Dealing with Spring Allergies

I suspect my child has allergies. What do I need to know?

All ages 

Do you find yourself constantly wiping your child’s runny nose, soothing their persistent cough, or noticing red, itchy skin? It’s not uncommon for parents to worry when their child seems to be frequently battling allergy-like symptoms, especially when siblings or other kids remain unaffected. If this scenario sounds familiar, your child might be struggling with environmental allergies. Can testing provide more certainty? Let’s learn more about childhood allergies, from recognizing symptoms to exploring testing options.

When do pediatricians suspect that a child might have allergies?

• If your child exhibits symptoms like a prolonged runny nose, persistent cough, red eyes, constant throat clearing or red, dry and itchy skin, allergies could be the culprit. Pediatricians often suspect allergies when these symptoms persist for weeks and seem more pronounced compared to siblings or peers. 
• When itching of the eyes, nose, throat or skin is a main problem.
• When one or both parents (or siblings) have a history of allergies to things in the environment.
• When a child exhibits excessive coughing or snoring that disrupts sleep.
• When a child has a history of eczema or asthma/wheezing/bronchospasm. 

Why Pursue Allergy Testing?

Understanding triggers for a child’s allergies can significantly improve the quality of life. Allergy testing may help identify specific allergens, enabling you to reduce both exposure and symptoms by making more informed decisions about environmental modifications and treatment strategies. Testing may also help determine if allergies are part of the cause in a child with frequent cold symptoms. Positive testing makes you lean more toward allergies, whereas negative testing points to more recurrent viral or other non-allergic irritants like smoke or perfumes.

Exploring Testing Options

Two primary methods are commonly used to identify allergic triggers in children.

Blood Test: This test assesses reactions (called immunoglobulin E) to common allergens, including foods and environmental triggers like pollen and mold. Results are graded on a scale ranging from 0 (no reaction) to 6 (severe reaction). 

The benefits of a blood test include the fact that one blood draw can evaluate several potential triggers with results that can be evaluated by the pediatrician. There is no need to stop any medications before the blood draw is done. 

The downsides are that a blood draw may be an unpleasant experience and the accuracy of the results is variable. Allergens with a score of 0 (no response) and 6 (major response) are easy to interpret — however, the other scores can be more confusing. 

Allergy Skin Testing: This test is conducted by pediatric allergy specialists. This method involves using small needles to place allergy triggers (like foods, grass and molds) into the skin of the back. The allergist then grades the skin reactions and determines a treatment plan.

Skin testing tends to be more accurate than blood tests and allows for the allergist to create an individualized assessment and treatment plan. However, this type of testing may cause discomfort and itching, and requires discontinuation of certain antihistamine medicines a few days before testing. Additionally, there could be some uncertain results, and kids don’t like needles, even if they are very small needles.

Can my child avoid testing and just start treatment?

Opting to forego testing and initiating treatment is a valid approach. Many families choose this route, as it aligns with the standard generalized treatments for allergies, such as antihistamines and nasal steroid sprays. Starting treatment promptly can provide relief, and if symptoms persist or treatment side effects arise, testing can be reconsidered.

Conclusion

Recognizing and addressing childhood allergies can help improve your child’s well-being. Whether you opt for testing or prefer to start treatment right away, prioritizing your child’s comfort and health is paramount. 

For comprehensive assistance with allergies and other pediatric issues, reach out to your pediatrician who can help provide expert and individualized care to your child and family. 

Dr. Chris Koutures is a dual board-certified pediatric and sports medicine specialist who practices at ActiveKidMD in Anaheim Hills. He is a team physician for USA Volleyball (including participating in the 2008 Beijing Olympics), the U.S. Figure Skating Sports Medicine Network, Cal State Fullerton Intercollegiate Athletics and the Chapman University Dance Department. He offers a comprehensive blend of general pediatric and sports medicine care with an individualized approach to each patient and family. Please visit https://activekidmd.com/ or follow him on Twitter (@dockoutures).