Category Archives: Allergies

What should I know about my child’s allergies (allergic rhinitis and conjunctivitis)?

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Suzanne Berman, M.D.

What are symptoms of allergies in children?

Allergies can show up many ways in children:

  • a chronic runny nose
  • a chronic stuffy/congested nose
  • a cough that won’t go away
  • red, puffy eyes with dark circles underneath

Allergies can also be manifested as atopic dermatitis (sensitive skin) and asthma (sensitive lungs.) Some children are unfortunate enough to have all three!  Although they may be worse in some seasons and better in other seasons, allergies are a chronic problem. This means they may last years, even one’s whole life.
What causes allergies?
The body’s immune system is trained to tell the difference between bad germs (like bacteria, viruses, and parasites) and harmless things (like fruits, cloth, and plastic.) The body gears up to fight infections when it is exposed to harmful germs, but is supposed to ignore harmless exposures.Sometimes, though, the body is too sensitive and overreacts to harmless material. These allergy-provoking items (called allergens) differ from child to child, but the most common are:

  • Dust
  • Fur and feathers
  • Cigarette smoke
  • Pollen
  • Molds

Should we test my child for allergies?
For many children, environmental allergies aren’t severe enough to warrant testing. We do recommend pinprick testing (at an allergist’s office) or blood sample testing (performed in our office) for food allergies, chronic allergies which aren’t responding to medication, or any allergy which has caused a severe reaction (wheezing or trouble breathing, for example.)

What allergy medications are safe for children?

Not all children with allergies require medications. Sometimes the allergies are mild and brief, or can be controlled adequately by making environmental changes. (See our information page on reducing allergens in the home and outside. Children with allergies severe enough to interfere with their lives should probably get some medication.For young children, medications are occasionally helpful. Otherwise, the best policy is generally the baby’s environment.

In older children, there are several medications that work quite well:

  • Nose sprays: Best for children with lots of congestion and nasal drainage. These help shrink swollen, boggy nasal tissue and dry up chronic drainage. There are both over-the-counter products (like Nasalcrom) and prescription products (like Nasacort, Nasonex, and Flonase.)  We can recommend one specifically for your child.
  • Antihistamines: These help block the over-reaction of the immune system and help nasal drainage, a scratchy throat, and cough. Over-the-counter antihistamines like Benadryl are inexpensive, but are sometimes sedating and make it difficult to stay awake in school. Newer antihistamines (like Claritin and Zyrtec, which are now over the counter) are not sedating and are safe down to 6 months of age.
  • Eye drops: Prescription allergy eye drops (like Patanol) work great for red, itchy, irritated eyes. Non-prescription eye drops like Visine do not help allergies: in fact, they can make itching worse.
  • Leukotriene antagonists: Singulair (montelukast) is a prescription medication originally designed for asthma patients which also helps with allergies.
What about allergy shots?

Allergy shots are designed to desensitize people to allergens. Allergy shots are customized for each individual, depending on what he or she is allergic to. They are painful and expensive, and sometimes don’t work very well for children. We recommend them when allergy medications don’t work, the allergen in question can’t be avoided, or if the allergy is quite severe.

What can I do to reduce allergen exposure outside?

Posted on by

Suzanne Berman, M.D

If my child has allergies, does this mean he can’t ever play outside?

No. It’s important for your child to get fresh air and exercise outside, just as much as any child. However, going outside without any precautions can make an allergic child miserable. Here are some tips to help your allergy-prone child get the most out of his or her active time outside:

  • Minimize outdoor play on days when the pollen count or humidity are high, and on windy days when mold and pollen are blown about.
  • Take a shower after spending time outdoors. Pollen and mold can accumulate on the skin and hair.
  • Consider vacations to relatively pollen-free areas, like the beach or seashore.
  • Be aware of what plans are particularly allergenic.
  • In the spring and summer, plants which tend to cause allergic reactions include: oak, elm, birch, ash, hickory, poplar, sycamore, maple, cypress, walnut, western red cedar, Timothy grass, Bermuda grass, orchard grass, red top grass, and sweet vernal grass.
  • In the late summer and fall, plants which tend to cause allergic reactions include: ragweed, sagebrush, pigweed, Russian thistle, and cocklebur.

