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What's an allergy?
An allergy is an immune reaction to a substance in the environment called an allergen.
When a child with allergies comes into contact with an allergen – either by touching it, breathing it, eating it, or having it injected – her body mistakenly views it as a dangerous invader and releases histamines and other chemicals to fight it off.
These chemicals irritate the body and cause symptoms such as a runny nose, sneezing, itching, and coughing. Symptoms can be mild or more severe, intermittent (seasonal, for example), or ongoing because of constant exposure to the allergen.
In some cases, an allergen can cause a severe reaction, called anaphylactic shock. This is a medical emergency, as the symptoms – including difficulty breathing and swelling – can be life threatening.
What are examples of allergens?
Possible allergens include food, drugs, insects, animal dander, dust mites, mold, and pollen. Allergens can cause respiratory symptoms, as in nasal allergies or allergic rhinitis, skin symptoms like eczema, or intestinal problems – from food allergies, for example.
Babies and toddlers are unlikely to have hay fever. Seasonal allergies to things such as pollen and grass usually don't rear their ugly (and stuffy) head until a child is about 3 or 4 years old. That's because the exposure to each individual pollen is only for a few weeks each year.
How common are allergies in kids?
According to figures released by the U.S. Centers for Disease Control and Prevention (CDC) in 2011, based on the agency's National Health Interview Survey, 4.5 percent of children younger than 18 years of age have a food allergy (up from 3.5 percent in 2000), 10.7 percent have a skin allergy (up from 7.3 percent in 2000), and 16.6 percent have hay fever or a respiratory allergy.
What causes nasal allergies?
The most likely culprits are:
- Dust mites: microscopic organisms that thrive on human skin flakes. Nearly 85 percent of allergy sufferers are allergic to dust mites.
- Animal dander, those white, flaky specks made up of skin and hair shed by cats, dogs, and other furry animals.
- Pollen, particularly from trees, grasses, and weeds.
- Mold: fungi found in wet, damp places such as bathrooms and basements or outdoors in humid climates.
Some children are allergic to down and feather pillows or wool blankets. And while most experts don't think children can be allergic to tobacco smoke, it can certainly make their allergic symptoms worse.
10 signs that your child has allergies, not a cold
Because the symptoms of nasal allergies are much like cold symptoms – runny nose, watery eyes, cough, nasal congestion, sneezing – it can be tough to tell the difference. There are some telltale signs of allergies, though.
Ask yourself the following questions:
- Does it seem like your child always has a cold? Colds usually wind down in a week to ten days; allergies don't.
- Is your child's nose continually stuffy or running?
- Is she constantly wiggling, wiping, or pushing her nose up in what doctors call the allergic salute?
- Is the mucus that drains from her nose clear and thin (as opposed to yellow or greenish and thick)?
- Does she seem to sneeze a lot?
- Are her eyes itchy, red, and watery?
- Does the skin under her eyes look dark or purple or blue – what doctors call allergic shiners?
- Does she breathe through her mouth?
- Does she have a persistent dry cough?
- Is her skin irritated or broken out in an itchy red rash?
If you answered yes to one or more of these questions, there's a good chance your child is allergic to something in her environment. Kids with nasal allergies are also more prone to ear infections, asthma, and sinus infections.
Are allergies inherited?
A child inherits the tendency to be allergic but not necessarily the specific allergies.
For example, if one of your child's biological parents has hay fever or pet allergies, there's a 40 to 50 percent chance your child will have some sort of allergy as well. That probability jumps to 75 to 80 percent when both biological parents have allergies.
Family members may differ widely in the kinds of things they're allergic to.
If my child is allergic, when will I know?
It depends on how often your child has been exposed to the allergen. It typically takes time for an allergy to develop. Each allergic person has a threshold that must be reached before an allergen causes a reaction, and this can take several months. That's why pollen allergies associated with hay fever usually take a few years to develop.
So if your child inherited the tendency to be allergic to cat dander, she may have no trouble at all for the first few months she's around Fluffy, or she may have a reduced reaction. But then one day, when the exposure level reaches her threshold, her body will react and mount an offense.
How can I figure out what my child is allergic to?
It takes some careful detective work and sometimes the help of medical tests to pinpoint the exact cause of an allergy. One clue may be when the allergy attacks occur.
Mold allergies usually develop during damp or rainy weather and can be hard to distinguish from colds. Dust mites or pet allergies often cause morning congestion throughout the year. Pollen-related allergies are more common in spring, summer, and fall.
Unfortunately, sending Fluffy away for a few days won't tell you for sure whether your child has a pet allergy. Studies at Johns Hopkins University suggest it can take more than a year after a cat is no longer around for cat dander to degrade to the point that it doesn't bother allergic people.
On the other hand, if you take your child away from your pet (on vacation, for example) and she seems better, then you have a good – but by no means conclusive – clue. You'd also want to consider that your child might be allergic to something else in your house.
If your own sleuthing doesn't give you the answer, it's time to see the doctor. He'll examine your child and ask lots of questions. If he believes the problem is allergies, he may refer you directly to an allergic specialist, or he may suggest a blood test to measure levels of IgE (allergy) antibodies in your child's blood.
