Allergies in Children
Overview
Allergies are problems of the immune system. Most allergic reactions happen when the
immune system reacts to a “false alarm.” Normally, the human body defends itself against
harmful things such as viruses or bacteria. But sometimes the defenses violently attack
mostly mild things, such as dust, mold, or pollen.
Normally, allergens are harmless. But when a person has allergies, the body thinks
these allergens are harmful. The body then attacks allergens with antibodies called
immunoglobulin E (IgE). These antibodies are attached to special cells called mast
cells. Allergens stick to the antibodies. This makes the mast cells release histamine
and other chemicals causing an allergic reaction. When the chemicals irritate nearby
nasal tissue, this causes nasal allergy symptoms. When this happens in the lungs'
breathing tubes, it can cause asthma symptoms such as coughing and wheezing. When
the
reaction involves the whole body, it can be a severe allergic reaction.
Symptoms
An
allergic reaction can happen anywhere in the body, including the skin, eyes, lining
of
the stomach, nose, sinuses, throat, and lungs. These are the places where immune system
cells are found to fight off germs that are breathed in, swallowed, or come in contact
with the skin. Allergic reactions can cause:
- Stuffy
nose, sneezing, itching, or runny nose, and itching in ears or roof of mouth
- Red,
itchy, watery eyes
- Red,
itchy, dry skin
- Hives or
itchy welts
- Itchy
rash
- Asthma
symptoms, such as shortness of breath, coughing, or wheezing
- A
severe, life-threatening allergic reaction called anaphylaxis. This medical emergency
can cause trouble breathing, coughing, vomiting, diarrhea, low blood pressure,
fainting, or death. Call 911 right away.
Causes
Many
things can trigger allergic reactions. But the most common triggers or allergens
are:
- Tree,
grass, and weed pollens
- Natural
rubber latex
- Molds
- Dust
mites
- Animal
dander, urine, and oil from skin
- Foods
- Medicines
- Feathers
- Bee
stings
- Pests
such as cockroaches and mice
Risk Factors
Allergies can affect anyone. It doesn't matter regardless of age, gender, race, or
socioeconomic status. Generally, allergies are more common in children. But they may
occur at any age. Allergy symptoms may also come back after being in remission for
many
years.
Allergies tend to happen in families, but the exact reason isn’t yet understood.
Allergy symptoms often develop slowly over time.
Diagnosis
To
diagnose an allergy, the healthcare provider will take a complete health history and
examine your child. The provider may also do these tests:
-
Skin test.
This is the most common allergy test. Skin tests measure if there are IgE
antibodies to certain allergens (like foods, pollens, or animal dander). A small
amount of diluted allergen is placed on the skin. The area is pricked or scratched.
If a person is allergic to the allergen, a small raised bump (like a mosquito bite)
appears after about 15 minutes. Testing for many allergens may be done at the same
time. An allergist may also do an intradermal test. In this test, a small amount of
allergen is injected just under the skin. This type of skin testing is more sensitive
than prick or scratch testing. Skin test results are available right after the
testing is done.
-
Blood test.
Blood tests for allergies measure IgE antibodies to certain allergens in the
blood. The testing that is most often used is called RAST (radioallergosorbent test).
Blood tests may be used when skin tests can't be done, such as in people with certain
skin conditions or those with a very recent severe allergic reaction. A positive
blood test does not always mean that you have a certain allergy. Any positive blood
test needs to be interpreted by a healthcare provider who is familiar with the tests
and knows your child's health history. These tests take longer to get results. It
may
be more costly than other allergy tests.
-
Challenge test. This test is supervised by an allergist. A very small amount
of the allergen is given to the child by mouth. Or it is breathed in. Only a
challenge test can figure out how severe an allergy is. Skin or blood test reactions
only tell the likelihood of having any type of reaction, not what that reaction will
be.
Any positive test needs to be explained by a healthcare provider who
is familiar with the test and your child's health history.
Treatment
Treatment will depend on your child’s symptoms, age, and general
health. It will also depend on how severe the condition is.
The
symptoms of allergies sometimes look like other conditions or health problems. Always
see your child's healthcare provider for a diagnosis.
The 3
most effective ways to treat allergies are avoidance, allergy shots (immunotherapy),
and
medicine. Avoidance means staying away from something that gives you an allergic
reaction.
Suggestions for staying away from allergens are:
- Stay
indoors when the pollen count is high and on windy days.
- Control
dust in the home, particularly your child’s bedroom.
- Use air
conditioning instead of opening the windows.
- Put a
dehumidifier in damp areas of the home. But remember to clean it often.
- After
playing outside when the pollen counts are high, have your child take a bath or
shower, wash their hair, and change clothes.
Take
vacations in areas where pollen is not as common, such as near the ocean.
Your
child’s healthcare provider will also have suggestions for staying away from the
allergens that cause reactions.
Treatments for hay fever (rhinitis) may include:
- Antihistamines
- Nasal sprays
- Decongestants
- Medicines for asthma symptoms
- Allergy
shots (allergy immunotherapy)
- Allergy
tablets (sublingual immunotherapy)
Decongestants are not recommended for children younger than age 4. Talk with your
child’s healthcare provider for more information about allergy medicine.
Key Points
- Allergies are problems of the immune system. Most allergic reactions happen when the
immune system reacts to a “false alarm.”
- Allergic reactions are often caused by tree, grass, and weed pollens, latex, molds,
dust mites, foods, and medicines.
- Tests used to diagnosed allergies include skin tests, blood
tests, or challenge tests.
- The 3
most effective ways to treat allergies are avoidance, allergy shots (immunotherapy),
and medicine.
- Working
with your child's healthcare provider or allergist can help reduce or get rid of
allergies.
Next Steps
Tips
to help you get the most from a visit to your child’s healthcare provider:
- Know
the reason for the visit and what you want to happen.
- Before
your visit, write down questions you want answered.
- At the
visit, write down the name of a new diagnosis and any new medicines, treatments, or
tests. Also write down any new instructions your provider gives you for your
child.
- Know why
a new medicine or treatment is prescribed and how it will help your child. Also know
what the side effects are.
- Ask if
your child’s condition can be treated in other ways.
- Know why
a test or procedure is recommended and what the results could mean.
- Know
what to expect if your child does not take the medicine or have the test or
procedure.
- If your
child has a follow-up appointment, write down the date, time, and purpose for that
visit.
- Know
how you can contact your child’s provider after office hours. This is important if
your child becomes ill and you have questions or need advice.