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 time has come. You and your kids spent time at the park on a beautiful spring afternoon. A few hours later, at home, the symptoms start (cue M. Night Shyamalan strange horror music). Or heck, for those really allergic, the symptoms began at the park!

• Itchy, watery eyes
• Congestion
• Draining, watery, itchy nose
• Sneezing
• Itchy roof of mouth (is this just me? Seriously? Anyone else get this?)
• Clearing the throat
• Coughing
• Complaining of a sore throat (this is due to drainage)

Congrats. See that bright green dust coating your trash cans and car? That’s pollen, and it’s now stuck to all the tiny hairs inside your nose, throat, and lung airways.

And the symptoms you’re having? That’s your body reacting to the certain pollens it doesn’t like.

Kids don’t really get seasonal (grass, plant and tree) allergies until at least age 2. I always tell parents, “your kiddo has to be EXPOSED to the planet’s seasons a few times before it can become allergic to them!”

Your child can become allergic to things like foods, pets, mold, and dust earlier than age 2 – because these are things they are exposed to daily in their home.

To help control your kid’s symptoms, there are a lot of over-the-counter medications you can try.

Listen – I’m a doc that usually says “less is more” when it comes to medication. But I do usually recommend daily meds for kids who suffer allergies, because I don’t want it to affect their happiness, or ability to get good exercise.

Start with a daily antihistamine – Allegra, Claritin, Xyzal, Zyrtec, Benadryl. If your child suffers from a lot of nasal problems like sneezing and congestion, add on a nasal steroid spray like Flonase or Nasacort.

There are also many types of antihistamine eye drops out there you can use daily to treat or prevent the itchy and watery eyes.

Here’s the thing – they’re often PREVENTATIVE. So, use them DAILY during the times of year you or your child suffer to PREVENT the symptoms from showing up.

You can dive further into treatment with your pediatrician – there are a few prescription options you can try to further help the problem.

If your child has asthma, it’s even more important to come up with a treatment plan with your pediatrician. These kids sometimes can have full-on asthma attacks this time of year if that’s a common trigger for them.

And do what an old, wise allergist once told me – “the minute you and your kids come in from playing outside, hold your heads over the sink, and spray nasal saline up in the nose to irrigate the nose and rinse out all the pollen!” You could also try this in the shower.

Makes sense to me! Try it! And good luck out there!

Both allergies and colds share a lot of similar symptoms:

• Sore throat
• Runny nose 
• Sneezing 
• Coughing 
• Feeling tired 
• Feeling achy

Honestly, it can be hard even for us to tell the difference when we examine kids.

HOWEVER, you don't get a fever with allergies. If you have a little fever (or a big fever), that's most likely a cold.

ALSO,  "itchiness" in general of nose and eyes, makes me think more allergies than cold.

AND, the time is important - Did  it come on really quickly? That's most likely a cold. Has it been going on for months with a slow onset? Most likely allergies.

Both allergies and colds can make you more susceptible to other problems like ear infections and sinus infections. That's why we say if your symptoms are lasting longer than 2 weeks, come in and see us so we can help.

"How do I know what to do?" Well, that depends on a lot of things.

Is your child under age 1? If so - this is more likely a cold than allergies (a child has to be alive longer than a year to develop allergies to their environment). Elevate the head of their crib. Stick a blanket under the mattress. Would you want to lay flat on your back with a bad cold? Suck out all that snot with a Nose Frida (dont knock it til you try it). Use saline drops. Tylenol (or ibuprofen if over 6 months) for the headaches and throat pain. Run a hot shower and sit in a steamy bathroom for a bit. And lots of lovins. There ain't much you can do for the tiny ones. They just have to push through it.

If they're over age 1 and they have what seems to be a cold, try some honey along with all of the above. It's been proven to help just as much as medication. There are some over-the-counter medications that have honey in them too. I wouldn't try cold medicines until they're at least 4. Studies don't even show that they help much.

