The American Academy of Pediatrics Guide to Your Child’s Allergies and Asthma
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 same time every year. 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; symptoms that increase 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.
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.
- Allergy testing should be performed to determine what, if any, of these environmental allergens your child is allergic to.
- An important step in managing allergy symptoms is avoidance of the allergens that trigger the symptoms.
- If your child is allergic to 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 your child is allergic to pests, professional extermination, sealing holes and cracks that serve as entry points for pests, storing foods in plastic containers with lids and meticulous clean up 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. 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. Children with allergies to molds should avoid playing in piles of dead leaves in the fall.
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 – Ones taken by mouth can help with 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.
- 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.
- Ask your doctor about additional therapies.
Managing Eczema (Atopic Dermatitis)
- Steroid creams are very effective. When used sparingly and at the lowest strength that does the job, they are very safe.
- Non-steroidal anti-inflammatory creams or ointments can be used for itching and redness and decrease the need for steroid creams.
- Antihistamine medication may be prescribed to relieve the itching, and help break the itch-scratch cycle.
- Long-sleeved sleepwear may also help prevent nighttime scratching
- Soaps containing perfumes and deodorants may be too harsh for children’s sensitive skin.
- Use laundry products that are free of dyes and perfumes and double-rinse clothes, towels and bedding.
- Lukewarm soaking baths are good ways to treat the dry skin of eczema. Gently pat your child dry after the bath to avoid irritating the skin with rubbing. Then, liberally apply moisturizing cream right away.
- Eczema, particularly when severe, may be associated with food allergies (e.g., milk, egg, peanut).
- Launder new clothes thoroughly before your child wears them. Avoid fabric softener.
© 2011 – Reprinted with permission from the American Academy of Pediatrics
Abstracted from the American Academy of Pediatrics Guide to Your Child’s Allergies and Asthma
For more information on allergies and asthma, visit the AAP Section on Allergy and Immunology web site.