Managing childhood allergies

Your child's immune system works overtime to protect her from disease. It produces antibodies that attack foreign invaders like germs and pathogens so your child won't get sick. Sometimes, though, the immune system makes antibodies for substances that aren't harmful, such as pollen, pet dander or certain foods. When that happens, it's known as an allergic reaction.  Allergies are very common in children.

Related podcast

Learn more about how to help a child with seasonal allergies by listening to the Children's Health Checkup podcast.

How do I know if my child has an allergy?

Most kids are allergic to something. so chances are good that your child probably has an allergy of some kind. Pollen allergies alone affect up to 40 percent of kids. Many allergies—especially food-related ones—go away as children age.

When your child comes in contact with an allergen such as pollen, it causes a reaction that can range from mild to severe. Depending on the type of allergy, symptoms can include itchy, watery eyes, a rash or stomach cramps. In the most serious cases, a reaction can result in anaphylaxis, a potentially life-threatening condition in which a child's throat closes up. Anaphylaxis is rare. Symptoms of most allergies are mild to moderate.

Common childhood allergies

Pollen allergies (allergic rhinitis or hay fever)

Hay fever is far and away the most common allergy in the United States. Depending on the type of pollen your child is allergic to, he may only have symptoms at certain times of year. For instance, a child with a birch pollen allergy will have increased symptoms in the spring when birch trees are in bloom. Kids with grass allergies will be hit hardest during the summer, while those with ragweed allergies will suffer most in the fall.

Symptoms

Hay fever sufferers usually have cold-like symptoms that may include:

• Congestion or sinus pressure

• Runny nose

• Itchy, watery eyes

• Scratchy or sore throat

• Cough

• Swollen, bluish-colored skin beneath the eyes

• Reduced sense of taste or smell

Hay fever may be just an annoyance for a child with mild symptoms. However, severe pollen allergies can affect kids' schoolwork and prevent him from playing outdoors. Symptoms of hay fever usually diminish as children age. The best way to combat hay fever is to avoid the particular allergen but, at certain times of year, that may be impossible. Treatments for hay fever include:

Prevention

• Keep your child indoors on days that are both dry and windy

• Don't ask your child do yard work or other outside chores during peak allergy seasons

• Remove and wash clothing that your child has worn outside

• Have your child shower or bathe when coming in from outside

• Keep doors and windows closed when pollen counts are high (check your local weather) and use air conditioning to keep your car and home cool

• Buy a portable high-efficiency particulate air filter (HEPA) or dehumidifier or both

• Vacuum your home often (using a machine with a HEPA filter)

Medications

Because hay fever is so common, there are plenty of medications available to treat its symptoms. If high pollen counts are in the forecast, ask your physician if you can start giving your child allergy medications before symptoms begin. Medications to treat hay fever symptoms include:

• Antihistamines, such as Benadryl or Claritin

• Decongestants including Afrin and Sudafed

• Combination antihistamine and decongestant medications like Actifed or Claritin-D

Nasal irrigation with a squeeze bottle or neti pot can help flush pollens from your child's nose as well.

Food allergies

An estimated 12 million Americans have diagnosed food allergies. The vast majority of those folks are kids. Food allergies can affect a child's skin, gastrointestinal tract or respiratory and cardiovascular systems. Just eight foods are responsible for 90 percent of the food allergies in North America. They are:

• Cow's milk

• Eggs

• Peanuts

• Shellfish

• Fish

• Tree nuts (including cashews and walnuts)

• Wheat

• Soy

Symptoms

Symptoms of a food allergy can range from mild to severe. Sometimes they come on suddenly or they may develop over several hours. Milder symptoms of a food allergy are like those of hay fever and may include sneezing, watery eyes and a stuffy nose. Other symptoms of food allergies include:

• Rash

• Swelling

• Stomach cramps

• Diarrhea

• Hives (itchy, blotchy and raised rashes)

• Dizziness or feeling faint

• Nausea (may include vomiting)

• Trouble breathing, including wheezing

• Swelling of the tongue, lips or throat (anaphylaxis)

Children with asthma are at an increased risk for an anaphylactic reaction to a food allergen.

Diagnosis and treatments

If your child has a reaction after eating certain foods, see your pediatrician. Your child's doctor can perform tests to identify the particular allergen.

Prevention

If your child has a food allergy, the best treatment, by far, is avoidance. Most supermarket foods are clearly labeled if they contain certain allergens (even in trace amounts). When dining in restaurants, make sure to ask your server if a dish contains the food your child is allergic to.

Feeding a baby only breast milk for the first four to six months has been shown to lower the risk of future food allergies in kids.

Treatments

Over-the-counter allergy medicines can help some kids with food allergies. If your child's allergy is severe, a doctor may prescribe a steroid medication. Steroids can have serious side effects, so make sure you know the risks ahead of time.

Other allergies

Though rarer than pollen and food allergies, lots of other things can cause allergic reactions in kids include animal dander, bee stings, mold, dust mites and air pollution such as cigarette smoke. Aside from bee stings, most of these types of allergies look a lot like hay fever. Bee stings, depending on the severity of the allergy, can cause anaphylactic shock. If your child has a severe bee allergy, she should carry an EpiPen auto-injector at all times when bees are active.

As with pollen and food allergies, avoidance is best. Keeping your home free of allergens such as dust, mold and cigarette smoke will prevent child’s suffering. Both of you will breathe a lot easier!

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