Kids and Allergies

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If your child seems to always have a runny nose, cough, throat clearing, itchy nose, watery eyes and is constantly wiping his/her nose then you might be dealing with allergies.

Why Do We Get Allergies?
Allergies happen when someone’s body overreacts to something it encounters. It ‘sees’ pollen, dust or another allergen and thinks – this is an enemy and I need to fight it off. And so it gears itself up and begins fighting something that it may truly not need to be fight. It overreacts. It produces IgE, which causes cells of the body to release histamine, and the signs of an allergic reaction begin. So the symptoms you see are not caused by the offending item – they are caused by the body itself.

The tendency to be allergic has a genetic component. In families in which parents have allergies, asthma or eczema, children are more likely to have allergies. Children will not necessarily be allergic to the same things as family members with allergies, though. And genetics is only one part of the equation. Two highly allergic parents can have children without allergies, and non-allergic parents can have highly allergic children.

Signs and Symptoms of Allergies

  1. Clear runny nose (occasionally it can be thick after a nap or first thing in the morning but it tends to just run and run)
  2. Dry Cough – often worse at night and first thing in the morning
  3. Itching Nose
  4. Sneezing
  5. Itching Throat
  6. Throat Clearing
  7. Itching Eyes
  8. Tearing
  9. Dark circles under eyes
  10. Faint crease on the nose right above the tip (from constant nose wiping in an upward direction!)

Common Causes of Environmental Allergies

  1. Dust Mites
  2. Pollen
  3. Grass
  4. Weeds
  5. Cockroaches
  6. Animals – Dog Dander and Cat Saliva
  7. Second Hand Smoke
  8. Mold

Diagnosis
It is possible to do allergy testing to find out what your child is allergic to. This testing includes both blood tests and skin testing. The testing is uncomfortable and can unearth more information than you may want. Allergy testing is less reliable in children under 2 years of age. If your child is less than two years old or is having mild symptoms it might be best to trouble shoot at home, try some of the prevention techniques listed below, and possibly treat with an allergy medication before going through with invasive allergy testing.

Prevention

  1. Keep your child in a smoke free environment.
  2. There have been studies to show that babies who are breastfed exclusively for 4-6 months are less likely to be allergic.
  3. Limit carpeting (remove it if you can) and remove drapery in your child’s room.
  4. Vacuum frequently.
  5. Cover air vents with filters
  6. Cover mattresses, box springs and pillows in airtight allergy proof covers.
  7. Keep humidity low and wash any mold with a bleach/water solution.
  8. If using a humidifier be sure to keep it clean and replace filter regularly.
  9. Wash bedding and stuffed animals in hot water once a week.
  10. Keep pets out of your children’s bedrooms and wash them weekly to minimize allergen shedding.
  11. Do not use ceiling fans.
  12. Do not allow your child to spend time in dark wet areas (mold is likely) – like basements.
  13. Use a HEPA filter.
  14. Keep your windows closed when pollen counts are high (spring).

Treatment
As always it is ideal to prevent an illness rather than to have to treat it. This is no different with allergies. If you can avoid your child’s symptoms by using the prevention methods above – great! If not you may need to consider allergy medication/treatment.

Medications

  1. Antihistamines – These medications reduce the amount of histamine in your child’s body to lessen the symptoms of allergies.
    1. Intranasal antihistamines: nasal sprays to lessen runny nose and itching/sneezing.
    2. Ophthalmic antihistamines: Eye drops to lessen watery, itchy, irritated eyes.
    3. Oral Antihistamines: To lessen all allergic symptoms.
      1. Diphenhydramine (Benadryl): one of the only medications that is safe to use in children less than 2 years of age. See Medication Dosing page for recommended dosage. Most common side effect is drowsiness (though some children have the opposite reaction and become extra energetic). Needs to be dosed every 6 hours if you want 24 hour coverage.
      2. Loratadine (Claritin, etc.): This medication is now over the counter and is safe to use in children over 2 years of age. It is much less likely to have side effects than Diphenhydramine and works for 24 hours, so is much more convenient. The dose in children under 6 is 5 mg per day. From 6 until adulthood the dose is 10 mg/day.
      3. Prescription medications: there are a number of prescription oral allergy medications available for the treatment of allergies.
  2. Intranasal steroids – These are nasal sprays that can help prevent the nasal symptoms of allergies. They make the nose less sensitive to allergens in the future. They need to be used for at least a month before their effects are seen.
  3. Inhaled Steroids – If despite treatment with antihistamines and nasal steroids your child has symptoms of cough your doctor may recommend daily treatment with an inhaled steroid. Inhaled steroids calm the airways and prevent progression of symptoms to avoid any breathing difficulty. They work over time and need to be used daily in order to prevent future symptoms. They are not a quick fix during breathing difficulty or a coughing fit.

Contact your doctor if your child has:

  1. Swelling of the mouth, lips, tongue or face
  2. Difficulty Breathing
  3. Tightness in his/her throat
  4. Hoarse Voice
  5. Lightheadedness

Call if you feel that something is just not right – remember: no one knows your child like you do!

-Monique Araya, MD, FAAP

The medical information on this Web site is provided for educational purposes only. The information provided in this site, or through linkages to other sites, is not a substitute for medical or professional care, and you should not use the information in place of a visit, call consultation or the advice of your physician or other healthcare provider.
If you believe you have a medical emergency you should call 911 or your physician immediately. If you have any questions regarding your health or a medical condition, you should promptly consult your physician.