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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.

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).

In This Article

    Tips parents need to know about poor air quality and caring for kids with asthma

    There are steps parents can take to keep their children as healthy as possible.

    When wildfires struck the West Coast in September 2020, there was a lot for parents to worry about. For parents of children with asthma, though, the danger could be even greater. "There are more than 400 toxins that are present in wildfire smoke. That can activate the immune system in ways that aren't helpful by both causing an inflammatory response and distracting the immune system from fighting infection," says Amy Oro, MD, a pediatrician at Stanford Children's Health. "When smoke enters into the lungs, it causes irritation and muscle spasms of the smooth muscle that is around the small breathing tubes in the lungs. This can lead to difficulty with breathing and wheezing. It's really difficult on the lungs."

    With the added concern of COVID-19 and the effect it can have on breathing, many parents feel unsure about how to keep their children protected. The good news is that there are steps parents can take to keep their children as healthy as possible.

    Here are tips parents need to know about how to deal with poor air quality when your child has asthma.

    Minimize smoke exposure.

    Especially when the air quality index reaches dangerous levels, it's best to stay indoors as much as possible. You can find out your area's AQI at AirNow.gov. An under 50 rating is the safest, but between 100-150 is considered unhealthy for sensitive groups, such as children with asthma. "If you're being told to stay indoors, listen. If you can, keep the windows and doors closed," Oro says.

    Do your best to filter the air.

    According to Oro, a HEPA filter is your best bet to effectively clean pollutants from the air. Many homes are equipped with a built-in HEPA filter in their air conditioning systems, but you can also get a canister filter. Oro says her family (her husband and children all suffer from asthma) also made use of a hack from the New York Times and built their own filter by duct taping a HEPA furnace filter to the front of a box fan. "It was pretty disgusting what we accumulated in the first 20 hours in our fan," she says.

    Avoid letting your child play outside or overly exert themselves in open air.

    "Unfortunately, cloth masks don't do very much [to protect you from the smoke pollution]," Oro says. "You really need an N95 mask, and most of those have been allocated toward essential workers." To keep at-risk children safer, Oro recommends avoiding brisk exercise outdoors. Instead, set up an indoor obstacle course or challenge your family to jumping jacks periodically to keep everyone moving safely.

    Know the difference between smoke exposure and COVID-19.

    "COVID-19 can have a lot of the same symptoms—dry cough, sore throat, shortness of breath and chest pain could overlap. But what COVID and other viruses generally cause are fever, chills, vomiting, diarrhea and body aches. Those would tell you it's not just smoke exposure," Oro says. When a child has been exposed to smoke, they often complain of a "scrape" in their throat, burning eyes, cough, shortness of breath, chest pain or wheezing. If the child has asthma, parents should watch for a flare of symptoms, such as coughing, wheezing or a tight sensation in their chest.

    Unfortunately, not much is known about long-term exposure to wildfire smoke on a healthy or compromised immune system, but elevated levels of air pollution have been associated with increased COVID-19 rates. That's because whenever there's an issue with your immune system, it distracts your immune system from fighting infections and you have a harder time fighting off viruses. Limiting your exposure to wildfire smoke is your best bet to keep immune systems strong.

    Have a plan in place if you think your child is suffering from smoke exposure.

    Whatever type of medication your child takes for asthma, make sure you have it on-hand and that your child is keeping up with regular doses. Contact your child's pediatrician, especially if your area has a hazardous air quality—they may want to adjust your child's medication schedule or dosage to prevent an attack. Oro also recommends that, if your child has asthma, it might be helpful to have a stethoscope or even a pulse oximeter at home to help diagnose issues with your pediatrician through telehealth.

    Most importantly, don't panic.

    In some cases, social distancing and distance learning due to COVID may be helping to keep sensitive groups like children with asthma safer. Oro says wildfires in past years have generally resulted in more ER visits for children, but the most recent fires haven't seen the same results. "A lot of what we've seen is that the smoke really adversely affects adults, especially older adults over 65," Oro says. "Children tend to be really resilient."

    This article was sponsored by Stanford Children's Health. Thank you for supporting the brands that support Motherly and mamas.

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