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Aero-Allergies in Kids

Aero-allergies are substances we take in with breathing that may sensitize our airways and result in inflammation with further exposures. Examples of aero-allergies are pollen, dust, mold and animal dander. Aero-allergies are unusual in the first 1-2 years of life, then often show up in early childhood. A family history of allergies, asthma or eczema (atopic dermatitis) is quite common. Nasal allergy (“allergy rhinitis”) may be seasonal (hay fever) or perennial (Year-round).

The inflammation from allergies causes tissue swelling and mucus production in the nose, throat, eyes (allergic conjunctivitis) and lower airways (asthma). Symptoms include nasal congestion, sneezing, cough (from post nasal drip or asthma), wheezing and itch. Aero-allergies may also aggravate eczema. Signs include sniffling, eye rubbing, rubbing the nose either vertically or horizontally (the “allergic salute”) and eye redness. Mouth breathing and a muffled voice or “hypo-nasality” occur from narrowing or closure of nasal passages and lack of voice resonance. Itch is really the sine qua non of allergy – especially itching of the throat, palate (roof of the mouth) and ears.

Chronic nasal congestion may lead to ear and sinus infections, hearing problems poor sleep and appetite, chronic fatigue and inability to focus at school. Snoring and loud breathing at night indicate a compromised airway, which may lead to obstructive sleep apnea. These kids may fall asleep at school or even be misdiagnosed with ADD.

Many parents may know or at least suspect their child has allergies, but fail to see the “big picture”. They don’t connect the dots between allergy and academic problems or sleep disturbance etc. Or if they do, they’re reluctant to “drug’ their child. This is really a shame since there are many effective and safe medications which will improve these kids’ quality of life.

Treatment with mild – moderate allergic rhinitis, empirical measures like “allergy-proofing” the child’s bedroom and doing a trial of medication for 6-8 weeks is appropriate. Medications include OTC’s like Zyrtec, Claritin and Nasalcrom; or prescription drugs like Singulair and inhaled steroid nasal sprays like Nasonex or Flonase. All these medications are extremely safe, including the nasal sprays (very little is systemically absorbed and they don’t stunt growth appreciably). Older OTC drugs like chlortrimeton and dimenhydramine (Benadryl) are usually too sedating to be practical.

With more severe symptoms or if the above measures fail, a consultant with an allergist would be the next step. Now, if only someone could come up with a cure for kids who are allergic to homework or doing his or her chores.

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Healthy Kidz Doc is written by a board-certified pediatrician who's practiced in Santa Cruz County since 1986. www.healthykidzdoc.yourmd.com


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