By Stacy Whitman
Yes, allergy season is here again—except this time, it’s your baby who’s suffering. Kids as young as age 2 can get seasonal allergies (otherwise known as seasonal allergic rhinitis or hay fever). Anyone who’s had them knows just how miserable they can be. In addition to a runny or stuffy nose, itchy eyes, coughing and sneezing, your child could experience a loss of appetite, trouble sleeping, fatigue and irritability. If left untreated, he’s apt to develop a sinus or ear infection—and could even have problems in school over time.
For the uninitiated: An allergy is the body’s immune system overreacting to a foreign matter or “allergen” that is breathed in, eaten, touched or injected. To fight off the “invader,” the body releases histamines and other chemicals that cause irritation—and that’s where the sneezing, itching and congestion come in. As many as 40 percent of American children suffer from allergic rhinitis, making it the third most common chronic disease among kids. Fortunately, with the right approach, experts say these allergies can be effectively managed and treated.
Spring, summer and early fall are prime time for seasonal allergies, which are usually triggered by grass, tree and weed pollens or mold spores. Exactly when the sneezing and other symptoms kick in depends on where you live and what your child is allergic to, says Todd Mahr, MD, director of pediatric allergy/immunology at Gundersen Lutheran Medical Center in La Crosse, Wis. In some places, like southern California or Florida, they can occur year-round.
Kids aren’t born with hay fever. Generally, it takes one to two years of exposure to an environmental allergen before symptoms develop, explains Paul V. Williams, MD, clinical professor of pediatrics at the University of Washington School of Medicine in Seattle and an allergist at Northwest Asthma and Allergy Center in Mount Vernon, Wash. That why, in most cases, children don’t exhibit signs of seasonal allergies until after the age of 2 or 3.
Symptoms of seasonal allergies are much like those of the common cold, which explains why many parents and caregivers have trouble telling the difference. If your child seems to get sick every year during pollen season or his symptoms get worse when he plays outside, there’s a good chance that allergies are to blame. While cold symptoms typically last for seven to 10 days, allergy symptoms can persist for weeks or may come and go from day to day. A kid with allergies won’t have a fever, and his mucus will be clear and thin as opposed to yellow or green and thick, adds Mahr. One final clue: If the skin under your child’s eyes looks dark or purple or blue, he may have what doctors call “allergic shiners,” thought to be caused by increased blood flow around the sinuses.
If you suspect your child is suffering from seasonal allergies, your first step should be to schedule a visit with his pediatrician or family practice doctor, who may do some detective work or refer you directly to an allergy specialist (preferably one with experience working with children), explains Morris Nejat, MD, assistant clinical professor of pediatrics at Columbia University College of Physicians and Surgeons and medical director of the NY Allergy and Sinus Center in New York City. Chances are you’ll be asked detailed questions about your home environment, eating habits and family medical history, as well as the frequency and severity of your child’s symptoms (so you may want to start keeping a record). To help determine the cause of the allergy, an allergist may order an IgE blood test, particularly if your baby has eczema. More likely, the specialist will conduct a skin-prick test, which involves introducing small amounts of common allergens into your child’s skin; if your wee one is allergic, she’ll have a reaction similar to a mosquito bite. Knowing your child’s specific allergy may help you reduce her exposure or come up with an effective treatment plan, Nejat says.
When combating any type of allergy, prevention is the name of the game, Nejat says. While it’s impossible to avoid pollen and mold spores altogether, you can lessen your child’s exposure by keeping your house and car windows closed. Likewise, try to keep your child indoors when pollen counts are at their peak, usually between 5 a.m. and 10 a.m. Don’t hang your baby’s clothes and bedding to dry outside, where they’ll be covered with pollen, Mahr adds. Since dust mites could exacerbate your child’s symptoms, it’s a good idea to put covers on his mattress and pillows, use blankets instead of a comforter and minimize stuffed animals in his room. Wash your child’s bedding once a week in hot water and, if possible, dust and vacuum weekly (just make sure he isn’t there!). Switching to a plant-based cleaning product like BabyGanics could help reduce the inflammation in his respiratory passages, too, Nejat notes.
In terms of treatments, your child’s doctor or allergist may recommend starting with saline (salt water) drops for a stuffed-up nose, which Williams says is fine for infants and young toddlers, but less effective for older toddlers and beyond. Or a short trial of an antihistamine such as cetirizine (Zyrtec) or loratadine (Claritin) may be advised if your child is older than 6 months (for cetirizine) or age 2 (for loratadine). Montelukast sodium (Singulair), which works by blocking leukotrienes (an underlying cause of allergies), is also approved for tots above age 2. Nasal steroids are another possibility for kids who are more than 24 months; they can be more effective than oral antihistamines but are more difficult to administer, Williams notes. Talk to your child’s physician about treatment options—and don’t give your little one over-the-counter allergy meds before discussing it with a medical professional.
Once your little one is off to kindergarten, if seasonal allergies are still plaguing him, immunotherapy may be worth a shot, Mahr says. Immunotherapy involves a series of injections in the upper arm given over a period of months or years that provide gradual exposure to allergens, allowing your child’s immune system to slowly build tolerance. Immunotherapy has been proven highly effective in both adults and kids and can significantly reduce symptoms or eliminate them altogether. And some research suggests that if immunotherapy is started soon after allergies first develop, it may actually reduce the risk of developing other allergies and asthma later in life. Now that’s nothing to sneeze at.
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