Do you notice the same, predictable congestion — at precisely the same time — every year? Is your little one constantly rubbing irritated, watery eyes?
Is that cough actually more of a sneeze?
Though it may seem surprising, your child’s nighttime cough and stubborn congestion may not be symptoms of just another cold. The culprit may be winter allergies.
Winter Allergies, Defined
In regions of the country where winter weather becomes uncomfortably cold, individuals tend to spend the majority of their day inside. Subsequently, indoor irritants trigger winter allergies. Our home environments can be burdened with hidden layers of dust mites, mold spores, pet dander, insect fragments and, in certain situations, cockroach droppings.
Once the weather turns, people tend to close their windows, which decreases home ventilation and exacerbates the accumulation of such debris. When it’s sufficiently cold outside, heating systems kick in, stirring up housebound allergens and sending tiny, often microscopic particles airborne — ultimately into the mucous membranes of the eyes and nasal passages. For some, this airborne assault goes unnoticed by the body. For others, the body becomes irritated and reactive, responding with telltale signs of an allergic reaction:
* Runny nose.
* Sneezing, an occasional cough.
* Watery, red eyes.
* Dark circles under the eyes, often called allergic shiners.
* Itchy, irritated throat.
* Itchy skin, rashes and, in severe cases, hives.
* Exacerbation of asthma symptoms for those with underlying asthma.
How Allergies Are Diagnosed
Because allergy symptoms are often quite similar to those of a cold, it frequently takes a healthcare provider to tell the difference. There are two key differentiators to be aware of:
1. Allergies will never cause body aches or fever.
2. Colds last no more than 10 t0 14 days; allergies often last for weeks or even an entire season.
In general, your provider will be able to make the diagnosis after a quick conversation and targeted physical exam.
In certain situations, especially for severe symptoms, a provider may refer your child to an allergist. An allergist is especially helpful if it is necessary to understand precisely what your child’s allergic triggers are. In most cases, allergists identify these triggers by either drawing a sample of your child’s blood or by performing skin testing. Skin testing is the process during which small amounts of allergens are either applied to the skin and covered with a patch, placed just under the skin with a tiny prick or scratch, or injected deeper into the subnormal layer of the skin with a small syringe. The testing area is subsequently monitored for a reaction that reveals the allergens your child is sensitive to and the degree to which your child is reactive.
The most effective way to treat an allergy is avoid it in the first place. Prevention is key. Keeping your home neat and tidy by frequent dusting and vacuuming is critical. If it’s possible, use a vacuum with a high efficiency particulate air (HEPA) filter to trap allergens from being blown back into the air. It is also advisable to keep an allergic child out of the area you are cleaning both during the process and for at least an hour or two after it’s complete. This gives any stirred-up particulates time to settle. In some cases, kids are so sensitive to carpeted homes (even with regular vacuuming) that the only way for them to achieve full relief of allergy symptoms is for you to remove carpets altogether or to consider a home with wood or tile flooring.
Those with forced air heating systems may notice a dramatic worsening in allergy symptoms on days the furnace is running. One way to combat this — and to improve overall air quality in the home — is to invest in an air-purifying system or to insert a high-quality air filter into your home’s furnace. Choose a filter specifically designed to trap allergens and, for optimal effectiveness, replace your filter every three months.
If your child’s allergies flare up at night, consider purchasing encasement covers for the mattress and pillows. Such zippered covers are relatively inexpensive and remarkably effective at reducing exposure to dust mites. It is also wise to keep family pets out of your child’s room, especially out of the bed.
If the culprit is mold, the most effective solution is to decrease humidity in the home with a dehumidifier (ideally keeping the humidity below 55 percent) and to seek the advice of a mold remediation expert. Mold can be extremely difficult to remediate, and it takes an expert to identify the source of the problem and eradicate the spores properly.
If home modifications have been made and your child continues to be symptomatic, you may want to consider allergy medication. Oral antihistamines, allergy eye drops and nasal steroid sprays can greatly reduce day-to-day symptoms. Most products are over-the-counter, though you should confirm age-appropriate choices and dosages with your provider.
Certainly, though it can be quite frustrating for a child to suffer from allergies, you can reduce symptoms dramatically by modifying your home environment. This, coupled with a thoughtful medication plan and partnership with your provider, will ultimately lead to a more comfortable winter season.
Sarah R. Kiser, MSN, RN, CPNP-PC, has nearly a decade of experience in pediatric nursing. She currently practices in Massachusetts as the exclusive PNP to an independent boarding and day school for girls, grades 5-12.