All About Allergies

By Dr. Natalie Geary, Pediatrician, author of  “The Food Cure for Kids”, founder of Mobile Pediatrics:  a charity that serves impoverished children in the US and abroad – http://mobilepediatric.org/

 Over 2 million school days a year are lost because over 40 million children in America suffer from allergies. Having uncontrolled allergies can put your child at risk for getting a secondary sinus infection, ear infections, and for having poor concentration at school. It can also make asthma symptoms worse. So what can you do to recognize allergic symptoms and control them in your child?

What is an Allergy?

An allergy is the immune system’s response to a substance that the body perceives as “foreign”, meaning a substance not recognized by the body as safe. In an attempt to protect the body, the immune system generates antibodies, in the case of allergies they are  mainly IgE antibodies. The response of the body to these IgEs is to release histamine into the bloodstream. It is primarily this histamine release that causes the typical allergic reactions such as watery eyes, runny nose, difficulty breathing, rashes, hives and upset stomach.

Who Gets Allergies:

Allergies tend to  run in certain families and are more common in children that have asthma or eczema. If both parents have allergies, there is a 75- 80% chance that their children will develop allergies. If one parent is allergic, then the chance of an allergy developing in his/her child is about 40%. Pets,  second-hand smoke and air pollution are also risk factors

Causes of Seasonal Allergies

The major source of seasonal allergy is pollen, from grasses, ragweed and other elements of nature that are released in to the air during different seasons of the year. The type of pollen a child is allergic to determines when symptoms will occur. For example, in the mid-Atlantic states, tree pollination begins in February and lasts through May, grass from May through June, and ragweed from August through October. The most common pollens causing spring/summertime allergies include:

Tree pollens (APRIL-JUNE): Maple, Ash, Oak, Elm, Birch and Cedar.

Grasses (JUNE-JULY): Kentucky Blue grass, Rye, Orchard and Timothy. Grass allergies are worsened when the grass (lawn) is mowed.

Ragweed (MID-AUGUST-OCTOBER):

Pollen counts measure how much pollen is in the air and are usually higher when it is warm, and windy, whereas they’re lowest when it’s colder and wetter.

Seasonal Allergy Symptoms

1. Allergic rhinitis: (Also known as hay fever). The most common symptoms are runny nose and sneezing, with itchy eyes and nose,  and a persistent cough without a fever. Other signs include the ‘allergic salute,’ a common habit of children which consists of rubbing their nose upward which leads to the development of a  small crease in the skin of the lower part of the nose. ‘allergic shiners,’ are dark circles under the eyes that many children develop due to the chronic nasal congestion that many parents mistakenly attribute to fatigue.

If a person has wheezing and shortness of breath, the allergy may have gotten more severe, and may be an early sign of developing asthma.

Symptoms:

  1. Nasal: runny or stuffy nose, itchy nose, itchy palate(the top of the mouth), frequent sneezing.
  2. Eye symptoms: redness, itchy and/or runny eyes. Sometimes these symptoms make a child very uncomfortable.
  3. Asthma: symptoms include wheezing, cough and/or difficulty breathing.

Diagnosing Allergies Approaching Seasonal Allergies

The most common presentation is if your child has cold-like symptoms lasting longer than a week or two or develops a “cold” at the same time every year. To determine the cause of an allergy, there are  skin tests which can be done that are more reliable in children over 2 years old. The test is a skin prick allergy test or a special blood test called RAST.

Treating Seasonal Allergies

The best treatment for seasonal allergies is avoidance. For seasonal allergies, this includes keeping windows closed in the car and at home during the pollen season will prevent the pollen from entering the home. Also attempt to limit outdoor activities when pollen counts are very high. During the pollen season avoid hanging the laundry outside to dry and keep the Air conditioners running to  filter out the pollen.

The medications that are used to control the symptoms of allergic rhinitis include decongestants, antihistamines and steroids. Over the counter allergy medicines with antihistamines ( such as Benadryl) cause drowsiness and poor performance in school.

Prescription allergy medications include Claritin and Zyrtec  and topical steroids, such as Nasonex, Flonase, and Nasacort Aqua. Allegra is another antihistamine that is commonly used in older children because it is not available in liquid form so your child must be able to swallow a pill.

For seasonal allergies, it is best to start using these medications just before your child’s season begins because it takes a while for the medications to work and they are not emergency relief.

**For more information on Dr. Geary please visit our Contributor’s profiles.

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