Pathway Pediatrics

What is Allergic Rhinitis?

Allergic rhinitis (also referred to by many as “allergies”) is a reaction that occurs when someone comes in contact with certain allergens in the air, or on their skin, that trigger the body to release histamine, a compound released by the body that causes an immune/inflammatory response in the body. 

Symptoms may include:

• Runny nose
• Itchy and/or watery eyes
• Sneezing
• Nasal congestion
• Itchy skin (or eczema flare ups)
  Other common symptoms may include drainage down the back of the throat, cough, fatigue, puffy eyes, and irritability. 

What is causing my child’s allergies?When your child’s body has an immune response to allergens in the environment, these are known as your child “triggers”. There are many triggers in a child’s typical environment. Some of these may include: 

• Dust Mites
• Cockroaches
• Mold
• Pollens
• Smoke
• Animal Dander (most commonly furry animals) 
• Certain chemicals (such as perfumes, cleaning chemicals, etc)
• Certain grasses/trees

What can I do to control my child’s allergy symptoms? The first line of defense against allergies is to reduce your child’s exposure to known irritants. Below we have listed some common ways to decrease exposure in your child’s home or daily activities. 

• Dust Mites:  Dust mites congregate in places where there is plenty of food for them (human skin flakes). Therefore, they are found more in bedding, upholstered furniture, rugs, carpets, etc.  You can reduce exposure to dust mites by following these recommendations:
  
  • Cover your child’s mattress and pillows with a special allergy-proof cover
  • Wash bedding/sheets/pillowcases in hot water every 1-2 weeks
  • Replace pillows at least every 2 years
  • Remove stuffed toys from the bedroom
  • Dust and vacuum regularly (at least 1-2 times per week)
  • Use an allergy friendly air filter and change at least every 90 days
  • Other (more difficult or expensive) measures that may be helpful include removing carpet in the bedroom/home and investing in a dehumidifier to reduce humidity in the home
    
• Molds: As many know, mold can be in areas unseen. Mold thrives in areas of higher moisture/humidity. This can occur from water damage due to flooding, leaking roofs/pipes, etc. Some ways to reduce mold exposure:
  • Invest in a dehumidifier
  • Repair any leaks in the home
  • Use exhaust fans in the bathroom/kitchen
  • Clean existing mold contamination with detergent and water
  • Certain porous materials (ex: wallboards with contamination) may need to be replaced.
    
• Animal Dander: If your child is truly allergic to furry animals, the only true way to reduce exposure is to remove the pet from the home completely. If this is not possible, or you choose not to do so, it is best to not allow the animal into the child’s bedroom or onto the furniture. You may also follow the recommendations for dust mites to reduce animal dander in the home. 
• Smoke: Smoke can be a very troublesome irritant for most children. 
  • Limit your child’s exposure by avoiding smoking (or allowing anyone to smoke) in your home or car
  • Change your clothing and wash your hands before coming in contact with your child if you have been smoking. 
  • Avoid your child being outside around an actively burning grill, firepit, etc.
• Outdoor irritants (such as pollen/trees/grasses): Obviously, you cannot keep your child indoors 24/7. Children want and need to be outdoors to run and play. The best ways to control your child’s allergy symptoms related to pollens or outdoor exposure are to:
  • Avoid letting your child play outside while someone is cutting grass/weed eating the lawn, or immediately after.
  • Keep windows and doors closed during times of high pollen count to reduce amount entering the home
  • Keep your child inside during days with poor air quality. You can check online for the air quality rating for the day. Any day listed as orange or red indicates poor air quality and the likelihood of your child having a reaction if excessively exposed. 
  • See below for information about the use of antihistamines to control your child’s response to these irritants.

Depending on your child’s symptoms, there are medication options that may help decrease the body’s response to allergens. 

Antihistamines suppress the effects of histamine that cause the itching, runny nose, watery eyes, and other allergy symptoms. Starting antihistamines at the first sign of symptoms could prevent your child from having a worse reaction or symptoms later. 

• Long acting: In children with known allergies, daily medications may be helpful to prevent problems (seasonally or year around) with allergy symptoms. The most commonly used medications are:
  • Claritin (loratadine) 
  • Zyrtec (cetirizine) 
    There are liquid and tablet options for both. Call our office if your child’s age or weight is not listed on the back of the bottle’s dosing chart to determine whether your child is eligible for this medication. 
• Short acting: At times, children may require quick relief (or short acting) medications to help during intense itching, drainage, or severe allergy symptoms. An example of the most commonly used short acting medication is Benadryl (diphenhydramine). 
  • Benadryl may be given up to every 6 hours as needed. Most commonly it is given at bedtime.
    
  • Benadryl should not be needed on a daily basis. If you find you are regularly needing to give Benadryl to your child, call our office regarding whether or not your child should see an allergy specialist.  
  • If your child is under 2, contact our office to determine whether or not he/she should take this medication. 
  • Some medications may contain or similar medication as Benadryl. If your child is currently taking any cough medications or other allergy medications, do not administer Benadryl without discussing with one of our nurses or providers to ensure your child does not receive too much. 
    

Intranasal corticosteroids are available over the counter as an option for control of allergy symptoms such as runny nose and/or nasal congestion. 

• Flonase or Nasocort are available over the counter and may be administered 1-2 sprays per nostril once per day
• Keep in mind that if this medication is only sprayed into the nostril and not taken appropriately, it will not be effective. Your child should be able to sniff gently as the spray is being administered to ensure the medication is received. 
• DO NOT confuse medications like Afrin with Flonase or Nasocort. Afrin is a nasal decongestant, which is different from an intranasal corticosteroid. Your child should not use Afrin on a daily basis as this can cause more problems and rebound congestion. Call our office for questions or concerns. 

Your child does not have feel miserable during allergy season. By decreasing exposure to known irritants and providing the most effective medication regimen, he/she can enjoy this exciting time of the year!

https://www.healthychildren.org/English/health-issues/conditions/allergies-asthma/Pages/Asthma-Triggers-and-What-to-do-About-Them.aspxhttps://www.healthychildren.org/English/health-issues/conditions/allergies-asthma/Pages/Seasonal-Allergies-in-Children.aspxhttps://www.healthychildren.org/English/health-issues/conditions/allergies-asthma/Pages/Allergy-Medicines.aspx
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