When Your Child Has Allergies

From the WebMD Archives

For the parent of a young baby or toddler, it's easy to miss the signs of nasal allergies.

"A lot of parents don't realize," says Neeta Ogden, MD, an allergist in Closter, N.J. "They assume that the constant runny nose and sneezing are just what happens when a child's exposed to day care germs."

While allergies in kids are underdiagnosed, the good news is that treatment really works. With medical care, your baby or toddler will not only feel better, but you could head off complications in the future, says Kenneth Bock, MD, pediatric neurotoxicologist and codirector of the Rhinebeck Health Center in Rhinebeck, N.Y.

Has your kid spent a lot of her life sneezing and drippy-nosed? Here's what you should know about nasal allergies in kids.

Nasal Allergies in Kids

While allergies are the most common chronic disease in children, some pediatricians won't diagnose nasal allergies in kids until they're age 4 or 5, Ogden says. The conventional wisdom is that it takes a number of years before a true allergy can develop.

However, the waiting rooms of pediatric allergists tell a different story. "I see a lot of kids who are age 3 with signs of nasal allergies," says Ogden. "I see some who are as young as 2."

The symptoms of nasal allergies in kids include:

  • Runny and itchy nose
  • Congestion
  • Frequent sneezing
  • Chronic cough
  • Red, watery eyes
  • Allergic shiners -- dark rings under the eyes
  • Mouth breathing, especially while asleep
  • Exhaustion, because of poor sleep quality
  • Symptoms that last longer than a couple of weeks

The problems with nasal allergies in kids go well beyond a runny nose. The constant congestion can lead to frequent sinus infections and ear infections. "Some kids have so many ear infections that they can't hear well," says Ogden. "That can lead to developmental delays."

Nasal allergies in kids are often linked with two other allergic conditions: eczema and asthma. In many kids, it starts with itchy patches of eczema as infants, progresses to nasal allergies as preschoolers, and then develops into asthma later.

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What Causes Nasal Allergies in Children?

Kids tend to be allergic to the same things that adults are, like dust mites, pet dander, mold, and pollen. Some children also have allergies to foods, like cow's milk, that can sometimes cause nasal symptoms.

The fragrances in household products like cleaners, shampoos, detergents, and soaps an also be a problem. They may contain allergens as well as chemical irritants that worsen symptoms.

What increases the odds of allergies in kids? Some of it is genetic. "If a parent has allergies or eczema, that substantially increases the odds that their kids might have allergies too," says Ogden.

Will your child outgrow her allergies? Ogden says that many kids do outgrow early food allergies. The long view is different with allergic rhinitis, however. "The nasal symptoms might wax and wane over the years," says Ogden, "but the allergy itself tends to stick around."

Diagnosing Nasal Allergies in Kids

The key to treating nasal allergies in kids is finding the allergic trigger. That can be tricky, especially in babies or toddlers. Allergy blood tests work fairly well in kids 3 and older, but they're not very reliable in children younger than that, Ogden says.

"It can take a little medical detective work to figure out what's causing the symptoms in young kids," says Bock. Ask yourself some questions. Have the symptoms changed:

  • At different times of the year?
  • When you're away from home or from household pets?
  • When your child has been out of day care for a few days?
  • After a leak or flood?
  • After renovations?

Making note of any changes in your child's symptoms could be helpful for your doctor. With food allergies, an elimination diet can be a way of finding the cause, Bock tells WebMD.

When you're trying to determine what your child might be allergic to, be methodical and work with your doctor. Don't jump to conclusions.

Some parents focus on a specific allergen without much evidence. As a result they waste effort and money making radical changes to their households -- banning common foods or undertaking extensive renovations. Then they find that their kid is still sneezing, and they were treating an allergy he didn't really have.

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Controlling Nasal Allergies in Kids

If your kid does have nasal allergies, your doctor might suggest allergy medicine. You might worry about using medicines in a young child, but there are some safe and effective treatments available. Go over the pros and cons with your doctor -- and never start using an over-the-counter allergy drug without a pediatrician's consent.

One key to good allergic control doesn't involve medicine. If you can keep your kids away from whatever triggers their symptoms, they'll feel better. That's the basic premise of environmental control. Here's how it's done.

  • Cover your child's crib or bed mattress with a dust mite-proof cover. Dust mites are a common cause of nasal allergies in kids. Ogden also recommends washing bedding weekly in hot water with an extra rinse cycle.
  • Get rid of the stuffed animals. Yes, it might seem heartless to take away your child's favorites. But stuffed animals can be a haven for dust mites and other allergens. If you don't remove them, wash them regularly in hot water. Sticking them in the refrigerator for 24 hours can also help, Ogden says, since it will help kill dust mites.
  • Keep your child's room uncluttered. The less stuff in your child's room, the less dust -- and the fewer potentials allergens.
  • Remove carpets and heavy drapes. They just trap dust and allergens. Use rugs that you can wash instead.
  • Use a vacuum with a HEPA filter. Standard vacuums might not have filters that are fine enough to catch allergens. As a result, they might spew those allergens back into the air.
  • Clean with a wet rag or mop. Sweeping or dusting might just move the allergens around.
  • Use air conditioners to filter allergens from outside. Clean or replace the filter regularly, Ogden says.
  • Reduce your reliance on chemical cleaners with strong scents. They're common irritants that can worsen allergies. Some fragrances contain allergens.
  • Don't allow smoking in the house. Tobacco smoke can be hard on kids with nasal allergies.
  • Remove pets from the household. If dander seems to be a problem, you may need to think about finding a new home for your pet. At the very least, keep pets out of your child's bedroom and playroom.

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If these suggestions seem like more than you can handle, remember that even small steps can help. Babies and toddlers with nasal allergies can handle some exposure to an allergen without symptoms. It's only once the allergens reach a certain concentration that the allergic response kicks in.

In the same way, a kid with nasal allergies might only have symptoms after exposure to multiple allergens, says Bock.

"Allergies are additive," Bock tells WebMD. "It's not always just a pollen or just a food." For instance, a child with an egg allergy might find that it only flares up during ragweed season. It can take a combination of exposures to push the body into an allergic reaction.

Your goal doesn't need to be an allergen-free home. Making a few sensible changes and reducing your child's overall exposure may be enough to stop the symptoms.

Coping With Nasal Allergies in Kids

Trying to get a handle on your baby or toddler's nasal allergies can be frustrating. Try not to get overwhelmed.

"It's really important that parents don't feel like they’re in this alone," Bock says. Instead, you need to work together with your child's pediatrician or allergist.

"You might not get the answer to your child's allergy symptoms right away," Bock tells WebMD. "But together you and a doctor can chip away at the problem." In time, you'll find the right approach -- and everyone will breathe a little easier.

WebMD Feature Reviewed by Michael W. Smith, MD on August 26, 2010

Sources

SOURCES:

Tanya Remer Altmann, MD, pediatrician; clinical instructor, Mattel Children’s Hospital UCLA, Los Angeles; author, Mommy Calls: Dr. Tanya Answers Parents' Top 101 Questions About Babies and Toddlers.

Kenneth Bock, MD, pediatric neurotoxicologist; co-founder and co-director, Rhinebeck Health Center, Rhinebeck, N.Y; author, Healing the New Childhood Epidemics.

Sonya Lunder, MPH, senior analyst, Environmental Working Group, Washington, D.C.

Neeta Ogden, MD, allergist, Closter, N.J.

American College of Allergy, Asthma, and Immunology.

Healthy Child Healthy World: "Clean Carpets without Dangerous Chemicals."

Seattle Children's Hospital.

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