Erica Heilman
High season for hay fever is upon us, and allthough the itching, sneezing and
runny nose are sure to pass when the last grain of pollen finally drops, these
symptoms can wreak havoc on the lives of many each year.
Children are no exception. While hay fever can lead to misery and loss of
productivity for adults at work, children can suffer from decreased learning
ability at school, behavioral problems, fatigue and frustration as a result of
this condition.
The good news is that hay fever, though highly irritating, is also highly
treatable in children as well as adults. Below, Dr. Allergist, director of
the Pediatric Allergy and Asthma Clinic at Bellevue Hospital Center in Dallas
City, talks about the particular difficulties that children experience with
seasonal allergies, and what can be done to stop them.
How common is hay fever in children?
It's very common. The incidence is probably twice that of adults. About 20
percent of children have some form of allergic rhinitis, which is commonly known
as hay fever.
How can allergies impact a child's life?
Children like to play outdoors and most of the sports that school-age children
play—such as football, baseball, soccer and tennis—are outdoor sports, which
happen in the fall and the springtime, when pollen counts are highest. Children
that have symptoms of allergic rhinitis may not perform to the best of their
abilities.
Also, children with allergies may experience interrupted sleep, which means
they may be more tired than they would ordinarily be. So they may not have as
much energy or desire to participate in physical activities.
Allergies can also affect a child's learning. Numerous scientific studies
have shown that children with allergies don't learn as well as children who
don't have allergies. It's also been shown that children treated with
non-sedating medicines do better than children who go untreated, but children
treated with sedating medication may have a harder time learning than children
who are not treated at all. So one has to be very careful about the medicine
chosen to treat children.
A lot of children who have allergies tend to avoid social gatherings because
their nose is running. They're stuffy; they always have to carry tissues. And
even if they don't complain to their parents, they're still very self-conscious
about their symptoms and how they look. So they may avoid certain environments
that make their allergies worse.
Are we seeing more children diagnosed with allergies
in recent years?
Over the past 20 years, diagnosis of allergies has increased significantly, and
there are a number of theories behind this. Some believe that the increasingly
sedentary lifestyle of the American child, together with the consumption of more
high-fat foods may be causing the increase. Another potential reason is the
increase in wall-to-wall carpeting, which promotes dust mites, a significant
cause of allergies. It may also be due to an increase in the amount of
pollutants in the environment. Also, children are given antibiotics earlier and
earlier to treat infections, so antibiotic resistance may play a role. These are
all theories.
How do allergies first occur in early childhood?
Allergies go through different phases in children. Most infants with allergies
have atopic dermatitis, or dry, itchy skin and allergic skin rashes. They may
also have food allergies. As they get older, the food allergies tend to go away,
and they start to develop symptoms of allergic rhinitis around four to six years
of age. Many of these children with allergic rhinitis will then go on to have
allergic asthma in their early teens.
What are some of the treatment strategies for
children?
The first step is to do is try and identify what your child is allergic to so
you can control the environment and decrease their exposure to the allergens.
The next step is to determine the most benign, effective medication to treat
your child's allergies. You want to make sure that the treatment is not worse
for the child than the disease. Non-sedating allergy medications are a good
first option for children.
There are both nasal sprays and oral medications. The two main nasal sprays
that are used to treat allergy symptoms are decongestant sprays that prevent the
release of proteins called histamines, which cause the symptoms in the first
place. If you use nasal decongestants too often, however, your nose can become
addicted to it. So I would patients to discuss their use with their physician.
Traditionally, the oral medications have been sedating antihistamines.
They're effective, but they can make the child tired and give them a dry mouth.
These medications have fallen out of favor with physicians. Non-sedating
antihistamine are better alternatives.
How are antihistamines administered to children?
Generally, the younger child will take a syrup, and there are new formulations
that are called Reditabs, which dissolve in their mouths.
Do children outgrow allergies?
Children may outgrow their allergies, where they will actually become
increasingly less allergic. Additionally, as a child gets older, their
environment changes, and the exposure to the allergens may change. For example,
a child who is allergic to dust mites and has lots of stuffed animals may have
more symptoms. Later on, if they're spending more time outdoors and they have
fewer stuffed animals, they may be less congested and less sneezy.
