Eczema

Eczema is an itchy inflamed skin rash which comes and goes in up to one in three Australian children. It is most common in children where there is another member of the extended family with an allergic condition, such as food allergy, asthma, hay fever and eczema. It can also be worsened by food chemical intolerance. 

It is an extremely stressful condition for both the child and the family, with itchiness contributing to irritability and poor sleep. Creams and ointments, dressings and other medications are often necessary, and are expensive, adding to the stress on the family.

The aim in this practice is to identify the factors contributing to the eczema, and then to remove or reduce these as much as possible, rather than just applying medications and hoping that it will “just get better”.  

http://www.eczema.org.au/
http://www.allergy.org.au/content/view/173/148/

http://www.allergy.org.au/images/stories/aer/
infobulletins/pdf/Allergy_&_the_skin_2004.pdf
http://www.allergy.org.au/images/stories/aer/
infobulletins/pdf/AtopicEczema.pdf

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Hay fever/Allergic Rhinitis

Some children are “always snuffly and congested”.  They seem to always have a cold, with a runny nose and seem to be unable to breathe through their mouths. Snoring, and sneezing is very common. Often the children have an itchy nose, and will be constantly rubbing at the nose (“the allergic salute”). In some children they also have itchy runny red eyes. Finding out the cause of the symptoms is important and treatments are available to improve the symptoms, and in some cases to “cure the allergy”. 

ASCIA Allergic Rhinitis checklist for patients

http://www.allergy.org.au/images/stories/aer/infobulletins/
pdf/Allergic_conjunctivitis_2004.pdf
 http://www.allergy.org.au/images/stories/aer/infobulletins/
pdf/Hayfever-treatment.pdf 
http://www.allergy.org.au/images/stories/aer/infobulletins/
pdf/Pollen.pdf 
http://www.allergy.org.au/images/stories/aer/infobulletins/
pdf/Sinusitis.pdf
http://www.allergy.org.au/images/stories/aer/infobulletins/
pdf/What_is_hayfever_2004.pdf

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Food Allergies

In Australia the most common food allergies are peanut,  other nuts, dairy foods, and eggs. Fortunately, most children outgrow their allergies to foods, although allergy to nuts can be life-long. The symptoms of an allergic reaction to foods can range from mild to severe in nature.

 Mild symptoms include hives on the face, tingling of the lips and mouth, and swelling of the face, particularly the lips, eyelids and ears. Some children develop abdominal pain, vomiting, or loose smelly stools as part of the reaction.

Severe symptoms involve breathing problems, with wheeze, persistent cough, hoarse voice, noisy breathing (“like Darth Vader”), swelling of the neck and tongue, collapse and loss of consciousness.

If you think your child may be allergic to foods, it is important to have this properly assessed by an Allergy Specialist, who will perform testing and give advice about the management of the child’s specific condition.

http://www.cs.nsw.gov.au/rpa/allergy  
http://www.allergyfacts.org.au/
http://www.allergy.org.au/       

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Food Intolerances

Does your baby have reflux, colic, or problems sleeping? Do you think that the baby reacts to the foods you are eating, if you are breast feeding, or to the formula you are giving the baby? Does your baby refuse feeds? Do you notice that your baby has rashes on the cheeks, or bleeding ulcers on the nappy area? Are the stools very hard, or are they always runny, different from the stools of other children of the same age? Are you tired of being fobbed off by other health professionals, when you ”just know there is something not quite right” about your baby? It is possible your child could have food intolerance.

Older children can have symptoms of tummy ache, constipation, diarrhoea, eczema, hives headache, easy vomiting, and some children may become overactive and silly after eating some foods such as chocolate or highly coloured sweets.

