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Monday, April 19, 2021

Allergy/ Immunology

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Hay Fever in Children

Sniff sniff. No, I’m not sad; it’s just another lousy spring allergy season. Seasonal allergies (hay fever) cause symptoms at certain times of the year. There are different types of allergens that can be inhaled, including pollens from trees, weeds, grasses, as well as dust mites, animal dander and molds. When a child with seasonal allergies inhales these substances, their immune system will react to them, and this results in runny nose, congestion, sneezing or itchy, watery eyes, and even increased respiratory symptoms in those with asthma.

Springtime in Shreveport/Bossier City is usually the most miserable time for hay fever sufferers due to tree pollen season starting in February and peaking in March. Grass pollen season usually begins in April and peaks in May. With some grass pollen lingering through the beginning of summer, it can make for a very long spring allergy season!

Most children with seasonal allergies begin having noticeable worsening of their hay fever during the elementary and middle school years. Patients with worse seasonal allergies have a higher likelihood of having other allergic conditions such as food allergies, eczema and asthma. Sometimes, children have difficulty explaining their symptoms, so signs such as sneezing, eye rubbing and swelling with dark circles appearing, and mouth breathing can indicate uncontrolled allergies. Uncontrolled allergies can impair your child’s sleep, which in turn may affect their memory, concentration and performance in school. If your child is having difficulties in school, you may want to consider allergies as a potential cause.

An allergist-immunologist is a specialist in this condition who can evaluate your child for allergies by doing an allergy skin test, or sometimes, a blood test. During a skin test, your child is pricked on the back with a small plastic instrument that contains some of the allergen. If your child is allergic to the allergen, the skin will become red, welt up and start itching around the pricked area. The good news is that the test doesn’t hurt, and the reactions disappear within an hour or two.

There are several treatment options for seasonal allergies. Most patients have tried over-the-counter antihistamine medications, but the next step is a steroid nasal spray when that isn’t enough. This will reduce the inflammation in the nose and improve the symptoms of runny nose and nasal congestion. Antihistamine medications are helpful for runny nose, sneezing and itching. They come in several forms, including pills, nasal sprays and eye drops. Nose rinses with salt water can reduce the pollen build-up in the nose.

Using air conditioning rather than keeping the windows open in your home may prevent pollen from entering. Vacuums with a HEPA filter will also help you keep your home free of allergens. If your child plays outside and has exposure to pollen, having them change their clothes when they come indoors and take a shower may help prevent symptoms.

Allergy immunotherapy (allergy shots) is the only cure for seasonal allergies. Your allergist will prescribe them based on your child’s allergy testing. Initially, allergy shots are given every week for close to one year, but after this “build-up” period, they can be spaced out to once a month. Most patients need to receive allergy shots for between three to five years in total but begin to see improvement in their symptoms after about six to 12 months. Although this is a big commitment to make, allergy shots may save your child from a lifetime of miserable symptoms and allow the sniff sniff of springtime to become a thing of the past.

Contributions by Vikram Malik, MD, and David Kaufman, MD, LSU Health Shreveport, Department of Pediatrics.

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