If it's allergies - you have lots of over the counter options like Benadryl, Zyrtec, Claritin, and Allegra. Some nose sprays are also very helpful and we can prescribe those in the office. And there is a prescription medication called montelukast that I find can help some kids.

Also, a wise allergist once told me that if you rinse out your kid's nostrils when they come indoors, it helps a lot (it washes away all the allergens/pollens clinging to the hairs in the nose and really helps symptoms go away faster). You could also try nasal saline spray here and just have them hold their head over the sink.

Hugs!

Dr. Diane

Fast forward five years and I have learned that my kids can decide for themselves what to wear to keep warm. I let them step outside in the morning and advise them that they might want pants or a jacket, but I let them decide.

Tuesday, they both went to school in shorts, but took a fleece. It was 40 degrees outside. Wednesday was the same.

They might wear pants when the temperature hits 20 degrees… maybe.

Beyond infancy, kids can self-regulate what they wear for warmth. As parents, it’s our job to provide the right clothes and then let them decide.

I encourage my parents to get their kids outside even in cold weather. If it’s above freezing, a jacket is often all they are going to need if they are active. Below freezing, a hat and gloves can be added/offered, but don't be surprised if they come off once your child is active.

Finally, even your toddler can go out and play in the cold for 30 to 60 minutes. Don't be afraid of the cold. There are wonders to discover out there and kids need to be outside. It’s good for their bodies, minds and souls. 

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About the author

Vanessa Charette, M.D., has been a pediatrician at Cook Children's for 10 years and is located in Fort Worth. Dr. Charette embraces the many components that contribute to health nutrition, physical activity, emotional, psychological stresses and the environment. As your pediatrician she will spend time with you discussing nutrition, child development and take the time to address any concerns you have about your child's health.

Unfortunately, for many children, allergies are simply a way of life in Texas. Usually, allergies occur in kids beginning at the age 2 years and older.

Physicians don’t know why some children suffer reactions when exposed to allergens such as pollen, ragweed and mold that can cause allergic symptoms, while others experience no problems at all.

Sometimes parents aren’t sure if their child has a cold or allergies. Some say you can tell by looking at the mucus. That’s not really the case. The only way to tell for sure is by seeing your pediatrician. But if your child develops cold-like symptoms at the same time every year (now for instance), he or she probably suffer from seasonal allergies.

Symptoms of allergies are often times similar to a cold – sneezing, itchy nose and/or throat, nasal congestion, clear, runny nose and coughing. With a cold, the symptoms run its course over a matter of days. With an allergy, the symptoms last as long as the child is exposed to allergens.

Parents should be especially careful that their child doesn’t develop wheezing and/or shortness of breath. That may mean your child’s allergies have progressed into asthma.

It’s possible to relieve allergy symptoms by eliminating or reducing a child’s exposure to allergens. A key, as you hear so often with colds and flu, is for your child to wash his or her hands often. Also, children should change clothing and shower after playing outside. Please don’t let your child mow the lawn during this time of year if they suffer from allergies.

Educating your child early about what causes allergic reactions and allergy symptoms is a crucial step in helping your child reduce or prevent allergic reactions.

Sometimes no matter how much you try to prevent allergy symptoms in your child, they still occur. Fortunately, various treatments are available to help your child when an allergic reaction happens, including:

• Over-the-counter medications. Some decongestants, antihistamines and nasal sprays can be purchased without a prescription. But even if you are thinking about picking up something from the drug store, please do not do so without contacting your pediatrician.
• Prescription medications. Those with more severe allergies might need stronger versions of over-the-counter medications prescribed by their pediatrician.
• Immunotherapy. Also known as allergy shots, these injections of allergens into the body help patients build tolerance to help relieve symptoms.

Eventually, your child might grow out of his or her allergy. However, until he or she does, talk to a pediatrician or allergy specialist to determine the best treatment option for your child.