An assessment by a Paediatrician and Dietitian trained in the management of food chemical intolerance could be very helpful, with advice and reassurance about diagnosis and management of this difficult condition, which fortunately is not lifelong in most cases.

www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.cfm

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Infant colic

Some babies are difficult to handle, and scream for hours at a time. Sometimes this is diagnosed as “silent reflux “. Some children just seem to have a difficult temperament.  In some cases the baby is reacting to the foods the mother is eating, which are being passed to the baby through the breast milk. In other cases the baby may not be able to tolerate the formula being given. An assessment by a Paediatrician and Dietitian trained in the management of food chemical intolerance could be very helpful, with advice and reassurance about diagnosis and management of this difficult condition, which fortunately is not lifelong in most cases.

www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.cfm

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Reflux

Some children “vomit all the time” from a young age. Some are just very unsettled babies. They are often more distressed when they lie flat. In severe cases they might refuse feeds and may even have streaks of blood in the vomit.

It is important to have your child assessed firstly by your family Doctor if you are concerned, and if you think the reflux is not improving with standard treatments, an assessment by a Paediatrician and Dietitian trained in the management of food chemical intolerance could be very helpful, with advice and reassurance about diagnosis and management of this condition.

www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.cfm

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Hives

Hives are also called urticaria. They are usually intensely itchy raised patches on the skin. They can be paler than the surrounding skin, or a bit more pink in colour. The patches tend to move around over minutes to hours, but in some cases can last for days to weeks. They can be associated with swelling of the hands and feet . As they are itchy, hives can be very irritating. Some hives are due to an allergic reaction, some due to food chemical intolerance and some from other causes, such as heat, cold or physical trauma.

It is important to have your child assessed firstly by your family Doctor if you are concerned, and if you think the hives are due to foods, an assessment by a Paediatrician and Dietitian trained in the management of food  allergy and food chemical intolerance could be very helpful, with advice and reassurance about diagnosis and management of this condition.

www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.cfm
http://www.allergy.org.au/images/stories/aer/
infobulletins/pdf/Urticaria.pdf 
www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.cfm

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Sensitive skin

Some people can’t use soaps, shampoos, or cosmetics. Some react to smells such as perfume, cleaning agents, or other strong smelling substances. Some people have large mosquito bite reactions, and get red skin if they apply sunscreen.  In some of these people there is associated food intolerance. Some have contact dermatitis due to sensitivity to certain chemicals. These conditions can be assessed easily.

http://www.scfa.edu.au/ 
www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.cfm
http://www.allergy.org.au/images/stories/aer/
infobulletins/pdf/AllContactDerm.pdf

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Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is one of the most common disorders that doctors see. Children and adults can be affected. Some signs and symptoms of irritable bowel syndrome are:

• Abdominal cramping
• Bloating and gas
• Diarrhea, constipation or both 

Most people with IBS find signs and symptoms improve as they learn to control the condition.
Fortunately, unlike more serious intestinal diseases such as ulcerative colitis and Crohn's disease, irritable bowel syndrome doesn't cause inflammation or changes in bowel tissue or increase your risk of colorectal cancer. In many cases, you can control irritable bowel syndrome by managing your diet, lifestyle and stress.

An assessment by a Paediatrician and Dietitian trained in the management of food chemical intolerance could be very helpful, with advice and reassurance about diagnosis and management of this difficult condition, which fortunately is not lifelong in most cases.

http://www.mayoclinic.com/health/irritable-bowel-syndrome/DS00106
www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.cfm

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Some behavioural problems may be made worse by what we eat

Many parents see their children become highly excitable and silly, overactive and impulsive, especially after going to birthday parties, where they eat highly coloured and flavoured foods.  An assessment by a Paediatrician and Dietitian trained in the management of food chemical intolerance could be very helpful, with advice and reassurance about diagnosis and management of this difficult condition, which fortunately is not lifelong in most cases. www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.cfm .

There is convincing evidence that children with Autistic Spectrum disorders can also be helped by changing the child’s diet, to avoid all gluten and dairy containing food. This can improve the child’s behavior, obsessionality, and even language function. These children are very difficult to feed, so a Dietitian experienced in the care of children with these disorders should be consulted for further help. The Dietitian in this service is able to provide this advice for parents. http://www.aspect.org.au/

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Infant feeding problems

If your child is refusing feeds, taking a long time to finish a bottle, or is fussing at the breast or bottle, food intolerance could well be involved. 

