April-June, 2003

Children and Allergies: More than just a runny nose
St. John's pediatrician John Hopkins, M.D., answers parents' questions

What are some signs a child may have allergies?

When most parents think of allergies, they think of allergic rhinitis (sneezing, clear runny nose, and itching nose) or allergic conjunctivitis (watery, itchy eyes). These symptoms usually do not manifest until a child is at least 4 to 5 years old. They can be seasonal or year ‘round depending on the child. Other common allergies that can occur even in infants are food allergy (vomiting, stomach pain, diarrhea, or hives) and eczema (itchy, scaling skin). The most severe allergic reaction is anaphylaxis which is a life-threatening shock often occurring after eating certain foods or insect stings.

How can you tell if your child has allergies or just a cold?

Most children with nasal allergies have one or all of the main symptoms of nasal itching, sneezing, congestion, or itchy throat. Colds have other associated symptoms such as fever, thicker nasal drainage, and cough. The pattern of illness can also be helpful. Every allergic person has triggers for symptoms that can often be identified or times of year when the symptoms seem to be worse. If there is any question, I recommend a consultation with a physician. Many times the wrong diagnosis can lead to unnecessary medication.

Are allergy medications for children available over the counter?

There are over-the-counter allergy medicines available which are safe and effective. Older allergy medicines such as diphenhydramine (Benadryl) and chlorpheniramine do have some side effects such as drowsiness and dizziness. The newest OTC product which is appropriate for use in older children is loratadine (Claritin). This product has fewer side effects and is very effective. For children under the age of 6, I recommend consulting your physician prior to using these medications.

What are some ways to alleviate children's allergies without the use of medication?

Avoidance of allergic triggers is a good way to alleviate allergies with or without the addition of medication. Common outdoor triggers can be pollen from trees, grasses, molds, or ragweed. Keeping windows closed during the particular problem-time of year can be helpful along with avoiding situations where the allergens might be worse, such as lawn mowing. Indoor allergens can be dust mites, dander from cats and dogs, particles from insects and molds. Try eliminating dust and animals from the place the child spends more time, the bedroom. Suggested measures include using an allergen-proof cover on bedding, washing bedding frequently in water that is at least 130 degrees, frequent and thorough cleaning and avoiding stuffed toys. Many patients ask about moisturizing the air. This can be helpful for those who are sensitive to low moisture but it may also create conditions that help dust mites survive and can promote mold growth. Vaporizers should be used with care. Another critical issue is avoidance of other irritants in the environment,
particularly cigarette smoke. This can create allergy symptoms in children with no previous allergies.

Common allergens

OUTDOORS
Common outdoor triggers can be pollen from trees, grasses, molds, or ragweed.

INDOORS
Indoor allergens can be dust mites, dander from cats and dogs, particles from insects and molds.