A Parent’s Guide to Childhood Allergies

Parents, does this scenario sound familiar to you? You notice your child scratching at a rash. Could an allergy be causing that rash? What should you do?

Brian Kriete, MD, a Phelps Health ENT (ear, nose and throat) and allergy doctor, talks about common allergies that kids may have and how parents can help find allergy relief for their children.

What is an allergy?

For many people, pollen or dust mites don’t cause problems. Their immune systems are able recognize those allergens as foreign, but not something that needs a response.

However, in some individuals, their immune system decides to recognize that allergen or pollen as a foreign invader. The immune system mounts an attack, or immune response, as though the allergen is a virus or bacteria.

Their immune system may release histamines (chemicals your immune system makes to help your body get rid of something that is bothering you). These histamines can lead to a stuffy nose, runny eyes or repeated ear infections.

What is the difference between an allergy and a sensitivity?

There's a big difference between an allergy and a sensitivity. Let's use milk as an example.

An estimated 36% of Americans have some degree of lactose intolerance, which is the inability to digest lactose, a sugar found in milk and dairy products.

Some people mistake lactose intolerance for an allergy. Lactose intolerance is caused by a shortage of an enzyme needed to digest this sugar. Signs of this condition include bloating and diarrhea after drinking milk or eating dairy.

If you have a true milk allergy, however, your immune system will release histamines. You can have anything from rashes to tongue swelling to a full-blown anaphylactic (life-threatening) reaction.

About 2% of children in the US have a milk allergy.

What are common allergies found in kids?

Allergies fall into two different categories: environmental and food. Environmental allergies can include pollens, grasses, weeds, molds, pet dander and dust mites. Kids also may develop allergies to foods, such as milk, eggs, tree nuts (almonds, cashews and pecans) or peanuts.

What are signs and symptoms of a food allergy in kids?

One of the most frequent signs is poorly controlled eczema (dry, itchy or inflamed skin). Sometimes, children may have GI (gastrointestinal) discomfort, but rashes or hives are more common symptoms.

Do children outgrow their allergies when they become adults?

When they're infants and toddlers, kids usually start out with eczema. They'll get a rash on their skin, which can be a sign of more severe allergies down the road. Next, they may develop some food allergies to milk, eggs, peanuts or tree nuts.

Kids typically outgrow milk and egg allergies. However, for some, the peanut and tree nut allergies don't go away and can be lifelong problems.

Some kids also may develop seasonal allergies or asthma. If kids get allergy treatment early, the development of other allergies, including the more severe forms of asthma, can be prevented.

How are kids tested for allergies?

Testing, as far as environmental allergies go, typically involves a skin test. Phelps Health offers some blood tests for food allergies. While adults are tested for more types of foods, kids are given a basic allergy panel, which checks for about eight different food allergies.

Usually kids around age 4 and older can be tested. With skin testing, the child needs to be able to tolerate needles. The allergy test lasts about 1 hour and involves about 20 to 30 needlesticks. During allergy testing, patients won’t bleed or feel more than a mild, momentary discomfort.

What steps should parents take to help manage their child’s allergies?

The biggest way you can help your child is by having them avoid the allergens. Keep them away from pollens, dust mites and foods if these allergens cause them to have a reaction. You also can keep track of your kid’s allergies with a diary.

You can use antihistamines, which include non-sedating or sedating histamines. Benadryl is a common antihistamine, but this medicine causes sleepiness. Other medications that don’t cause drowsiness include Zyrtec, Claritin, Allegra and their generic versions that block histamines and can help lessen an immune reaction.

What is an anaphylactic reaction?

An anaphylactic reaction is a life-threatening reaction that causes a lot of swelling and excess tissue fluid. When this type of reaction happens in your airway, you can't breathe well. Your blood pressure also may drop and your heart rate may increase.

Patients with anaphylaxis (severe, potentially life-threatening allergic reactions), including lips, throat or tongue swelling; and/or a severe rash along with nausea and vomiting and light-headedness, should seek immediate medical care.

What is an EpiPen?

An EpiPen is basically adrenaline that you inject into the muscle. Adrenaline can cause your blood vessels to constrict and raise your blood pressure. In addition, adrenaline also can release fluid from your tissues and decrease swelling as well as tightness in the lungs or wheezing.

When should parents take their child to see an allergy or ENT specialist?

The decision will vary from family to family. Some parents are more comfortable with managing allergies in their children on their own. As your kid gets older, you can have them retested for allergies. If your child has a rash, take a photo to show your care provider.