Diagnosing, treating and managing your child’s symptoms.
Allergies are among the most common chronic conditions. Symptoms range from feeling miserable to being at risk for life-threatening reactions. An allergic reaction begins in the immune system, which protects against organisms invading our system and making us ill. If you have an allergy, your immune system considers the allergen an invader and reacts by releasing a histamine. An allergic reaction typically triggers symptoms in the nose, throat,sinuses, ears, lungs and lining of the stomach or on the skin. For some people, allergies can also trigger symptoms of asthma. In the most serious cases, a life-threatening reaction called anaphylaxis can occur, which can cause swelling in the throat, an inability to breathe and/or hives. The most common symptoms are coughing, sneezing, runny nose, nasal congestion and itchy nose, eyes, throat, ears and skin.
A number of different allergens are responsible for allergic reactions. The most common include pollen, dust and dust mites, animal dander, mold, insect stings, cockroach and mouse droppings, and food. If your child is having allergy symptoms, your healthcare provider may be able to help you identify the allergens that are triggering the symptoms. Your provider may do blood work or send your child to an allergy specialist to have allergy testing.
* Allergy injections or drops in the mouth are used to desensitize your child to the allergen. This is done by an allergist and is a commitment of a few years.
* Antihistamines work with your child’s immune system, helping to decrease some symptoms.
* Nasal steroids decrease inflammation in the nose.
* Leukotrienes are sometimes added with your child’s antihistamine to decrease allergy symptoms.
* Allergy eye drops are sometimes added to help red, itchy eyes.
* Getting daily pollen counts helps you predict whether your child will struggle with allergies that day. You can find out the daily pollen count through several resources:
- Subscribe to a website that will send you daily emails reflecting the pollen count in your area.
- Get an up-to-the-minute pollen count directly on your phone by downloading a mobile app.
- Listen to the weather report.
* Avoid or decrease exposure
* Shower after being outside and avoid the outdoors between noon and 4 P.M. during high-pollen days.
* Use the medicine that your provider has recommended when your child is having symptoms.
Dust and Dust Mites
* Encase your child’s pillows and mattresses using allergen-impermeable encasings.
* Wash bedding weekly to remove allergens.
* Wash bedding in hot water (130° F) to kill mites.
* For non-encased bedding (such as blankets and quilts), choose items that can withstand frequent hot-water washing.
* Remove or wash and dry stuffed toys weekly.
* Use a HEPA vacuum cleaner.
* Avoid humidifiers. They increase humidity, which promotes dust mites. The goal is to have humidity at 50 percent.
* Replace draperies with blinds.
* Remove any carpeting from your child’s bedroom.
* Remove upholstered furniture.
Your pet’s hair/fur is not what causes an allergic reaction or aggravates asthma. The culprit is the protein found in a pet’s dander, skin flakes, saliva and urine.
* Use encasings, a HEPA air cleaner and a HEPA vacuum.
* Keep your child’s room animal-free.
* Keep pets outside, and bathe them weekly.
* As a last resort, find another home for your pet.
Many people who are allergic to mold develop symptoms outdoors when mold spores are in the air. Symptoms occur indoors if mold is in the home, school or workplace.
* Decrease humidity to less than 50 percent.
* Use a dehumidifi er or central air conditioner.
* Avoid using a humidifier.
* Vent bathrooms/clothes dryers outdoors.
* Use an exhaust fan in the bathroom and in other damp areas.
* Check faucets and pipes for leaks, and repair them.
* Have a licensed contractor inspect mold levels in your home.
Stings can range from mild to serious (life-threatening). A mild reaction is usually swelling and soreness at the site. A serious reaction can be diffi culty breathing due to swelling in the throat. If this happens, call 911 and follow up with your child’s provider for further evaluation. Your child may receive an epinephrine autoinjector to have at all times in case of another sting.
Cockroaches and Mouse Droppings
Integrated pest management (IPM) is long-term prevention of pests that is environmentally friendly and safe. Always use the least toxic methods first.
* Clean up food/spills.
* Store food and trash in closed containers.
* Fix water leaks.
* Clean counter tops daily.
* Use boric acid, a low-toxicity mineral with insecticidal, fungicidal and herbicidal properties. Use caution with children nearby.
* Use bait stations/gels.
* Don’t spray liquids in your home, especially in sleep/play areas, and avoid using industrial-strength pesticides that require dilution.
Your child may have an intolerance or an allergic reaction to a particular food.
* Avoid foods that give your child allergy symptoms.
* Ask your provider about replacing food items as needed if your child is allergic to dairy or other important food groups.
* Some children can have life-threatening reactions to food and may need to carry an epinephrine autoinjector with them in case of accidental ingestion.
Talking to your child’s provider can help identify the causes of the symptoms, which will allow you to manage them at home. Untreated allergies can cause secondary infections in the ears, lungs and/or sinuses. Controlling an allergy is key to preventing your child from feeling bad, missing school or facing more serious concerns such as triggering asthma or an anaphylactic reaction.
Tami Kochan, RN, MSN, CPNP, AE-C, works in primary care at Hillsboro Pediatrics, Hillsboro, OR. She is chair of the NAPNAP Allergy Asthma Special Interest Group and has taught asthma to students and parents. She has also lectured OHSU FNP students on pediatric asthma.