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I'm a pediatrician by training with an undergrad degree in journalism. I spend my days teaching and mentoring future pediatricians. My wife and I spend our evenings and weekends keeping up with very active twins. This blog will chronicle my thoughts on current children's health care issues and trends, trials and tribulations as a parent and husband mixed in with a lot of life experience.


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photo William Stratbucker, MD
Monday, June 13, 2011
Achoo! Managing Allergies
by William Stratbucker, MD at 09:43 AM

Guest blogger Karyn Gell, MD, is an allergist and immunologist.

Are your child's sneezing, coughing, blowing, itching, headaches and/or asthma symptoms worse than usual? That's understandable. With all the rain we've had, mold may be particularly plentiful, but pollens are the worst troublemakers in the spring, with spurts of warm weather this year bringing both trees and grass into the picture. It will probably get worse before it gets better as we now move into summer.

We've just had a little dry spell which keeps pollen suspended in the air. That yellow dust coating your car or porch is also coating your child's eyes, nose and throat. The ocular and respiratory mucosal surfaces provide sticky areas for pollen deposition, and in an allergic child there may be intense sneezing, itching of the eyes, nose, and throat, and wheezing in asthmatics. Just this week at my son's baseball game, I noticed many kids on the field were rubbing their eyes vigorously because of severe itching.

Reducing Pollen Exposure

Here are some tips to reduce your child's pollen exposure:

  • Use air-conditioning in your home and car.
  • Keep your windows closed at night.
  • Use dust mite-proof covers for the bedding.
  • Wash all bedding in hot water weekly, including mattress pads and blankets.
  • Vacuum frequently.
  • Don't forget to bathe Fido and Fluffy and keep them out of the bedroom.
  • Do a good "spring cleaning" of the bedroom and throughout your home.
  • Wear a mask and goggles for yard work.

Over-the-Counter regimens may be helpful for your child. I find the following to be most beneficial:

  • Saline nasal irrigations (e.g., Sinus Rinse, Nasaline or Neti Pot)
  • Antihistamines (e.g., cetirizine, loratadine, or fexofenadine, with or without a decongestant such as pseudoephedrine)
  • Antihistamine eyedrops (e.g., ketotifen)
  • Nasalcrom or Opticrom

I would avoid topical decongestants such as Afrin or Vicks Spray for longer than three to five days and any ocular drops that "take the red out," as they can be addictive if used longer.

Is It a Cold-Or Allergy?

In my 19 years of working as an allergist, this is one of the questions parents ask me most often. It can be confusing-both allergy and summer colds can present with congestion, mucus production, and fatigue.

Here are a few tips to help you tell the difference:

  • If a cat sits in your child's lap while you are visiting relatives and his or her eyes itch and he or she begins sneezing, it's probably an allergy.
  • If your child feels feverish and has yellow or greenish drainage, your child may have an infection
  • Colds are generally viral and last seven to 10 days, but allergies can last an entire season or be present year-round.
  • If you notice symptoms about the same time every year, it's likely allergy.

Many parents wait too long to send their child to an allergist. Children with allergies have more doctor visits, days of feeling ill, missed school, more frequent infections, difficulty concentrating, fatigue and a "couch potato" feeling. Once a child is treated aggressively, however, quality of life quickly improves.

- Dr. Gell

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