ALLERGIES
Allergic rhinitis is an inflammation of the nasal membranes and
eyes caused by sensitivities to certain particles in the environment, such as pollen and molds (spring and fall) or dust mites and animal dander (all year round). The symptoms of allergic rhinitis are a runny or stuffy nose, sneezing, itching of the eyes, nose, or throat, and sometimes headache and fatigue.
The first step in treatment is to help your child avoid the allergens causing the problem. Dust mites, mold, and pets are the major indoor allergens. Concentrating on eliminating allergens from the bedroom is often an effective first step, since children spend eight to twelve hours each day in the bedroom. See the NIH Fact Sheet "How to Create a Dust-Free Bedroom" for tips on how to do this.
Dust mites are microscopic organisms which live in
bedding, rugs, and upholstered furniture. They survive on human and
animal skin cells, fabric fiber and food crumbs and thrive when the
humidity rises above 50%. The most effective way to decrease your child's contact with dust mites is to cover the bedding, mattresses and box springs in air-tight vinyl or nylon cases that zip shut. Also, remove drapes and upholstered furniture and wash linens, area rugs and stuffed animals frequently using water hotter than 130 degrees. Cold or warm water does not kill dust mites. Other effective control measures are to remove bedroom carpeting, avoid wool blankets and use synthetic pillows (not down or feathers).
Mold grows where humidity is high. In addition to the above
measures, use chlorine bleach to reduce mold growth in bathrooms, cellars and other damp areas. Pets with fur or feathers should be given away, but if this is not possible at least do not let them in the child's bedroom. A weekly bath will decrease the amount of allergen a furry animal sheds. Outside the problem is usually pollen.
Pollen counts are the highest between 5 a.m. and 10 a.m., so keep your child's bedroom window closed at night during pollen season. It is also helpful to keep car windows closed to avoid pollen blowing into children's faces while driving in the car. For current data on pollen counts in the Greater Boston area, see the web site of the National Allergy Bureau.
Medications can help relieve many of the symptoms of allergies. Antihistamines can help control the runny nose and itchy eyes. Many antihistamines have the side effect of making the child sleepy, but there are new types of prescription antihistamines that do not have a sedating effect. Anti-inflammatory nose sprays can also be very helpful and have minimal or no side effects. New eye drops can help to minimize redness, itching, and tearing of the eyes without causing burning or irritation. It is generally a good idea to take allergy medication regularly during your child's allergy season, rather than only when symptoms are present. Speak with your child's doctor for more information on these medicines.
Occasionally, environmental controls and medications will not relieve symptoms, so your pediatrician may refer you to an allergist for your child. Allergists usually try some skin testing to diagnose the offending agents and then may start a series of desensitizing injections ("allergy shots".) We generally resort to allergy testing and possible shots only when the above efforts fail. Fortunately, this happens infrequently. Allergy shots are not useful for food allergies.
With the correct treatments, most children will be able to find relief from allergy symptoms and be able to function happily.
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