Blood tests may be less accurate than skin tests. So if the blood test does suggest an allergy, the next step for your little sniffler may be a skin test. You'll need to see an allergist for that.
During a skin test, an allergist applies small amounts of common allergens to your child's skin. If your child is allergic to a substance, she'll have a reaction similar to a mosquito bite on that spot. Infants may have smaller reactions than older children, but the tests can still be very useful.
"Keep in mind that testing tells you what your child is allergic to at that point, but it may change as your child gets older," says Seattle pediatric allergist Frank S. Virant. If your child has a negative skin test but continues to have allergy symptoms, have her reevaluated in six to 12 months.
How can I protect my child from allergens?
Here are the best ways to reduce your child's exposure to the most common allergens:
Dust mites live in fabrics and carpets and are common in every room of the house. But children are usually exposed to the most dust mites in the bedroom, where mattresses and pillows are veritable dust-mite condominiums.
The following steps may seem like a lot of work, but they really help.
"Parents who take these steps might expect a 60 to 70 percent rate of improvement in their child's allergies," says Virant, "and this should markedly cut down the level of medication needed for the problem."
- Encase your child's mattress in an impenetrable cover made of very tightly woven fabric, found at allergy supply stores. Unlike vinyl covers, these provide a barrier that's breathable and not crinkly. Avoid big, fluffy comforters and use blankets instead.
- Wash bedding once a week in hot water to kill dust mites. Set your water heater to about 130 degrees Fahrenheit before laundering bedding, and warn family members that the water will be hotter than usual. Be sure to turn the water heater back down (to about 120 to 125 degrees) afterward so family members won't scald themselves when they wash their hands or shower.
- Avoid piling up stuffed animals in your child's room – they're dust-mite magnets. Wash the few favorites your child can't live without in hot water weekly or stick them in the freezer for an overnight killing frost.
- Dust and vacuum weekly or every other week, but make sure your child isn't in the room when you do it. Dusting and vacuuming stir up residual dust-mite particles in the room. Wet mopping can help prevent this.
- Consider investing in a vacuum cleaner with a HEPA (high-efficiency-particulate-arresting) filter, which traps even microscopic particles that pass right through ordinary vacuum cleaners.
- If your child has a severe dust mite allergy, consider replacing carpeting with a smooth floor like hardwood or vinyl.
- Clean or replace filters on your furnace and air conditioners monthly during seasons they're in use. Have heating ducts cleaned each fall.
If your child is allergic to a pet, the only foolproof solution is to give the animal away. That's not an easy decision to make, of course, and, understandably, you'll want to consider it only as a last resort.
To keep the dander down, wash your pet frequently. You can find shampoos that reduce dander in the pet store. Also keep your pet off the furniture and out of your child's room.
During allergy season it can be close to impossible to avoid airborne pollens. You can try to keep your child indoors with the windows closed during the height of pollen season, particularly on windy days, but this may be unrealistic.
If your child does go outdoors, make sure you bathe her and wash her hair each night to remove any airborne allergens. Dry her clothes in the dryer rather than on the clothesline, and close the air ducts to her bedroom.
Keep tabs on the pollen counts in your area so you know which days to be particularly mindful of your child's exposure.
Use a dehumidifier and air conditioner when the weather is warm and moist, especially in a wet basement or other areas of your home where mold growth is a problem.
If your bathroom is a mold factory, clean it regularly with mold-inhibiting disinfectants, such as a little bleach and water or a natural solution like tea tree oil and water. And consider investing in a better ventilation system.
Mold can often be found growing in closets, attics, cellars, planters, refrigerators, shower stalls, and garbage cans and under carpets. Even a fake Christmas tree can harbor mold.
Are there any medications that can help my child?
Yes, but don't give her over-the-counter allergy medicine without talking to your doctor first.
He may suggest antihistamines or a nasal steroid spray and offer you a prescription. Many of the newer allergy medicines have fewer side effects than other products on the market, though these medications are not approved for children younger than 6 months.
What about allergy shots?
If your child is really plagued by allergies, an allergist might suggest allergy shots (immunotherapy), but usually not until she's 4 to 6 years old. There are occasional exceptions for younger children, such as kids with severe asthma.
Allergy shots are given in the doctor's office and contain small doses of the offending allergen — like pollen, mites, or dander – that help your child's body get used to the substance over time.
With allergy shots, what usually happens is this: Your child receives weekly shots for about four to six months, until she's been exposed to enough of the allergen to train her body to tolerate it as well as possible. Then she continues getting shots once or twice a month for four to six months, followed by monthly shots for a year.
After that, the doctor evaluates the need for further treatments. If the shots have been helpful, your child might continue getting them for years.
What can I do to prevent my child from getting allergies in the first place?
There's a lot of conflicting information about preventing or delaying allergies by postponing – or accelerating – a child's exposure to potential allergens.
"Someday we'll be able to look at genetics and really know what a child is destined to be allergic to and what to do about it," says Virant. "But the reality is that, right now, there's nothing that predictably helps."
Of course, if you or your mate is allergic to cats, you won't want a feline in the house anyway. (Ditto for any other allergy-causing animal or substance.)
And keeping your home – in particular your child's room – clean and as free of mold and dust mites as possible is a good idea, regardless of whether your child has allergies.