Pediatric allergies

What are pediatric allergies?

Allergies are among the most common health problems in children, and particularly, food allergies are on the rise.

Allergic reactions

An allergic reaction is when your child’s immune system reacts negatively to one of a number of substances that are normally harmless when they are touched, eaten, or inhaled, such as latex, milk, or dust mites.

In response to these substances, the immune system produces antibodies called immunoglobin E (IgE), which attach to blood cells called mast cells, causing them to release a variety of chemicals such as histamines, cytokines, and leukotrienes.

This cascade of events results in allergic reactions, including:

• Allergic conjunctivitis

• Allergic rhinitis (seasonal)

• Anaphylaxis 

• Asthma

• Contact dermatitis

• Urticaria

How are pediatric allergies diagnosed?

Your child’s doctor may order a group of these tests to look for reactions to a variety of suspected triggers.

• Blood test - this test is used to measure your child’s level of IgE antibodies in response to allergic triggers, or allergens. A blood test is often used to detect allergens such as mold, dust mites, foods, animal dander and certain medications. 

• Challenge test - this test involves having your child safely inhale or ingest a small amount of a suspected allergen to measure any response.

• Nasal smear - this test involves measuring the amount of eosinophils in your child’s nose. An eosinophil is a type of white blood cell that multiples during an allergic reaction. 

• Skin test - this test is often used to determine environmental or seasonal triggers such as pollen. During the test, the doctor will either prick the skin and apply a small drop of a purified form of a liquid allergen, or inject the allergen under the skin with a needle. If the skin reddens at the test site after about 15 minutes, your child may be sensitive to the test allergen.

How are pediatric allergies treated?

There are three key ways doctors treat allergies—avoidance, medication and immunotherapy. Your child’s doctor will educate you and your child about the best ways to avoid contact with allergens to prevent reactions.

When complete avoidance isn’t possible, immunotherapy or medications can bring relief. Immunotherapy involves painless shots that are given over a period of time to treat environmental allergies and asthma.

Medications may include antihistamines and decongestants. And, for children with asthma or other respiratory difficulties associated with allergies, other drugs may be used,  such as bronchodilators, anti-inflammatories, antileukotrienes, and a monoclonal antibody.

Our physicians also treat children for other immune reactions, such as:

• Food protein induced enterocolitis - a gastrointestinal reaction to a food protein

• Eosinophilic esophagitis - a reaction in the esophagus that produces symptoms resembling those of gastroesophageal reflux (GERD)

• Oral allergy syndrome (OAS) - a cross-reactivity that causes some people with environmental allergies to exhibit symptoms upon eating certain foods.

Children with allergies may also be evaluated and counseled by a registered dietitian. Your doctor will work with the allergy care team and with you to create a treatment program that is best suited to your child’s particular symptoms.