You can also review our tips for making the inside of your home an allergy-friendly environment.

What can I do to reduce allergens in my home?

Posted on by

Suzanne Berman, M.D.

Is allergen control in the home worth my time?

Absolutely! Some of the benefits include:

  • Your child’s asthma and/or allergies will get much better. With the right environmental changes, sometimes allergy medications can be eliminated entirely.
  • Your house will be cleaner — and easier to clean.
  • Allergic and asthmatic guests to your home (about 20% of the population) will be more comfortable.

It will be to make every change listed here; some are expensive and inconvenient. Don’t let this discourage you, though. Go step-by-step through each room of the house and take a hard look at things you can change.

What can I do to reduce allergens in my home?

In your house:

  • Keep indoor humidity less than 50% with a dehumidifier if necessary. Be sure to empty the dehumidifier daily and clean it at least weekly.
  • Don’t forget to lower the humidity in the basement!
  • Use air conditioning, not fans. Air conditioning lets you keep doors and windows closed in warm weather and at night. After all the trouble you take to remove allergens from your home, don’t let allergens blow in from outside.
  • Change air filters regularly and clean out air-conditioning ducts and heating ducts yearly.
  • Don’t allow strong odors in your home, like wood stove smoke, paint or cleaner fumes, strong personal care product odors (like hairspray and perfume), and strong cooking odors (especially from frying.)

In the bedroom:

  • Wash all bedding weekly in hot (>130 F) water. (Cold water is less effective at killing allergenic organisms.)
  • Encase the mattresses, box springs, and all pillows with non-permeable casings. Casings with tightly woven frabrics (pore sizes of 6 micrometers) are the most effective.
  • Switch from featherdown pillows and comforters to synthetic, hypoallergenic materials.
  • Stuffed animals should be washed weekly. If they can’t be washed, put them in a bag in the freezer.

In the living room:

  • Remove carpets and use wood or tile floors. Small throw rugs should be washed weekly.
  • Remove or clean all heavy draperies and blinds. Use synthetic fibers instead of natural fibers for curtains where possible.
  • Remove or replace upholstered chairs and sofas, or cover with light slipcovers that can be washed weekly.
  • Remove things that accumulate dust (like magazine piles, knick-knacks, and clutter.)
  • Arrange furniture so it is easy to vacuum and dust.

With your pets:

  • Most pets, including cats, dogs, birds, and rodents, make allergies worse. Consider finding a new home for them, or making them outdoors-only pets. Tropical fish are ideal pets for people with allergies.
  • Cats are especially bad for allergies. Cat allergen can persist 24 weeks even with vigorous cleaning, and has been shown to last in mattresses for up to 15 years!
  • Keep all pets out of the bedroom. Never sleep or nap with pets.
  • Wash pets twice a week.

In the car:

  • Keep car windows closed while traveling.
  • Don’t forget to clean and vacuum your car. Dust and debris can build up there too.

With smokers:

  • NEVER SMOKE INSIDE THE HOUSE. Wear an old shirt or bathrobe over your clothes when you smoke, and leave it on the back porch or in the laundry room when you come inside — it’s contaminated with allergenic cigarette ash.

When cleaning the house:

  • People with allergies should leave when the house is being vacuumed, cleaned, or dusted. If this isn’t possible, wear a paper mask.
  • Use a damp cloth to catch dust. A dry cloth will stir dust up.
  • Clean moist areas, especially in and around the sink, toilet, and bathtub, weekly to kill mold.
  • Contact an exterminator if cockroaches, mice, or other pests inhabit your home.

You can also review our tips for reducing allergen exposure outside.