Q: What are the most common allergy triggers?
Spring is truly the peak season for allergies, and our changing climate has extended its duration. Tree and grass pollen are the most prevalent this time of year. Families should consult sites like pollen.com to monitor relevant pollen levels for the areas they will be visiting this spring.

Q: What are the differences between a common cold and allergies in younger children?
Seasonal allergies typically appear after age 2, and their prevalence increases thereafter. Before that age, many of those symptoms are usually viral upper respiratory infections; however, we can look at the pattern and duration of symptoms to distinguish them. If there is a family history of atopy (such as allergies, asthma, or eczema), it helps clarify that the patient may be allergic. Sneezing, itchy eyes, and clear nasal discharge are more common in allergies, while coughing, congestion, and thick mucus are more characteristic of respiratory infections.

Q: When staying in hotels or vacation rentals, what are some potential hidden allergens?
There are several allergens to consider: pet dander, mold, dust mites, and even contact allergens in the provided personal hygiene products.

To lower these risks:

• Bring your own dust-mite-proof pillowcases or your personal pillow.
• Mold requires moisture, so inspect the property for visible water damage and ensure proper ventilation upon arrival.
• Pet dander can persist even after the animal is gone; therefore, request pet-free accommodation if allergies are a serious issue.
• If you are concerned about contact allergens, it is recommended to bring your own toiletries.
   

Q: What should be included in an "essential kit" for an allergic child who is traveling?
Dr. Waters emphasizes avoiding Benadryl due to its potential side effects, which include cognitive effects and arrhythmias (abnormal heart rates). However, there are other options for treating allergies that are more effective:

• Nasal sprays, such as Flonase or Azelastine, are excellent primary treatments.
• For additional relief, second-generation antihistamines like Zyrtec, Allegra, or Claritin are ideal, as they come in practical formats like liquids or chewable/dissolvable tablets.
• For the eyes, use preservative-free cooling drops or itch-relief drops like Pataday, but avoid Visine, as it can be irritating. Saline drops or a nasal wash bottle are also excellent for clearing out allergens.
• Finally, if your child has asthma or severe allergies, never travel without their inhaler or prescribed EpiPen.

Q: What immediate steps should be taken if a child has a sudden allergic flare-up?

• Identify and remove whatever triggers the reaction. If you know it is due to pollen or a pet, remove the child from that environment. It is recommended to administer a full dose of antihistamine such as Zyrtec, if the reaction includes hives or swelling and does not include anaphylaxis.
• If your child is asthmatic and needs an inhaler for respiratory issues, use it.
• Another over-the-counter medication is Famotidine (Pepcid), which is used to treat hives or swelling.
• If you observe an anaphylactic-type reaction and have been prescribed an EpiPen, use it immediately. Remember to always seek medical attention right after use.

It is rare for seasonal allergies to cause anaphylaxis, which include loss of consciousness or difficulty breathing/swallowing. You must monitor your child to ensure none of these symptoms are present and seek emergency care if they appear.

Q: Are there new treatments or preventive measures?

• First-line treatments remain to be nasal sprays, followed by antihistamines.
• A saline rinse helps clear mucus. By optimizing the sinuses and upper airways, it helps control any infections or allergies occurring there, as well as any subsequent respiratory issues. Additionally, nasal washes, such as rinsing bottles, neti pots, or other child-specific products, help decrease the total allergen load.
• Showering after being outdoors helps remove pollen residue.
• Keeping windows closed during peak pollen hours or when driving long distances helps reduce pollen exposure.

Long-term Options
Allergy shots exist for children with severe symptoms, but these require dedication and commitment. Children with significant allergies, asthma, or eczema might qualify for an injectable medication called "biologic." If you are facing these issues, consult your doctor about this possibility.

Other Related Stories:

• Does My Kid Have Allergies, COVID, a Cold or the Flu?
• How to Treat Your Child’s Seasonal Allergies
• Essential Oils and Their Use on Children

The holiday season is full of fun and festivities but with all the excitement, accidents can happen. By taking a few simple safety steps, families can reduce the risk of injuries and focus on what matters most: enjoying time together.

Food Safety & Allergies

The holidays often revolve around food and family gatherings but for children with food allergies, celebrations can be stressful. A food allergy reaction can cause symptoms that range from mild to life-threatening. In the United States, food allergy is the leading cause of anaphylaxis outside the hospital setting.

Tips for parents:

• Communicate clearly with teachers, nurses, family members, and friends about your child’s allergies before the event.
• Bring safe dishes your child can enjoy.
• Always have epinephrine auto-injectors on hand. It is the first-line treatment for anaphylaxis, which works to reverse the life-threatening symptoms.
• Practice at home so your child knows what to do if a reaction occurs.

With a little bit of preparation and awareness, families can enjoy a safe, joyful, and worry-free holiday season.

Car Safety

During this busy travel season, make sure everyone is buckled up correctly. According to the National Highway Traffic Safety Administration (NHTSA), motor vehicle crashes are the leading cause of death for children. NHTSA estimates car seats and proper installation of them have saved more than 11,600 children under the age of five since 1975. 

Best Car Seat for Your Child

• Rear-facing: For infants through preschoolers. Supports the head, neck, and spine until your child reaches the seat’s height or weight limit.
• Forward-facing: For preschoolers through school-age kids. Please keep them in a 5-point harness until they outgrow it.
• Booster seat: For kids who’ve outgrown a harness but aren’t ready for a seat belt. Ensures proper belt fit.
• Seat belt: The final stage is when your child is at least 4 feet 9 inches or 57 inches tall and the belt fits snugly across the hips and shoulder.

Free Car Seat Checks

Texas law requires children to ride in a safety seat until age 8 or 57 inches tall.
The Injury Prevention Collaborative offers free car seat checks by a certified Child Passenger Safety Technician (CPST). A CPST can help ensure a child is safely and correctly secured in their car seat. Cook Children’s Health Care System has 66 CPSTs across North Texas.  

Call 682-885-2634 or click this link https://freecarseatcheck.as.me/schedule/d3206e82.

Those without appointments will be seen on a first-come/first-served basis. You must have your child with you, unless you are an expectant parent.

But, is he allergic?

Listing medications as an allergy may not seem like a big deal, but it can have significant consequences:

1. Your doctor may have to choose “stronger” antibiotics that have more risk of side effects.
2. Your doctor may have to choose more expensive antibiotics.
3. Your doctor may have to choose antibiotics that are known to be less effective against your child’s infection.

If a medicine is listed as an allergy for your children, it will carry on with them into adulthood. When they are 30 and having to make big decision about their medical care, many will have no idea why a drug is listed as an allergy for them.

A recent study conducted in adults at the Mayo Clinic in Florida showed that, out of 384 adult patients who listed a penicillin allergy, 94 percent did not actually have an allergy after being tested. I knew it would be pretty high but, WOW!

Even if a child has a true reaction, the authors report that some people “outgrew” their allergic reaction over time. This is true no matter how severe the first reaction was.

Here are some questions to ask yourself and your doctor about possible drug allergies:

1. Was this an allergy or a side effect? There is a big difference.
2. If we are going to list this medicine as an allergy, does this mean to never try it again? Some doctors might recommend retrying an antibiotic later if the reaction was mild or possibly not truly related to the antibiotics. Some reactions are clearly allergic and the medicine should not be used again.
3. Should we have testing done (at some point) if we are unsure?

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . View more from The Doc Smitty at his Facebook page. He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.