Allergies

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KEY POINTS

• An allergy is the body’s reaction to a substance that is normally harmless. With allergies, your child’s body sees the substance as harmful or foreign and the immune system reacts to the substance.
• Treatment may include avoiding the things your child is allergic to, and medicines.
• Your child may also need to wear a medical alert bracelet or necklace that warns of your child’s allergy and tells what to do in case of an emergency.

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What are allergies?

An allergy is the body’s reaction to a substance that is normally harmless. With allergies, your child’s body sees the substance as harmful or foreign and the immune system reacts to the substance. Substances that can cause an allergic reaction are called allergens. Allergic reactions are common.

What is the cause?

The immune system is the body's natural defense against bacteria, viruses, and other foreign substances.

Before your child can have a reaction to a particular substance, the immune system must first be sensitive to it. Usually this means your child’s body must be exposed to the substance at least once. Once it is sensitive to it, your child’s body will react every time your child has contact with the substance. Most reactions are mild, but some are life-threatening.

Many things can cause an allergic reaction. Your child’s body may react to an allergen when breathing, swallowing, or touching it. The most common allergens are:

• Pollen, which is small particles in the air from grasses, weeds, or trees
• Mold
• Animal dander (dried skin flakes)
• Dust and dust mites (very tiny bugs)
• Latex, which is a liquid from rubber trees that is used in many products such as gloves and toys
• Medicines
• Insect stings and bites
• Foods such as shellfish, fish, eggs, milk, tree nuts, peanuts, and wheat
• Chemical irritants such as nickel, dyes in fabric, or cleaning products
• Poison oak, poison ivy, or poison sumac

It is not known why some people develop allergies.

Your child may have an increased risk if other people in your family have allergies. Also, children who are around tobacco smoke may be more likely to have allergies and asthma. Children may outgrow some food allergies as they get older.

What are the symptoms?

Allergy symptoms may go away in a few minutes without treatment, or they may last for several days. Common allergy symptoms may include:

• Sneezing
• Itchy, watery eyes
• Stuffy or runny nose
• Swelling of the eyelids
• Itching, a rash, or hives (raised, red, itchy areas on the skin)
• Stomach pain
• Diarrhea

Sometimes an allergic reaction may be severe. This is called anaphylaxis and is a life-threatening emergency. It can affect the whole body within minutes. Insect stings, certain foods, and drugs such as penicillin are some of the more common causes of severe allergic reactions. Symptoms of a severe allergic reaction may include:

• Severe trouble breathing, including wheezing
• Swelling of the lips, tongue, or throat
• Hives
• Pale, cool, damp skin
• Fast or pounding heartbeat
• Nausea and vomiting
• Feeling intense fear that something terrible is about to happen
• Drowsiness, confusion, or fainting

How are they diagnosed?

The healthcare provider will ask about your child’s symptoms and medical history and examine your child. Most common allergies can be diagnosed from your child’s history and physical exam.

Tests may include:

• Blood tests
• A skin prick test, which uses a drop of liquid allergen extract put under your child’s skin using a needle
• Elimination diet, which means your child avoids eating certain foods for a few weeks to see if allergy symptoms go away
• Food challenge test, which is eating food that is a possible allergen to see if your child has a reaction. This test is done only by a healthcare provider who is ready to treat your child if your child has a serious reaction to the food.

How are they treated?

Your child’s treatment will depend on the type of allergy your child has and the symptoms. Mild symptoms may not need treatment, but your child may need to avoid the known allergen.

Several kinds of medicines may be used to treat allergies:

• Decongestants reduce swelling in the nose and sinuses. They may also lessen the amount of mucus made by the nose. If your child uses decongestants more often than directed, your child’s stuffy nose may get worse. Do not give decongestants to children under the age of 4. If your child is between the ages of 4 and 6, ask your healthcare provider before giving decongestants.
• Antihistamines block the effect of histamine and help reduce symptoms. Histamine is a chemical the body makes when your child has an allergic reaction. Do not give antihistamines to children under the age of 4. If your child is between the ages of 4 and 6, ask your healthcare provider before giving antihistamines.
• Steroid medicines, taken as pills or nasal sprays, help reduce the irritation and swelling in the body. By lessening the swelling, your child will have fewer symptoms and be able to breathe better. Make sure that your child takes steroid medicine exactly as your healthcare provider prescribes. Your child must not take more or less of it than prescribed or take it longer than prescribed. Your child should not stop taking a steroid medicine without your child healthcare provider's advice. You may have to lower your child’s dosage slowly before stopping it.
• Immunotherapy is a type of treatment that includes shots or pills containing small amounts of the allergens your child is allergic to. It may be recommended if your child’s allergy symptoms cannot be controlled with medicine. It may take several months of treatment before symptoms get better.

A severe allergic reaction is life-threatening and usually needs to be treated with epinephrine. Epinephrine relaxes the muscles in your child’s airways and throughout the body. It is usually given as a shot. Your child may need more than one shot to decrease symptoms. If your child is known to have a serious reaction, your child’s provider may want your child to carry an emergency kit. You or someone with your child can give the shot. Whether or not your child has epinephrine, call 911 or your local emergency services right away for all severe allergic reactions.

How can I take care of my child?

Follow the full course of treatment prescribed by your child's healthcare provider. In addition, teach your child to:

• Try to avoid the things your child is allergic to.
• Not smoke or use e-cigarettes and stay away from others who are smoking.
• Wear a medical alert bracelet or necklace that warns of your child’s allergy and tells what to do in case of an emergency. Teach family members and teachers how to help if your child has a severe reaction.
• Carry an emergency kit at all times, if one was prescribed. Use it as directed by your child’s provider. You should check the expiration date for the medicine and replace it as needed to make sure it will work.
• Call 911 or your local emergency services for all severe allergic reactions.

Ask your child’s healthcare provider:

• How and when you will get your child’s test results
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

For more information contact:

• The Asthma and Allergy Foundation of America
  800-727-8462
  https://www.aafa.org/
• The Food Allergy & Anaphylaxis Network
  800-929-4040
  https://www.foodallergy.org/

How can I help prevent allergies?

There is no sure way to prevent allergies.

If your family has a very strong history of allergies, try to avoid your family's most common allergens.