Asthma and Allergies: a closer look at respiratory health
Spring can be a rejuvenating time of year when long-dormant buds bloom and provide tangible evidence that the season of renewal is upon us. However, it also brings with it pollen, mites and molds — which, for families who suffer from environmental allergies, can be slightly less welcome.
It can be important to know whether your child has these allergies, what to do about it, and how it can affect everyday life. Parenting NH reached out to a pair of experts to discover what you need to know: how to identify allergies, how to alleviate discomfort, and what parents can expect if their child suffers from allergies or asthma-related symptoms.
- Nicola Vogel, MD, Core Allergy & Immunology; corephysicians.org
- Amitha Harish, MD, Southern NH Asthma and Allergy; snhhealth.org
How can I tell if my child has allergies or a common cold?
Harish: “Both allergies and the common cold affect your respiratory system potentially causing cough, sneezing, runny nose and nasal congestion, but there are some key symptoms that set them apart from each other. The common cold and the flu are caused by viruses. They can result in general aches and pains, sore throat, and fever. Symptoms typically last from 3 to 14 days and usually resolve more quickly than allergies. While conjunctivitis can occur, your child should not develop itchy eyes. Allergies last for as long as you are exposed to your trigger, which in some cases, can be several weeks. With allergies, your child’s immune system is overreacting to an external trigger. Common symptoms include itchy eyes, runny nose, and congestion, but never fever or aches and pains.”
Vogel: “This can be very tricky because the symptoms are very similar. If your child always has symptoms during a certain season and symptoms last longer than 7-10 days, then environmental allergies may be the culprit. Certain symptoms such as itching of the eyes and/or nose and repetitive sneezing are more likely to be from environmental allergies than from a common cold. Also consider the age of the child because environmental allergies especially for pollens and mold usually start after the age of 2. Sometimes indoor allergies such as pets and dust mites can cause symptoms before the age of 2.”
What causes environmental allergies and what are some typical symptoms?
Vogel: “If your child has environmental allergies, the body recognizes certain substances like pollen, pet dander, dust mites and/or molds as intruders instead of a harmless substance. The immune system responds by releasing histamine and other substances. When this happens, your child may have typical symptoms of stuffy and runny nose, sneezing, itchy eyes and nose and/or post-nasal drip. Sometimes allergies can trigger asthma symptoms, frequent cough, irritability and fatigue.”
How can I best alleviate the symptoms?
Vogel: “Avoid triggers as much as possible. For outdoor pollens, keeping windows closed and using air conditioners, especially in bedrooms, is helpful to prevent pollen from coming inside. Taking a bath or shower before bedtime helps to remove pollen. For pets, avoid being around pets that trigger symptoms as much as possible. If your child is living with a pet that triggers allergy symptoms, keep the pet out of her/his bedroom permanently. For dust mite allergy, zippered protective covers for pillows and mattress can help decrease exposure to dust mites.
“There are lots of over-the-counter medications that can help the symptoms of environmental allergies including oral antihistamines, nasal steroid sprays and antihistamine eye drops. Sometimes a combination of these medications rather than just one is needed to best help with symptoms. If your child always has symptoms during a certain season, starting these medications before and continuing them through the allergy season can be very helpful. This may prevent or lessen symptoms overall by preventing or decreasing the histamine release.
“If symptoms are difficult to manage with avoidance and over-the-counter medications, allergy immunotherapy (shots) are an option. A newer option that was recently approved in the U.S. is sublingual immunotherapy (SLIT). Instead of shots, these are tablets are taken under the tongue every day, sometimes before and during an allergy season, and sometimes year round. Currently, they are only available for a few allergens including grass, ragweed and dust mites.”
What are the risks associated with leaving possible allergies untreated?
Vogel: “Environmental allergies are also a significant trigger for many patients with asthma. Treating allergies can help minimize asthma symptoms. Since one of the major symptoms of environmental allergies can be nasal congestion and inflammation, untreated nasal congestion can potentially block sinus drainage and may encourage sinus infections to develop.
“Fatigue can often be associated with environmental allergies, from the symptoms or from disrupted sleep. Environmental allergies have been associated with cognitive issues in children and adolescents such as attention deficit and poorer concentration. Symptoms can interfere with sports performance too. For adults, environmental allergies have been associated with anxiety, depression, and decreased work productivity.”
Harish: “While allergy symptoms can be a nuisance, there can be serious consequences of leaving them untreated, including the development or worsening of asthma, sinus infections, and fatigue or decreased school performance due to bothersome symptoms. As a mother of young children, I feel it is important to know what your child’s triggers are in order to jointly develop the best and most appropriate treatment plan.”
How can environmental allergies change as my child gets older?
Vogel: “Milder symptoms one season often progress to more intense symptoms the next few seasons. Symptoms are most likely to develop from early school age through early adult years. Most adults who had symptoms in childhood will continue to have symptoms but often the symptoms are not as severe.”
Can kids outgrow asthma?
Harish: “In young children, it can be hard to distinguish whether symptoms of cough, wheezing or shortness of breath are caused by asthma or something else, especially if they are too young to have a breathing test. Many asthma-like conditions such as bronchitis and bronchiolitis improve as children get older. There are many children that don’t outgrow asthma, and symptoms can improve or worsen depending on several factors. Once the airways become sensitive, they remain more susceptible for life. There are many children, however, who outgrow the need for medication with time.”
Vogel: “Yes! Many infants that have asthma symptoms only with upper respiratory illnesses/colds will eventually outgrow the symptoms. Some studies suggest that up to 75% of school-aged children will outgrow asthma by adulthood. However, if there is any history of environmental allergies, eczema or food allergy, and/or a family history of asthma, the chance of outgrowing asthma is less likely.”
Can asthmatic kids still participate in team sports?
Harish: “With the right diagnosis and treatment plan, your child should be able to participate in team sports without any problems. Being active, working out, and playing sports can be beneficial in kids with asthma by maintaining a healthy weight and strengthening breathing muscles. I always like to encourage asthmatic children and their parents that there are many elite athletes in the world who are not held back by their asthma.”