Slievemore Clinic, Old Dublin Road
Stillorgan, Co. Dublin
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20% of the population have some type of allergy and in most people these allergies first appear during infancy or childhood. It is not surprising that allergic disorders rank first among children's chronic diseases.
Any child may become allergic, but children from families with a history of allergy are more likely to be allergic. Children may inherit the tendency to become allergic from their parents, but only some of them will develop active allergic disease. Allergies can show up in different ways in children. Some children get skin rashes (atopic eczema/dermatitis) from allergy, some develop asthma, and some get allergic rhinitis, or hay fever.
Hay fever, also known as seasonal allergic rhinitis, is the most common of all allergy problems. It is characterized by a runny, itchy nose, sneezing, pos tnasal drip and nasal congestion. The child with allergies may also have itchy, watery and red eyes and chronic ear problems. Despite its common name, "hay fever" these allergy problems can occur at any time of the year -- seasonally or year-round.
The following are just a few points on potential problems for children with allergic rhinitis. Early identification of allergic problems in your child will improve their quality of life, decrease missed school days and keep you at work.
Allergies are the most common cause of chronic nasal congestion in children. Sometimes a child's nose is congested (obstructed) to the point that he or she breathes through the mouth, especially while sleeping.
If the congestion is left untreated, this mouth breathing forces air currents through the mouth. The force of the air then changes the way the soft bones of the face grow. The face may actually become abnormally elongated in a pattern called "adenoidal face." This causes the teeth to come in at an improper angle as well as creating an overbite. Braces or other dental treatments may be necessary to correct these problems. Early treatment of the allergies causing the nasal congestion may prevent these problems.
Allergies lead to inflammation in the ear and may cause fluid accumulation that can promote ear infections and decreased hearing. If this happens when the child is learning to talk, poor speech development may result. Clinically, allergies can cause earaches as well as ear itching, popping and fullness ("stuffed up ears"). Anyone with these symptoms should be considered for testing and treatment.
Autumn is back to school time. For allergic children, that may mean absences due to problems related to nasal allergy. The following are some of the problems to look for so that allergy can be properly diagnosed and treated, as well as several suggestions for helping the allergic child.
The best food for a newborn is mother's milk. However, some especially sensitive babies can have allergic reactions to foods their mothers eat. Babies can be tested for allergies. Eliminating these foods from the mother's diet may provide relief for the child, but some babies will be allergic regardless of what their mothers do. When this occurs, your physician may recommend a hypo-allergenic (special low allergy) formula.
As infants grow, their nutritional needs continue to change and your doctor will advise when it is time for solid foods. It is best to start with foods that generally do not cause allergic reactions in adults -- carrots, pears, potatoes and rice, for example. Foods that should be avoided early on include wheat, eggs, corn products, citrus fruits and nut butters.
Solid foods should be introduced one at a time in small quantities -- a teaspoonful, for example. After 3-4 days, if the child is adjusting well to the new food item, another may be introduced. As the child becomes accustomed to a variety of foods that do not traditionally cause allergic reactions, foods from the second list above may be introduced in small quantities as well, one at a time. This progressive introduction of food items allows parents to better monitor potential allergic reactions to specific kinds of foods.
Cow's milk is another food that frequently causes allergies in children, but it is a nutritionally important part of a child's diet. Milk should be eliminated from a child's diet only if you are sure the child is allergic to it. Parents may suspect allergy if the child exhibits respiratory problems or rash. If you suspect your child may be allergic to dairy products, consult your doctor.
Sneezing, wheezing, watery eyes and runny nose aren't the only symptoms of allergic diseases. Many people with allergic rhinitis also report feeling "slower" and drowsy. When their allergies are acting up, they have trouble concentrating and remembering.
Many parents of children with allergic rhinitis observe increased bad moods and irritability in their child's behaviour during the allergy season. Since children cannot always express their uncomfortable or painful symptoms verbally, they may express their discomfort by acting up at school and at home. In addition, some kids feel that having an allergic disease is a stigma that separates them from other kids.
It is important that the irritability or other symptoms caused by ear, nose or throat trouble are not mistaken for attention deficit disorder. With proper treatment, symptoms can be kept under control and disruptions in learning and behavior can be avoided.
Experts believe the top two culprits contributing to cognitive impairment of people with allergic rhinitis are sleep interruptions and over the counter (OTC) medications.
Secondary factors, such as blockage of the Eustachian tube (ear canal), also can cause hearing problems that have a negative impact on learning and comprehension. Constant nose blowing and coughing can interrupt concentration and the learning process, and allergy-related absences can cause people to miss school or work and subsequently fall behind.
Chronic nasal congestion can cause difficulty in breathing, especially at night. Waking is a hard-wired reflex to make you start breathing again. If you have bad allergic rhinitis, you may waken a dozen times a night. Falling back asleep can be difficult, cutting your total number of sleep hours short.
The average person needs about eight hours of sleep per night to function normally the next day. Losing just a few hours of sleep can lead to a significant decrease in your ability to function. Prolonged loss of sleep can cause difficulty in concentration, inability to remember things, and can contribute to automotive accidents. Night after night of interrupted sleep can cause serious decreases in learning ability and performance in school or on the job.
Most allergy therapies don't take into account the effects of allergic rhinitis on mental functioning - they treat the more obvious physical symptoms. Some allergy therapies may even cause some cognitive or mental impairment.
In a recent poll in which allergy sufferers were asked how they treat their symptoms, about 50 percent responded that they use over-the-counter (OTC) medications. The most commonly used OTC medications for allergy symptoms are decongestants and antihistamines - both of which can cause sleep disturbances.
With all the allergic diseases, the best way to control your symptoms is to avoid coming into contact with your triggers - the substances that cause you to have an allergic reaction. This is often easier said than done. Sometimes it is impossible to avoid the substances that cause symptoms, especially when you are not in control of your environment.
Reprinted by permission of the American College of Allergy, Asthma & Immunology)