Anna Mendenhall, MD, FAAP
Children’s Physician’s Medical Group

When to Suspect an Allergy:

Here are some common clues that could lead you to suspect your child may have an allergy:

• Repeated or chronic cold-like symptoms that last more than a week or two, or develop at about the “allergy season”.  These could include a runny nose, nasal stuffiness, sneezing, throat clearing and itchy/watery eyes.
• Recurrent coughing, wheezing, chest tightness, difficulty breathing and other respiratory symptoms may be a sign of asthma.  Coughing may be an isolated symptom; increases at night or with exercise are suspicious for asthma.
• 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.
• Symptoms that occur repeatedly after eating a particular food that may include hives, swelling, gagging, coughing or wheezing, vomiting or significant abdominal pain.
• Itching or tingling sensations in the mouth, throat and/or ears during certain times of year or after eating certain foods.

How do I know if my child has allergies?

If some of the above clues are present you will want to make an appointment with your pediatrician and discuss the symptoms.  There are simple blood tests that your pediatrician can now order instead of the 40 (or more) pokes on the back used to do skin testing to allergies in the specialist’s office.  There are positives and negatives to each test’s accuracy and specificity but the blood test is a good one poke start to investigating allergies.

Common Allergens on the Home Front:

• Dust mites (dust mites are microscopic and are found in bedding, upholstered furniture and carpet as well as other places)
• Furred animal allergens (dogs, cats, guinea pigs, gerbils, rabbits, etc.)
• Pest allergens (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, eggs, peanuts, 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 including indoor allergens such as dust mites, pets, and pests as well as outdoor allergens such as pollens.  Molds, which can be found indoors and outdoors can also trigger nasal allergy symptoms.
• Pets:
  • The addition of pets to your family would not be recommended.  If your child has allergy symptoms and is allergic to a pet that lives with your family, the only way to have a significant impact on your child’s exposure to pet allergens is to find the pet a new home.  If this is not going to happen, there are things we can do to make a good improvement in the allergy symptoms, but you need to talk to your doctor about this.
• Pests:
  •  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 the 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.  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).
• 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.  Remove clothing & shoes in the garage or laundry area so allergens are not tracked all through the home.  (Removing clothing in the bedroom is especially bad for pollen allergy sufferers).  For patients with grass pollen allergy, remaining indoors when lawn is mowed and avoiding playing in fields of tall grass may be helpful.  Children with allergies to molds should avoid playing in piles of dead leaves in the fall.

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

Medication 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:
  • Nasal, oral, and ophthalmic.  These can help greatly reduce itchy watery eyes, runny nose and sneezing, as well as itchy skin and hives.  Some types may cause drowsiness.
• Nasal Corticosteroids:
  • Highly effective for allergy symptom control and are widely used to stop chronic symptoms.  Safe to use in children over long periods of time.  Must be used daily and take 2 weeks to notice an improvement.
• Allergy Immunotherapy:
  • Immunotherapy or allergy shots, may be recommended to reduce your child’s allergy symptoms.  Allergy shots are only prescribed in patients with confirmed allergy.  If allergen avoidance and medications are not successful, allergy shots for treatment of respiratory allergies to pollen, dust mites, cat and dog dander, and outdoor molds can help.  Decrease the need for daily medication.