After a long winter of sweaters, snow boots, and Fortnite, the first signs of spring should bring elation for kids and parents everywhere. But for Geri Amera, a mom in Elmhurst, New York, it’s crunch time.
“You know that pretty moment when the trees release their flowers and it looks like it’s snowing?” says Amera. “That’s the worst day of the year for us.” Her 11-year-old daughter, Sophie, has had severe seasonal allergies since she was 3, meaning her body treats seemingly harmless spores of pollen like dangerous invaders. When they get into her mouth and nose, they cause her immune system to release histamines, which pump up mucus production. This leads to lots of sneezing, sniffling, coughing, and itching.
Over the past few years, Amera has carefully crafted a regimen involving antihistamines, housecleaning, vaporizers, and lots of Boogie Wipes to ensure that Sophie can play outside without feeling miserable. Staying vigilant is key. Research suggests that with each passing year, pollen is becoming increasingly allergenic, and allergy season is lasting longer, says Jeffrey Demain, M.D., director of the Allergy, Asthma and Immunology Center of Alaska, in Anchorage. (The likely culprit behind this trend: rising global temperatures.) Plus, untreated allergies can lead to irritability and interfere with sleep—which is no good for anyone in your house, says Edith Schussler, M.D., a pediatric allergist at Weill Cornell Medicine, in New York City.
How can you help ease your child’s symptoms? A science-backed plan is coming your way.
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In young kids, allergy symptoms can easily be mistaken for a cold or another virus. The biggest sign that your kid actually has a pollen problem? His symptoms stick around. “A cold usually lasts a week and then goes away,” Dr. Demain says. “An allergy flare, however, could last weeks or months.”
And since most people in America with allergies are sensitive to more than one thing—dogs and ragweed, grass and dust mites, for example—sniffles often persist for longer than one season. Other signs of seasonal allergies: a clear drip coming out of the nose (rather than a yellowish or greenish one), itchy eyes, symptoms that worsen outdoors, and what doctors call “allergic shiners,” or dark circles under the eyes caused by nasal and sinus congestion.
Remember, too, that seasonal allergies run in families. If a parent has allergies, her child has about a 50 percent chance of developing them; if both parents are sneezing from spring through fall, the odds are even higher.
The best way to get your child diagnosed correctly is to see a pediatric allergist. After taking a detailed history, she’ll run skin and blood tests to pinpoint your kid’s specific allergies and effective treatments. Once you have a diagnosis and plan, your regular pediatrician can handle follow-ups, Dr. Demain says.
First, consider the fabrics on your floors and windows, especially in your kid’s bedroom and playroom. “Heavy carpets and rugs hold on to allergens,” Dr. Schussler says, noting that you can easily mop hardwood and tile floors and wipe blinds and shutters clean.
“I have all our mattresses and pillows covered in allergen and dust protectors,” says Heather Nelson, of Greenwich, Connecticut, whose 7-year-old twins both have allergies. Washing sheets regularly in hot water can also remove lingering dust and allergens. Other smart ideas: Keep the windows closed during pollen season, run an air conditioner with a HEPA filter, and ask people to take off their shoes when they enter the house so they don’t track in pollen.
Amera puts her daughter’s hair in tight braids to keep pollen from infiltrating her long locks (a baseball cap does the trick for shorter hair). Immediately showering and changing into “indoor clothes” when everyone gets home helps too. If you have a dog who spends time outdoors, bathe him as often as he’ll let you and keep him off your child’s bed. Some parents also like to keep a bottle of saline nasal spray handy to literally wash the pollen out of their child’s nose throughout the day and before bed.
And don’t forget one of the most powerful tools in your arsenal: your phone. Download Pollen.com’s free app, which delivers the forecast for specific pollen counts in your area. When possible, schedule outdoor activities on low-pollen days. “The day after a rainy day is the best time to be outside,” says New York City pediatrician Alison Mitzner, M.D., whose 7-year-old has allergies.
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Most allergists recommend starting with the simplest over-the-counter treatment and adding more meds as needed. “We want to keep children on the lowest amount of medication possible to control symptoms so they have the least possible side effects,” Dr. Schussler says.
Consider starting with a daily dose of an over-the-counter, second-generation antihistamine such as Zyrtec (cetirizine), Allegra (fexofenadine), or Claritin (loratadine) in a children’s formulation. Unlike first-generation antihistamines such as Benadryl, these drugs were designed not to cross the blood-brain barrier, which means they are less likely to cause drowsiness or hyperactivity. If your child begins taking medication even before his symptoms kick in, he may not produce histamines at all. “I recommend that patients start taking an antihistamine on March 1 for a spring-pollen allergy,” Dr. Schussler says. Take it at night, since some newer medications can still cause drowsiness.
In many cases, an antihistamine should provide enough relief for your child to get through the day. If he needs something more, consider reaching for a steroid nasal spray such as Nasonex (mometasone), Flonase (fluticasone), or Nasacort (triamcinolone acetonide). These daily-use sprays, which reduce swelling in the nasal passages and eyes, take a few days to kick in, and your child may not love the feeling of a spritz up his nose at first. But stick with it. A nasal spray can relieve the same symptoms that antihistamines do and also clear airways. For children with severe allergies that don’t respond to over-the-counter meds, ask about prescription-strength antihistamines and sprays.
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Itchy, red, teary eyes are one of the most aggravating symptoms of allergies. (The itch stems from inflammation of the mucus membrane covering the whites of the eyes and inner eyelids.) The fix: Keep pollen away from your child’s face. Dr. Schussler advises wearing sunglasses and a hat with a brim. Kids touch their face all the time, but with these accessories on, your child will be less likely to rub her eyes.
You can also use saline eyedrops to wash away pollen. Or ask your child’s doctor about antihistamine eyedrops such as prescription Pataday or OTC Zaditor. “The drops can sting a little, but if you refrigerate them, it takes a bit of that away,” Dr. Demain says. Antihistamine nasal sprays often help with eye symptoms as well.
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If you’ve tried pills, sprays, and rinses, ripped the carpet out of your home, and blinged out your kid with rock-star sunglasses, but he continues to suffer, talk to his allergist about allergy shots.
“They are still the cornerstone of long-term treatment,” says Dr. Demain. “We have shots for almost every common allergen, and they also reduce the risk for developing new allergies and asthma.” The only real drawback? Getting your kid on board with a plan involving needles. The treatment starts out with two shots a week for up to two to three months, then tapers down to once a week, then every other week, and finally monthly.
After about three years, the allergy may be gone for good. Dr. Schussler suggests allergy shots after a patient has tried everything else and is at least 7 or 8 years old. “Some kids will be completely cured, and some still need to take an antihistamine when pollen counts are very high, but pretty much all children feel much better,” she says.
Is your child mainly allergic to grass? Good news: There’s a new option called sublingual immunotherapy (SLIT) that works the same way shots do but without the ouch of needles. Instead, patients take one tablet daily that dissolves under the tongue. SLIT tablets for dust mites and ragweed have been FDA-approved for adults, but grass is the only allergen approved for kids as young as 5. Still, it’s worth checking in with your allergist; the other allergens are under FDA evaluation and may be approved for children soon.
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