Managing Allergies at School

Help keep your child on the ball despite allergies.

From the WebMD Archives

Does your child miss school due to allergies? If so, you're not alone.

Seasonal allergies are believed to affect as many as 40% of U.S. children. On any given day, about 10,000 of those children miss school because of their allergies. That's a total of more than 2 million lost school days every year.

Even if your child doesn't miss school, allergies can get in the way of a productive school day, so managing allergies at school is an important part of caring for your child's health.

Managing Allergy Symptoms at School

Symptoms like fatigue, headache, sneezing, runny noses, watery eyes, and itchiness can get in the way of attention and concentration, and the medications taken to manage these symptoms can also interfere with school performance. What's a parent to do?

At home, you can do a lot more to control your child's environment and limit exposure to allergens than you can at school. But it's worthwhile to ask your child's teacher or principal how they handle allergies at school, and if they will consider measures such as:

  • High-efficiency air filters
  • Keeping windows closed on high-pollen days
  • Asking the lawn crew to mow the lawns when children are not present.

Treating Allergies at School With Prescription Nasal Sprays

If your child has moderate to severe allergies, simple environmental control measures and over-the-counter medications probably will not control their symptoms well enough.

For these children, the best method of controlling many allergy symptoms is prescription nasal steroids, says childhood allergy specialist Charles E. Lowe III, MD, a pediatric allergy and asthma specialist in Pikeville, Ky.

"You only need to use a prescription nasal spray once a day, and they work best at controlling [nasal] allergy symptoms. They're the preferred first-line treatment," Lowe says. "But kids don't like spraying liquid up their nose, and there's a misconception that you can get hooked on them."

In fact, prescription nasal steroids do not cause dependency problems. (Over-the-counter sprays can cause dependency and rebound symptoms.)

Lowe recommends that a child begin using a prescription nasal spray at the beginning of local allergy season, and use it throughout the duration of seasonal symptoms. To avoid that unpleasant taste in the back of the throat, the child should be taught to take a big sniff right up the nostril.

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Turning to Antihistamines for Allergies at School

If you can't get your child to use a nasal spray, or if the sprays aren't completely controlling your child's allergy symptoms at school, then antihistamines are your next step. Antihistamines help reduce the symptoms of itching, sneezing, and runny nose.

Many parents worry that prescription antihistamines will leave their children groggy and unable to concentrate. Although antihistamines can have a slight sedating effect, Lowe says untreated allergies will make your child even drowsier and distracted.

"A lot of studies have looked at this. While kids who don't have allergies at all certainly do better in school in terms of alertness and staying on tasks, the kids with allergies who are treated do better than those who are not treated. You can't get them to be perfect, but you can get them a lot better," says Lowe.

Talk to your child's doctor to get a prescription for one of the antihistamines approved for young school-age children. There are quite a few available, including Allegra, Claritin, Xyzal, and Zyrtec.

Other Treatments for Allergies at School

Parents may be concerned about whether or not to treat their child's allergies with Singulair, a different class of antiallergy drug, after the FDA began investigating whether or not the drug played any role in the suicide of a 17-year-old boy who was taking it.

The American Academy of Allergy, Asthma and Immunology recommends that children taking Singulair should be monitored closely. "If they show no signs of depression or anxiety, they can stay on the drug," says Lowe. "But if they have any problems, they should be taken off."

Experts have also recently revisited the question of allergy shots for children. Previously, immunotherapy was not recommended for children under age 5. Now, as new evidence has accumulated that immunotherapy may be able to prevent the onset of asthma, new guidelines leave the question of whether or not to start allergy shots before age 5 up to the child's doctor.

"If your child has very bad allergies and a significant family history of asthma, and perhaps they're starting to wheeze when they have a cold, you might want to go ahead and start immunotherapy before age 5," says Lowe.

"If they're not responding to antihistamines or nasal steroids, immunotherapy is a good option. It's not one of those last resorts anymore, because it lets us actually modify the disease and prevent the onset of asthma."

WebMD Feature Reviewed by Brunilda Nazario, MD on July 01, 2008

Sources

SOURCES:

American Academy of Allergy, Asthma and Immunology, Milwaukee, Wis.

Charles E. Lowe III, MD, pediatric asthma and allergy specialist, Pikeville, Ky.

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