Dr. Watson: There are many factors that contribute to the development of asthma in children. Having a mother or father with asthma is only one of the risk factors.

There are studies looking at an index called the Modified Asthma Predictive Index. In children with three or more wheezing episodes, one of which is documented by a physician, major risk factors include family history, personal history of allergy and allergies to inhalant allergens.

You also ask whether taking precautions will prevent asthma. There isn’t enough evidence to support any recommendations. For example, exposure to pets in children has been  protective in some studies, yet contributed to the onset of asthma in other studies. For children who developed asthma or hay fever, month of birth seemed a risk factor.

The bottom line is that these are things you really cannot control. If you have pets, there is not enough evidence to say to keep or get rid of them. The only option would be if your child develops symptoms around the pets, then you should give them away.

As far as the springtime, there are no special precautions to protect your child. Watch instead for early symptoms and, should you have concerns, speak to your doctor. As a father of an 18-year-old and a 22-year-old (and an empty-nester), the most important piece of advice I can give you is to relax and enjoy your child.

We welcome your question to Allergic Living’s Ask the Allergist. Thank you for understanding that the specialists aren’t able to answer every question received.

Dr. Wade Watson is a pediatric allergist and Professor of Pediatrics at Dalhousie University. He is also the head of the Division of Allergy at the IWK Health Centre in Halifax.

Dr. Watson: Parents are always concerned about introducing highly allergenic foods, especially if they or other children have food allergies. There is very little data in the medical literature to support any advice. You are correct that skin testing an individual who has never been exposed to a food doesn’t make much sense. False positive reactions occur up to 50 per cent of the time, so a positive test means little. The only rational is that if the test is negative, you can be relatively comfortable giving the first exposure at home, as the risk of a reaction is no greater than in the general population.

As a person with peanut allergy, you should not be the one feeding your son peanut. You can be close by. There are different options on how to introduce an allergen, but it’s generally recommended to start with a small amount of peanut butter on the lip. If that’s tolerated, then your son can try a small amount in his mouth. If he refuses to eat it, or if you are worried, don’t push him.

If he tolerates the peanut, he should eat it at least once per week, as the chance of developing an allergy to a food eaten regularly is less than if the food is eaten rarely. If the thought of this procedure keeps you awake at night, talk to your allergist about trying peanut in his or her office.

We welcome your question to Allergic Living’s Ask the Allergist. Thank you for understanding that the specialists aren’t able to answer every question received.

Dr. Wade Watson is a pediatric allergist and Professor of Pediatrics at Dalhousie University. He is also the head of the Division of Allergy at the IWK Health Centre in Halifax.

Dr. Watson: The question of French fries fried in the same oil as fish is one that I have been asked for many years. In my opinion, it is not safe to eat French fries that are fried in the same oil as fish. Even though the oil is at a very high temperature, I would worry about contamination of the French fries.

I have reviewed the medical literature and cannot find any study to support this opinion, but most allergy information websites recommend avoiding French fries if they have been cooked in the same oil as fish or seafood. Why take a chance?

We welcome your question to Allergic Living’s Ask the Allergist. Thank you for understanding that the specialists aren’t able to answer every question received.

Dr. Wade Watson is a pediatric allergist and Professor of Pediatrics at Dalhousie University. He is also the head of the Division of Allergy at the IWK Health Centre in Halifax.

Dr. Watson: Venom immunotherapy for people who have had anaphylactic reactions can be very helpful. The risk of having an anaphylactic reaction to a wasp’s sting is reduced from approximately 50 per cent to less than 5 per cent.
I would recommend that you see an allergist to find out whether immunotherapy is an option for you. More importantly, you should carry an EpiPen and know how to use it to treat a reaction.

While severe reactions to bees and wasps can be very scary, it is important that you take control with steps to reduce the chance of being stung. Bees and wasps are attracted to odours and bright colours in the environment. Avoid looking or smelling like a flower. Do not use perfume, cologne, or scented soaps and don’t wear brightly coloured or patterned clothing. Avoid going barefoot while outside, especially in clover and blooming ground covers.
If a bee or wasp lands on your skin, remain calm. The insect will eventually leave on its own. If you don’t want to wait for it to fly off, gently and slowly brush it away with a piece of paper. When swimming in pools, watch out for and remove bees or wasps trapped on the surface of the water.

Stinging incidents often occur when nests are disturbed. If you see insects flying to and from a place, avoid it. If you are going to be in an area where disturbing a nest is possible, such as an old building or in the woods, wear long pants and a long-sleeved shirt.

We welcome your question to Allergic Living’s Ask the Allergist. Thank you for understanding that the specialists aren’t able to answer every question received.

Dr. Wade Watson is a pediatric allergist and Professor of Pediatrics at Dalhousie University. He is also the head of the Division of Allergy at the IWK Health Centre in Halifax.

Dr. Watson: The 11 foods that the Canadian Food Inspection Agency has identified as priority allergens were declared such because they account for more than 90 per cent of severe adverse reactions related to food. They include peanuts, nuts, sesame seed, milk, egg, fish, shellfish, soy, wheat, sulphites and mustard.

My interpretation would be that sunflower seeds were not part of this group because they were responsible for fewer reactions. For your son, however, I realize that this is not relevant, and you must exercise the same precautions as with one of the priority allergens.

Mustard is, indeed, a seed. There have been several reviews of cross-reactivity in food allergy. Although there are a number of seed storage proteins and although mustard was recently added to Health Canada’s priority allergen list, cross-reaction among seeds is not common.

The most important question is: “Does your child currently eat mustard?”

If the answer is “no”, then there is no issue. If the answer is “yes”, the risk is extraordinarily low. I would suggest you talk to your allergist about any precautions to take if introducing mustard to his diet.

We welcome your question to Allergic Living’s Ask the Allergist. Thank you for understanding that the specialists aren’t able to answer every question received.

Dr. Wade Watson is a pediatric allergist and Professor of Pediatrics at Dalhousie University. He is also the head of the Division of Allergy at the IWK Health Centre in Halifax.

Dr. Watson: Unfortunately, peanut allergy is increasing. A negative skin or blood test for peanut allergy in a child before they are exposed to peanut only tells you that they have not yet made any IgE, the allergic antibodies, to peanut. It does not predict the development of an allergy.

For children who have outgrown this allergy, regularly eating peanut appears to reduce the risk of the peanut allergy coming back. It is not known if this is true for children who do not have a peanut allergy. So it is difficult to know why your second child developed her peanut allergy at age 7. Was she eating peanut regularly?

For your third child, I would exercise caution because of your other children’s allergies. I would keep peanut-containing products out of the house. There are no good studies that say prevention of an allergy is possible, so I cannot make a scientific recommendation. The longer you avoid peanut exposure, the more you may delay a possible allergic reaction.

If you decide to have your son tested, I would recommend doing so before school, while he’s under your supervision. If the test is negative, then you will need to decide whether you are comfortable with continuing to avoid peanut versus feeding it to him regularly. I wish I knew the right answer. I do not, but neither does any other allergist. This is an area of heated debate.

We welcome your question to Allergic Living’s Ask the Allergist. Thank you for understanding that the specialists aren’t able to answer every question received.

Dr. Wade Watson is a pediatric allergist and Professor of Pediatrics at Dalhousie University. He is also the head of the Division of Allergy at the IWK Health Centre in Halifax.