III. History: Allergy

  1. Early Onset of Allergic Rhinitis
  2. Positive Family History of Atopy
  3. Seasonal Allergic Rhinitis symptoms
  4. Provocative Symptoms
    1. Worse with animal exposure
    2. Worse outdoors
    3. Worse near cut grass
    4. Better in air conditioning
  5. Tobacco and chemicals are not the primary cause
  6. History of prior relief with Immunotherapy

IV. Prevention

  1. See Allergen Control (especially Dust mite exposure)
  2. Protocol in children with strong atopic family histories (2 first degree relatives)
    1. Exclusive Breast Feeding (preferred) or hydrolyzed formula for first year
    2. No solid foods until after 6 months of age
    3. Delay nuts, shellfish, and fish until over age 4 years
    4. Breast-feeding mother avoids eggs, milk, tree nuts, peanuts, and seafood
    5. Fiocchi (2006) Ann Allergy Asthma Immunol 97(1):10-20 [PubMed]

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