Is my child allergic to something?

Kirk Coverston, MDWHEN TO SUSPECT AN ALLERGY
Here are some common clues that could lead you to suspect your child may have an allergy:

  • Environmental allergies or "hay fever": Repeated or chronic cold-like symptoms that last more than a week or two or develop around the same time every year. Symptoms may include an itchy, runny nose, nasal stuffiness, sneezing, throat clearing, and itchy, watery eyes.

  • Allergic Rhinitis: Nasal congestion and postnasal drainage, itching of nose and inside the mouth, snoring, frequent sore throats, headaches, dark, puffy lower eyelids, and chronic ear infections.

  • Asthma: Recurrent coughing, wheezing, chest tightness, difficulty breathing, and other respiratory symptoms. Coughing may be an isolated symptom; symptoms may increase at night or with exercise.

  • Eczema: Recurrent red, itchy, dry, sometime scaly rashes in the creases of the elbows and/or knees or on the back of the neck, buttocks, wrists, or ankles.

  • Food allergy: Symptoms that occur immediately after eating a particular food that may include hives, swelling of face or extremities, gagging, coughing or wheezing, vomiting or significant abdominal pain.

  • Oral allergy syndrome: Itching or tingling sensations in the mouth, throat and/or ears during certain times of year or after eating certain foods, particularly fresh (raw) fruits.  Typically, however, cooked forms of the food are tolerated.

COMMON ALLERGENS ON THE HOME FRONT

  • Dust mites (microscopic organisms found in bedding, upholstered furniture and carpet as well as other places)
  • Furred animals (dogs, cats, guinea pigs, gerbils, rabbits, etc.)
  • Pests (cockroaches, mice, rats)
  • Pollen (trees, grasses, weeds)
  • Molds and fungi (including molds too small to be seen with the naked eye)
  • Foods (cow's milk, hen's egg, peanut, tree nuts, soy, wheat, fish and shellfish)

HOW TO MANAGE ALLERGIC NASAL SYMPTOMS

  • Nasal allergy symptoms can be caused by a variety of environmental allergens from both inside and outside the home.

  • Allergy testing should be performed to determine whether your child is allergic to any environmental allergens, if severe and recurring.

  • An important step in managing allergy symptoms is avoidance of the allergens that trigger the symptoms.

  • Serious consideration needs to be given to keeping or having a pet if there is a serious allergen to household animals.

  • If your child is allergic to pests in the home, professional extermination, sealing holes and cracks that serve as entry points for pests, storing foods in plastic containers with lids and meticulous cleanup of food remains can help to eliminate pests and reduce allergen levels.

  • Dust mites congregate where moisture is retained, and food for them (human skin scales) is plentiful. They are especially numerous in bedding, upholstered furniture, and rugs. Padded furnishings such as mattresses, box springs, and pillows should be encased in allergen-proof, zip-up covers, which are available through catalogs and specialized retailers. Wash linens weekly and other bedding, such as blankets, every 1 to 2 weeks in hot water. (The minimum temperature to kill mites is 130 degrees Fahrenheit. If you set your water heater higher than 120 degrees, the recommended temperature to avoid accidental scald burns, take care if young children are present in the home.)

  • If your child is allergic to outdoor allergens, it can be helpful to use air conditioners when possible. Showering or bathing at the end of the day to remove allergens from body surfaces and hair can also be helpful. For patients with grass pollen allergy, remaining indoors when grass is mowed and avoiding playing in fields of tall grass may be helpful during grass pollen season. Children with allergies to molds should avoid playing in piles of dead leaves in the fall. Pets tracking in and out of the house can also bring pollen and mold indoors.

MEDICATIONS TO CONTROL SYMPTOMS
Your child's allergy treatment should start with your pediatrician, who may refer you to a pediatric allergy specialist for additional evaluations and treatments.

  • Antihistamines –Taken by mouth, they can help with itchy watery eyes, runny nose and sneezing, as well as itchy skin and hives. Some types cause drowsiness.

  • Nasal Corticosteroids - Highly effective for allergy symptom control and widely used to stop chronic symptoms. Safe to use in children over long periods of time. Must be used daily for maximal effectiveness.

Allergy Immunotherapy - Immunotherapy, or allergy shots, may be recommended to reduce your child's allergy symptoms. Allergy shots are prescribed only for patients with confirmed allergy. If allergen avoidance and medications are not successful, allergy shots for treatment of respiratory allergies to pollens, dust mites, cat and dog dander, and molds can help decrease the need for daily medication.

(Kirk D. Coverston M.D. is a Board-certified pediatrician who practices at Visalia Medical Clinic. His practice covers all general pediatrics, from newborns to adolescence, with a special interest in behavioral pediatrics and ADHD.)

References

  • Allergies and Asthma: What Every Parent Needs to Know, by the American Academy of Pediatrics.