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Allergies are not just an annoyance. If you or your child suffer from seasonal allergies or experience severe allergic reactions to food, you know that allergies can be a serious health issue that can interfere with daily activities and impact the quality of life.

It's important for parents to partner with a pediatrician or board-certified allergist for diagnosis and treatment of all allergies, food or environmental.

Since it's impossible for parents to control absolutely everything their child eats and is exposed to, the American College of Allergy, Asthma, and Immunology (ACAAI) recommends that parents instead focus on monitoring their child for symptoms.

Here are some warning signs to look out for if you think your child has allergies:

Environmental allergies

First a sneeze. Then a complaint of an itchy throat and a congested or runny nose. Maybe there's eye redness or fluid buildup in the ears. It's not always easy to decipher if your child has a cold or an allergy. Here's a clue: If there's no fever and symptoms last one week or longer, it's probably an allergy.

And if it's springtime, there's a good chance your child is allergic to grass, tree or ragweed pollen, or mold spores that hide outdoors in damp, dark places such as under fallen leaves. When your child breathes in pollen or mold, the immune system identifies it as a dangerous invader and produces antibodies to destroy it—a process that results in allergy symptoms such as mucus and inflammation.

Common indoor allergens include pets, dust mites found in bedding, furniture and rugs, cockroaches, mice and indoor mold. Physical contact with indoor allergens such as pet dander or saliva can also cause itchy skin and hives in addition to nasal and respiratory symptoms. A reaction can happen within minutes or may be delayed for hours after the exposure.

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Allergic rhinitis is one of the most common illnesses among both adults and children. It's often referred to as "hay fever"—even though there's no connection to hay and there's no fever. Triggers include both seasonal and indoor allergens.

Symptoms of allergic rhinitis include:

  • Runny nose with clear or pale-colored mucus
  • Sneezing
  • Red, watery eyes
  • Itching around the nose, mouth or eyes

Left untreated, symptoms may worsen leading to nasal congestion, intense coughing, sore throat, headache, or an ear or sinus infection.

If your child develops these symptoms and they linger for more than a week, it's best to see a pediatrician or allergist for allergy testing and a discussion of treatment options. Plenty of over-the-counter and prescription medications are available, but it's best to discuss which best meet the health needs of your child.

You may also want to discuss with your doctor allergen immunotherapy, which desensitizes patients to their allergen so they can be exposed to it without symptoms. Allergy shots cover pollen, mold, pet dander, dust mites, and cockroach allergens; allergy tablets, which dissolve under the tongue, cover grass and ragweed allergens. Both are options for children.

Food allergies

Approximately six million children have food allergies, according to Allergy and Asthma Network. Symptoms can be different each time there's an exposure to a food allergen, and they can vary in severity each time—but once they start, they usually progress quickly.

People can be allergic to any food, but the most common food allergens in the United States include:

  • cow's milk
  • eggs
  • peanut
  • tree nuts
  • fish
  • shellfish
  • wheat
  • soy

In addition, sesame allergy is on the rise in the United States.

Most food-allergic reactions are mild, but there are approximately 30,000 episodes of food-induced anaphylaxis—a severe, life-threatening allergic reaction—every year in the United States.

Symptoms to watch for include:

  • itchy, red skin
  • swelling
  • hives
  • itchy mouth, swelling of lips or tongue
  • vomiting, cramps, diarrhea
  • coughing, wheezing, chest tightness, or shortness of breath
  • headache
  • nasal congestion
  • sweating
  • watery eyes

Anaphylaxis can occur when two or more organ systems—such as skin, respiratory, digestive, or heart—are impacted. When symptoms are severe, your child may also become dizzy or faint, feel confused, or even lose consciousness.

When anaphylaxis strikes, epinephrine is the only drug that will treat symptoms. And it should be given as soon as a severe reaction is suspected. The medication, a form of adrenaline, will suppress the immune system's response to the food allergen, halting the life-threatening effects.

When epinephrine is administered for a severe allergic reaction, the child should immediately go to the hospital for additional evaluation and treatment.

Delays in administering epinephrine can increase the risk of hospitalization and more serious reactions.

What about using an antihistamine like Benadryl®?

While antihistamines may be effective for mild allergic reactions, they do not treat severe or life-threatening reactions. And when allergic reactions occur, there's no way of knowing whether it will progress from mild to severe.

The only proven way to prevent an allergic reaction is to avoid the offending allergens —that's why an accurate diagnosis is essential.

Other severe allergies

In addition to food, children may experience severe allergic reactions to insect venom, latex, and certain medications.

Stings by wasps, hornets, bees, and fire ants have been known to trigger anaphylaxis. Exposure to latex, found in balloons, rubber bands, mouse pads, pacifiers, goggles, rubber gloves, and thousands of other consumer products, can cause skin irritation and potentially lead to a severe reaction.

And medications such as antibiotics, aspirin, and non-steroidal anti-inflammatory drugs can trigger anaphylaxis symptoms.

Similar to food-allergic reactions, epinephrine is the first-line treatment for severe reactions to insect stings, latex, and medications.

If you have any concerns regarding your child's allergies, speak with your pediatrician. Knowledge and some precautions will empower you and your child to be as safe as possible.

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Purvi Parikh, MD, is an allergist and immunologist with Allergy & Asthma Network. She practices in New York City at Allergy and Asthma Associates of Murray Hill and the New York University School of Medicine. She is on the Board of Directors for the Advocacy Council of the American College of Allergy, Asthma & Immunology (ACAAI).

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