lot of people perceive children have an allergy when they don’t, and if you’re excluding foods from a child’s diet it can be determintal to their nutrition.

It’s good to make sure they’re definitely allergic to [a particular food] and, if they are allergic, know how to avoid it and where those foods hide. Eggs and cows’ milk you find in random foods. For example, lots of cheeses are washed in egg.

A patient’s mum kept saying that when she gave her child pesto he would sometimes break out in hives, and sometimes not. She was making the pesto herself so she really didn’t understand what the cause might be. It turned out it was because she was using different brands of cheese, and some were washed in egg. All that knowledge you need to have.

Parents also need to know, if their child does have an allergic reaction, what to do and how to treat it. Doctors can prescribe adrenalin pens but if parents don’t know how to use them or when to use them [they’re useless]. So it’s important that that side of education is done.

I do a lot of education with parents [to help them understand the importance of testing]. It might not be an allergy, it could be just irritable bowel syndrome.

There’s a difference between food intolerances and food allergies. It’s obviously important that we’re not excluding stuff unnecessarily. But I think it’s always likely that you’ll meet parents who, no matter what you say, will do their own thing anyway.

Q: I understand you’ll also be speaking with healthcare professionals while here?

A: Yes. I don’t know how much they already know. We’ve definitely reached out to GPs and nurses — people at the front door of seeing [people with allergies] — to indicate which ones need referral; so these children are sorted out more quickly and there’s a greater likelihood of the child outgrowing their allergies rather than leaving them off that food for the rest of their life.

It is important to see if it has been outgrown and reintroduce it to them as they get older.

•Join Dr McQueen at the Bermuda Underwater Exploration Institute on Thursday. Paediatrician Richard Fulton will speak on exercise-induced asthma at the free event which takes place between 5.30pm and 7.30pm. Nurses will be available to offer asthma education from 5pm. For more information call 232-0264 or e-mail nurse@openairways.com