For some children, sneezing arrives with springtime. Recent data from the National Health Inventory Survey indicate that 15 to 20 percent of kids younger than 18 years of age have a respiratory allergy, making it one of the most common conditions in children. When the allergy season affects your child will depend upon where you live and which allergies bother her.
The immune system usually protects the body from invading organisms that can cause illness. An allergy is the immune system over-reacting and producing antibodies to a usually harmless substance. The antibodies, immunoglobulin E (IgE), cause cells to release chemicals that result in an allergic reaction. Allergic reactions can cause symptoms — ranging from mild to very severe — in the eyes, nose, throat, sinuses, lungs, lining of the stomach or skin. Very serious allergic reactions are called anaphylaxis. Anaphylaxis can occur with a food, a drug or a bee sting allergy. It is not clear why some people have reactions, but kids who have family members with allergies are more likely to have them as well.
Spring is in the air in many parts of the country, and with spring comes tree pollen. Tree pollen is a major trigger of allergies. Actually there are three pollen seasons in most areas of the country. Besides tree pollen in the spring, there is grass pollen in the summer, and weeds, like ragweed, cause problems in the fall.
The seasons begin and end depending on the climate. Specific pollens are more common in certain areas of the country. Allergy maps online or allergy counts by local media can help you learn the allergy levels near your home. The National Allergy Bureau (NAB) is a source that compiles pollen and mold levels from certified stations across the nation. NAB is certified by the American Academy of Allergy, Asthma & Immunology (AAAAI). You can find allergy counts for your geographic region at www.aaaai.org/nab.
Ash, beech, birch, cedar, cottonwood, elm, hickory, maple, oak and pine trees pollinate in the spring and are common causes of a spring pollen allergy. Common spring allergy symptoms are: sneezing; a runny nose; a congested or stuffy nose; itching on the roof of the mouth, nose, or lips; itchy or watery eyes; and dark circles under the eyes. Allergic nasal symptoms may be called allergic rhinitis, which means inflammation of the nose. It may take several seasons for allergens to cause symptoms for kids. The data from the National Health Inventory Survey show that a respiratory allergy is more common in older, compared to younger, kids.
The good news is that usually symptoms triggered by spring allergens will stop when the season is over, but the bad news is that symptoms during the season can be severe and affect quality of life for child and family. Children can lose sleep, develop sinus infections, miss school and have more problems with asthma due to respiratory allergies. It’s sometimes difficult to tell if your child has a virus or allergies. Kids with viruses may have thick or colored nasal drainage, a fever, and symptoms that will resolve in seven to ten days. However, kids with allergies usually have clear drainage, no fever and a seasonal pattern to their symptoms. For example, the allergic child might have “a cold every spring.” Allergy symptoms that occur year round may be caused by indoor allergens such as dust mites, mold or animals.
The best way to prevent spring allergies is to avoid allergens. Easier said than done! You cannot keep your child in a bubble, but there are ways to avoid spring allergens and lessen a child’s exposure:
* Keep your car and home windows closed, and use air-conditioning.
* Encourage indoor play, activity and exercise when pollen levels are high.
* Keep your child indoors during any lawn mowing and leaf raking. (Note that lawn mowing and leaf raking are not good chore choices for an allergic child.)
* Wash hands and face and change clothes when coming from the outdoors.
* Bathe your kids and wash their hair before they go to bed.
Talk with your health care provider to develop an allergy plan for your child. The plan may include medicines to help relieve spring or pollen allergy symptoms. Medicines used to treat allergies include: antihistamine pills, liquids or nasal sprays; nasal corticosteroid sprays; decongestant pills or liquids; or leukotriene modifier pills. Your provider will help to determine which medicines are best for your child.
Antihistamines work to prevent or stop an allergic reaction. Some antihistamines are available over-the-counter, others are by prescription. Some older or “first generation” antihistamines such as diphenhydramine may cause sleepiness and may interfere with your child’s activities or schoolwork. Newer antihistamines are less likely to cause side effects. While antihistamines may be the most commonly used medicine for allergic rhinitis, nasal steroids may be an even better option. As prescribed by your provider, nasal steroids are safe and effective and will not cause sleepiness or addiction. Decongestants and leukotriene modifiers also may be prescribed to help with symptoms.
Your provider will take into account your child’s allergies and symptoms, as well as your preferences regarding medicines and your insurance coverage to determine the best medicine plan. Usually allergy medicines work best when they are started ahead of the allergy season. Working with your provider to determine the start-up time for your child’s seasonal allergy medicine is important. It’s hard to play catch-up once the allergy symptoms start.
Only you and your child will know if the medicines are helping, and it’s crucial to discuss their effects on the symptoms with your provider. Tell her if the symptoms are not improving once your child is getting the medicines as prescribed. Your provider might adjust your child’s medicine, prescribe different medicines, conduct further testing or recommend a visit with an allergist.
Allergists specialize in allergy and immunology. Regardless of your child’s age, an allergist will work to understand your child’s allergy. Some kids may benefit from allergy testing. Determining the specific allergens can help fine-tune your child’s allergy plan of care. When allergy symptoms are not controlled by avoidance or medicines, immunotherapy or “allergy shots” may be recommended as an effective, cost-efficient, long-term treatment. Immunotherapy is a series of shots that can build up your child’s antibodies, so her body doesn’t over-react when exposed to the allergens.
Every child should feel good and be able to play, sleep and attend school during every season. Sometimes a spring allergy is more than just a little sneeze.
Anne Borgmeyer, MSN, RN, CPNP-AC, AE-C, is a PNP at St. Louis Children’s Hospital, St. Louis, MO, and works with children with asthma and allergies in the in-patient setting.