Kids Love Dr. Barton

It's Allergy Season Again

by Dr. Douglas Barton, M.D., Pediatrician 04/08/2009

You know what you have. The itchy eyes, itchy nose, constant drainage from the nose, the near constant sneezing, and the morning yuck stuck in your throat. It’s allergy season again and you’re miserable! This is not a difficult problem for adults to diagnose…but for children, there are as many questions as there are answers.

The big question is whether or not children really can have allergies. Many experts believe that children under the age of three can not be shown to have a true allergic reaction to environmental allergens…that is, a reaction to pollens, molds and pets. At odds with this belief is my own personal experience, as well as the experience of many parents who have seen their children experience the chronic runny nose, red eyes and sneezing when they go outside during a certain time of the year. I also believe that some form of allergies can contribute to sinus infections and ear infections. And I have seen children as young as one year old respond appropriately to allergy medications.

The first thing to try to do when confronted with possible allergies is to minimize exposure. The easiest way to do this is close up the windows and turn on the air conditioning as allergy season approaches. But you don’t want to stay inside, you say! Again, we’re trying to minimize, not eliminate exposure. Spend short periods of time outside, and then head back in.

Medications have come a long way in treating allergies. Benadryl is the old stand-by. It probably works better than most other oral medications, but it is likely to be sedating, and interferes with concentration in school age children. Zyrtec, Claritin and Allegra are also antihistamines that have some effect on allergies. The nasal steroids, in my opinion, produce a much more significant response to the nasal symptoms of allergies. These are once or twice-daily medications that may also help with snoring and have few side effects other than the occasional nosebleeds. Singulair is a non-antihistamine medication that seems to work best in kids with asthma who also have allergies (which is most of them). It recently obtained approval for the treatment of pure allergies.

Allergy testing is something I reserve for when all of the above treatments fail. Allergy testing is not 100% reliable. A patient may test positive for something they don’t react to and may test negative for something they do react strongly to. It’s unclear why this happens. Nonetheless, if avoidance and medications don’t work or become cumbersome, allergy testing can give guidance to an allergist in developing an allergy immunotherapy plan (allergy shots) for you or your child.

As you can see, the treatment of allergies can be very complex. If you have questions about whether or not your child has allergies, it may be time to contact your pediatrician.




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