The enemy may be invisible, but the symptoms certainly are not. Itching, swelling and irritation in the eyes, nose and throat from things like pollen, dust and animal dander affect up to 40 percent of children in the U.S. And while allergies or hay fever, a.k.a. allergic rhinitis, often tends to flare up in the spring and summer, some unlucky children — and their parents — end up battling it year round.
But experts emphasize that in many cases seasonal allergies aren’t something families need to lose sleep over; often they can be managed at home if parents keep an open dialogue with their pediatrician, use over the counter medications correctly and know what signs to look for in case their kids allergies may need some extra attention.
The first step is determining whether allergies are, in fact, the culprit. Dr. Miriam Anand, advisor to the Asthma and Allergy Foundation of America, tells Yahoo Life that while symptoms like sneezing and runny nose can make it hard to tell the difference between a virus and allergies, things like itchy eyes and nose and absence of a fever likely point to the latter. And while children are more prone to catching colds, those symptoms generally resolve in five to seven days; allergies, however, can last for weeks, months or longer.
And if you’ve suffered from allergies in the past, odds are your child will, too.
“Look at the parents,” Dr. Clifford Bassett, a clinical assistant professor at the NYU Grossman School of Medicine and founder and medical director of Allergy and Asthma Care of NY, tells Yahoo Life. “I would say more than half of my patients if not higher will have at least one family member with allergies, asthma, eczema, food allergies and so forth. So it’s about genetics.”
Parents may worry about how best to treat their little one’s allergies, wondering if they’re doing too much or too little to help alleviate their child’s symptoms. But while allergy meds may seem daunting, experts say they can be helpful when used correctly.
“It’s not so much over-medicating as probably inappropriately medicating,” Dr. Paul Williams, former chair of the American Academy of Pediatrics Section on Allergy and Immunology, tells Yahoo Life of parents fretting about using over the counter allergy drugs on their kids.
Williams says a big mistake parents can make is using “old fashioned” first generation antihistamines, which have been around for over sixty years and include oral medications like diphenhydramine. They may need to be taken up to six times a day to be effective, and are notorious for making children and some adults feel drowsy. Some parents even try to harness the drugs’ sedative qualities to get their kids to sleep on long car or plane trips, but experts warn this could have the opposite effect; first generation antihistamines can cause hyperactivity in roughly 10 to 15 percent of children. Instead, newer second and third generation antihistamines like fexofenadine and cetirizine are now recommended as the best choice for parents. They only need to be taken once or twice a day, and have less side effects.
“If they’re going to be using medications,” Williams says of worried parents, “it’s important to steer them to the right medications, and reassure them that correct medications are not over medicating or harmful.”
Allergy medications can be safe and helpful — but not all meds are created equal.
“Many parents are concerned about using medications in their child,” Anand says. “It is important to remember that using certain medications, such as a daily antihistamine, is associated with much fewer side effects than treatment with steroid pills or syrup.”
“The fact that they may only be given occasionally, such as once a year, may mislead one to believe that it is better for their child than the daily medicines,” she explains of oral steroids. “The opposite is true, however.”
Regular use of oral steroids for allergies, Williams says, can have adverse effects.
“Primarily with children, growth is often the earliest manifestation,” he explains. “They have decrease in growth rate, which can result in ultimately shorter children, if they’re used frequently.”
Williams says his first choice for children with nasal allergies is usually a nasal steroid spray, which works by reducing inflammation in nasal passages and doesn’t have the risky side effects of an oral steroid. But he acknowledges some kids may resist having medicine sprayed up their nose. So if nasal sprays are a no-go, Williams suggests a non-sedating antihistamine as the next best thing. Both options are considered safe and effective, but work best if taken before symptoms begin.
Still, Williams cautions parents that if they’re regularly relying on two or three medications to keep their child’s allergies at bay, that’s when it may be time to visit an allergist. Options could include immunotherapy, also known as allergy shots, which works for adults and kids as young as five-years-old by giving injections of the allergen to gradually build up tolerance or immunity.
Other signs that your child’s allergies may need some extra attention include a persistent cough, wheezing, shortness of breath or complaints of chest pain, which Anand says may be indicators of asthma. A fever or complaints of ear pain should also be a red flag for parents.
“If allergy symptoms aren’t treated,” Anand explains, “they can get worse and lead to other issues, such as ear or sinus infections.”
Long-term untreated allergies may also cause other problems. Congestion can force kids to breathe through their mouths, which if unaddressed over time may lead to "tongue thrust" — a condition where the tongue sits lower in the mouth to allow for better airflow, resulting in speech impediments. This can also cause the child’s teeth to shift, increasing the need for orthodontics later on.
But in general, Williams says parents shouldn’t stress too much; more than anything else, the reason to treat allergies is if they’re interfering with a child’s quality of life. If sneezing and congestion are causing your child to avoid enjoying time outdoors with friends, interfering with sleep or making it difficult to concentrate in school, that’s when over the counter allergy medications or possibly a more tailored approach from an allergist may be a good idea.
“But otherwise, no, if it’s just a runny nose and it doesn’t bother them, then you don’t really need to treat it.”
Bassett says trusting your pediatrician will also help many parents of allergy-sufferers breathe a little easier.
“If you have a child or even an adolescent, you’re going to rely on the pediatrician,” he says. “I think it’s important to have a dialogue. Clearly there are individuals that would absolutely benefit from visiting a board certified allergist to find out whether they indeed have a variety of the allergic conditions that are treatable, identifiable, manageable. And instead of guessing, we can actually work on things that work, that are safe, that have been around that are designed to improve quality of life.”
“There’s also good news,” he adds. “As a child I had allergies and asthma — so did my son — and we tend to grow out of it.
So about the only benefit of aging I can tell you is that as you get older, allergies in many people tend to dissipate or improve.”