Parents Allergy Guide

Pediatric Allergy Basics

Boy blowing his nose outdoors
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Allergies can be a big problem for kids.

Learning more about allergies can help parents get their kids some much-needed relief.

The first step in treating allergies is trying to make sure that your child really has allergies to begin with, as allergy symptoms are often confused with cold symptoms.

Allergy Symptoms

If your child doesn't have a cold, then he may have allergies.

Although most parents just think of a runny nose when they think of allergies, there are actually a range of allergy symptoms, such as:

  • itchy red skin rash - from nickel, known as contact dermatitis
  • runny nose and itchy eyes - from ragweed, known as allergic rhinitis
  • itchy red rash that comes and goes - from peanuts, known as hives

Of course, if you are thinking of the classic allergy symptoms and signs that are associated with hay fever (allergic rhinitis), then they can include:

  • runny nose with clear discharge
  • stuffy nose (congestion)
  • sneezing
  • itchy nose
  • red eyes, with tearing and itching
  • dark circles under the child's eyes (allergic shiners)
  • a crease near the bottom of the child's nose (allergic crease)
  • rubbing the nose a lot (allergic salute)

Food Allergies

Although you can be allergic to almost any food, 90% of children with a food allergy are going to be allergic to one of these 'allergy foods':

  • cow's milk
  • eggs
  • peanuts
  • soybeans (soy milk, tofu, etc.)
  • wheat
  • tree nuts (walnuts, cashews, almonds, pecans, pistachios, etc.)
  • fish (cod, salmon, tuna, etc.) and shellfish (shrimp, crab, lobster)

    If your child eats a food that he is allergic to, he will quickly develop any number of food allergy symptoms, which can range from simple hives and vomiting to a life-threatening anaphylactic reaction.

    Seasonal Allergies

    Classic triggers of seasonal allergies include:

    • ragweed and other weeds (late summer and fall)
    • trees (early spring)
    • grasses (late spring and early summer)
    • outdoor molds (season varies depending on where you live and can be year-round in some areas)

    You can often tell that your child has seasonal allergies if his allergy symptoms start or get worse each year during a specific season, although that is sometimes hard to track. You may also notice that your child's seasonal allergy symptoms are better on days that it rains and are worse when it is dry and windy since pollen can move around better on those days.

    Indoor Allergies

    While most things that cause seasonal allergies are outside, these children with year-round or perennial allergies are usually allergic to things inside your house, such as:

    • dust mites
    • indoor molds
    • animal dander (cat and dog allergies)
    • cockroaches

    Learning to control these allergy triggers is important to reduce your child's indoor allergies.

    Other Allergy Triggers

    In addition to foods, dust, and pollens, other common allergy triggers can include:

    • medications, especially antibiotics like penicillin and sulfa drugs
    • latex
    • poison ivy
    • ingredients in topical medications, such as neomycin and bacitracin (antibiotics), PABA (sunscreens), and lidocaine (topical anti-itch creams)
    • additives in foods or medications, such as the food dye tartrazine (Yellow No. 5) and sulfites
    • insect bites and stings

    Allergy Relief

    To get allergy relief for their kids, it can help if parents:

    • avoid allergy triggers as much as possible, which can range from putting a special allergy-proof cloth mattress cover on your child's mattress if he is allergic to dust mites to keeping windows closed in your car and home when pollen counts are high if he has seasonal allergies
    • figure out what is triggering your child's allergies with a symptom diary or allergy testing
    • try nasal washes to clear allergens, irritants, and mucus from your child's nose
    • consider giving your child an allergy medicine every day, especially during his allergy season
    • consider a combination of medications, such as an antihistamine and a nasal steroid
    • consider allergy shots if you child has moderate to severe allergy symptoms that are hard to control

    Allergy Medicines

    Since avoiding allergy triggers can be tough, especially if your child has seasonal allergies, many children with allergies require allergy medicines for allergy relief. Fortunately, a variety of allergy medicines available, even for younger children.

    Allergy medicines can include:

    • Older sedating antihistamines - Benadryl (diphenhydramine), Extendryl (chlorpheniramine)
    • OTC antihistamines - Allegra (fexofenadine), Claritin (loratadine), Zyrtec (cetirizine)
    • Prescription antihistamines - Clarinex (desloratadine), Xyzal (levocetirizine)
    • Leukotriene Antagonists - Singulair (montelukast)
    • Steroid nasal sprays - Flonase (fluticasone), Nasonex (mometasone), Omnaris (ciclesonide), Rhinocort Aqua (budesonide), Veramyst (fluticasone)
    • Antihistamine nasal sprays - Astelin (azelastine), Patanase (olopatadine)
    • Allergy eye drops - Acular (ketorolac), Optivar (azelastine), Pataday (olopatadine), Patanol (olopatadine), Zaditor (ketotifen)

    What You Need To Know

    • Allergy shots are overlooked as an option to treat children with hard-to-control allergies. Some parents don't think that they are available for children, while others don't think that children will tolerate getting allergy shots every week.
    • Allergy testing can be helpful if your child has hard to control allergies, asthma, or eczema.
    • A pediatric allergist can be helpful to diagnose and manage your child's allergies.
    • Still unsure whether your child has any food allergies? This quiz may be able to help!

    Sources

    Adkinson: Middleton's Allergy: Principles and Practice, 6th ed.

    Kliegman: Nelson Textbook of Pediatrics, 18th ed.

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