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. Morris Nejat, director of the Pediatric Allergy
and Asthma Clinic at Bellevue Hospital Center in New York 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.
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