August 18, 2005
Clearing the Air About Allergies
Scary statistic to contemplate: About 10 to 15 percent of kids suffer from allergies, and the rate has been rising steadily for the past 20 years. Though no one knows why allergies are skyrocketing, we do know what causes them. Allergies are an immunological "overreaction" to a substance that enters the body through airborne particles such as pollen, skin contact, or ingested foods. Though this may sound quite simple, allergies are notoriously tricky to diagnose. The symptoms are remarkably diverse, varied in degree, and easy to confuse with other ailments.
1. If your child has cold symptoms that seem to drag on forever, allergies may be the real culprit. Does your child get endless but fever-free head colds -- complete with sniffling, sneezing, itchy nose, watery eyes, and noisy mouth-breathing? Could be that she's suffering from perennial allergic rhinitis, the body's unhappy response to such year-round allergens as dust mites and animal dander.
How to handle: Talk to your pediatrician about whether your child should be evaluated by an allergist/immunologist; a skin test can identify what triggers your child's symptoms. Once the results are in, you can work on minimizing the presence of the offending triggers. But unless you plan to lock your child in a mold-free closet for the rest of his life, complete elimination isn't always possible. Over-the-counter oral antihistamines and decongestants can help, but they can be sedating. Ask your doctor whether the prescription drug Claritin, a nonsedating antihistamine, is an option; it's approved for use by children age 6 and older.
2. If your child experiences these same symptoms, but they always strike in spring or summertime, you're probably dealing with seasonal allergic rhinitis. Sometimes inaccurately called hay fever, this kind of allergy can actually be triggered by an array of pollens that become airborne as plants bloom. Need further help diagnosing your child? Look for this give-away, says Dr. June Engel, a biochemist and author of "The Complete Allergy Book": Since your child's nose will be itching like crazy, he may well do what's known as "the allergic salute" -- he'll rub the palm of his hand upward against the tip of his nose to relieve the itching.
How to handle: Electric bills be damned: You may want to shut the windows and run air-conditioning during the height of the season to minimize pollen entering your home, says Dr. Francis V. Adams, pulmonary specialist and assistant professor of clinical medicine at New York University Medical School. Check with your pediatrician for advice on which antihistamines to try, and keep in mind that this medication actually prevents symptoms rather than cures them, so use them at the first hint of seasonal rhinitis.
3. Wheezing, coughing, tightness of the chest, and shortness of breath are usually hallmarks of asthma, an allergic condition in which the bronchial tubes narrow and the lungs become congested due to inflammation. Triggers may be anything from dust mites to mold to animal dander to cigarette smoke. Complicating matters still more, exercise has been known to bring on episodes, and in about 80 percent of cases, a viral infection will kick off the reaction. Typically, a child with asthma will experience his first symptoms before age 3.
How to handle: If your child wheezes or you have any other reason to suspect asthma, contact your pediatrician right away.
Obviously, you'll want to keep your child away from the specific allergens and irritants as much as possible (warning: this may mean finding the family pet a new home). Beyond that, your child should have a bronchodilator spray available to be used whenever he feels wheezy and take an anti-inflammatory drug on a regular basis to keep his airways open. If your child ever seems to be struggling for breath and his medication doesn't bring relief, bring him to the emergency room immediately.
4. When raised red patches crop up on your child's skin, you're probably dealing with hives. Hives can be an allergic reaction, commonly to an insect sting or food (peanuts, for instance).
How to handle: Of course, avoiding your child's triggers is the best defense. But if your child is afflicted, be on the lookout for those cases of hives that can turn deadly: "If your kid brushes up against a tree and gets only a hive or two, it's nothing to be concerned about; treat the itchiness with an over-the-counter oral antihistamine such as Benadryl," says Dr. Jack Becker, chief of the allergy section at St. Christopher's Hospital for Children in Philadelphia. "But if all of a sudden he feels funny -- that's how a child will typically describe the sensation -- has trouble breathing and is breaking out in hives all over, that's extremely serious."
This can progress to a potentially deadly condition known as anaphylactic shock, in which the tongue and throat swell up, cutting off the child's air supply. If your child ever does show these symptoms, call for an ambulance immediately.
The deadly stage of the reaction might not hit until 10 hours later -- when you mistakenly think everything's back to normal. Also, get a Medic Alert bracelet or some other kind of identification that will let emergency workers know what the problem is in case you're not present.
Beth Levine is a writer whose essays have appeared in Redbook, Woman's Day, Family Circle, the Chicago Tribune, USA Weekend and Newsday.