An assessment by a Paediatrician and Dietitian trained in the management of food chemical intolerance could be very helpful, with advice and reassurance about diagnosis and management of this difficult condition. www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.cfm .

Occasionally children will gag on liquids or solids, and in these cases may require assessment by a speech therapist experienced in the treatment of infant feeding problems. This service is available through caswellhealthcare.com.au and through children’s speech therapists at   major Children’s Hospitals. In NSW these are http://www.sch.edu.au/, http://www.chw.edu.au/ , http://www.hnehealth.nsw.gov.au/services_and_facilities/
john_hunter_childrens_hospital

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Weight management

In the media, we frequently hear about children becoming heavier, and being unhealthier.  Their self esteem suffers, they are teased, and they find it hard to participate in sporting activities. Many parents are uncertain about what can be done for their children with “a weight problem”, and often are reassured by family members that it is “just  a gland problem “ or “puppy fat” or that other members of the family were a similar shape and are OK now. This is not necessarily the answer. A Dietitian can be a very useful in the assessment and management of weight, so children don’t go on to have the life-long health problems that overweight and obesity can cause.

Another useful service is CHISM, http://www.chw.edu.au/prof/services/chism/about.htm, the Children’s Hospital Institute of Sports Medicine, where children can be assessed and given specific exercise programmes to help them in the management of their weight.

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Headache

Many people have heard that headaches can be caused by eating rich foods such as tomatoes, red wine, tasty cheese, pork, chocolate, citrus fruit, and coffee. In some cases these really do contribute to headache. An assessment by a Paediatrician and Dietitian trained in the management of food chemical intolerance could be very helpful, with advice and reassurance about diagnosis and management of this condition.

http://www.headacheaustralia.org.au/ 

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Abdominal pain

Children often complain of tummy ache. It can be hard to work out the cause of the pain, but in some cases the parents feel there is a pattern with some foods being eaten  just before the pain. In some cases the parents say that sometimes the children have a tummy ache after eating that food, but not the next time that food is eaten. This is typical of food intolerance, because people are usually intolerant to a group of chemicals that occur in more than one food. When we eat several foods in that group over a series of days, that chemical builds up in the body, and when it reaches a certain level causes the symptoms in question. What usually happens is that people blame the last food that was eaten, when the real cause is the build up from several days of similar chemicals in the food we eat. A useful link is www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.cfm .

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Constipation

One of the common causes of constipation is intolerance of dairy products. Other foods can also cause constipation. If your child has constipation that is difficult to treat, and doesn’t respond to standard treatment, then food intolerance may be the cause. An assessment by a Paediatrician and Dietitian trained in the management of food chemical intolerance could be very helpful, with advice and reassurance about diagnosis and management of this condition.
www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.cfm

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Diarrhoea

Some children seem to never have a formed stool, or have trouble with toilet training because their stool is so loose  they can’t get to the potty in time. Some parents are tired of changing the baby’s nappy and clothes several times a day because the stool won’t stay in the nappy, as it is loose, and too much for the nappy to hold.

Not all diarrhoea is due to infection. Some cases of diarrhoea are related to the food the person is eating. Some causes are celiac disease http://www.coeliac.org.au/ , dairy intolerance, or more general food chemical intolerance.

If your child has diarrhoea that is difficult to treat, and doesn’t respond to standard treatment, then food intolerance may be the cause. An assessment by a Paediatrician and Dietitian trained in the management of food chemical intolerance could be very helpful, with advice and reassurance about diagnosis and management of this condition. www.cs.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.cfm .

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General Dietetics

Many parents wonder if their child’s diet is adequate. Are they getting enough vitamins and minerals for growth and development.  Some parents find it hard to get their children to eat what is offered to them, and some parents wonder if food is causing symptoms in their child.

A Dietitian is a University qualified professional who is trained in assisting you with a healthy diet appropriate for your individual needs. Our clinic offers the services of a Paediatric Dietitian, trained in both general dietetics for well children, and in the management of children with problems with food chemicals. http://www.daa.asn.au/

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