Wellness Medical Care

The best way to manage an allergy is to remove the offending agent. If you know what your child is sensitive to, this should be easy. But often you have no idea. In such circumstances, you can begin by trying to minimize exposure to the most common aller­gens. Here are some good initial steps.

- Vacuum your child’s room daily or every other day (if it has carpeting) to reduce the number of dust mites.

- Try running an air purifier such as a HEPA (high-efficiency particulate air) filter in the corner of your child’s room to pick up additional dust mites and dander.

- If there is a flowering tree outside one of your windows, try to keep that window closed to minimize pollen entry into the house.

- If your child sleeps with a down pillow or down com­forter, try hypoallergenic covers to seal in the feathers.

- If you have a family pet and you suspect that he is the cause of the allergy, make sure the pet is limited to one part of the house away from your child’s bedroom.

- If you see mold growing along ceiling, walls, or floor, clean it or have it removed professionally.

- If your child comes home from school with allergy symp­toms and her condition improves once she gets home, consider visiting the classroom to see if an obvious aller­gen — such as a class pet or aging carpeting — is present.

Of course, if the problem is something in the environment, such as pollen, it is almost impossible to minimize exposure. Sub­stances in the air that cause allergies are ubiquitous. But when the seasons change, the allergens in the air change, too, and your child’s symptoms should get better.

If your child is just beginning to have a runny nose and the mucus is still fairly clear, you will want to minimize further con­gestion. Some people feel that it helps to limit your child’s intake milk, cheese, yogurt, and other dairy products. Soy or rice milk products can be used as alternatives.

When does my doctor need to be involved? Call your doctor if this is the first time your child has allergies and you are having trouble controlling the symptoms. Classic allergy symptoms involve a clear, watery discharge. If the nose runs green or you notice a discharge from the eyes, your child may have a secondary infection, and you should contact your doctor.

Also call your doctor if the symptoms seem to be getting worse or are simply not getting better. If your child is having trouble participating in her usual activities or is having difficulty sleeping, let your doctor know.

What tests need to be done, and what do the results mean?

Whether your child needs testing depends on the severity of her symptoms. A runny nose and an occasional dry cough or sneeze, even if they last a few weeks, don’t warrant allergy tests. But con­gestion and a cough that interrupt normal activity or sleep may prompt testing. Likewise, if your child has associated allergic symptoms, such as hives, you will probably want to find the underlying cause.

There are two main types of allergy tests — a skin test and a RAST test. The RAST test may be a bit more sensitive, but it also is more invasive. Neither test is extremely reliable in children under two years of age.

A skin test involves pricking the child’s skin with tiny needles, each coated with a specific allergen — cat dander, mold, egg, and so on. If the area around a specific needle stick becomes red and ‘ irritated, the test is positive. This test generally works well as long as someone can convince the child to participate. In children younger than two years old, negative results do not mean much — in other words, if the skin around the mold needle stick does not react, the child may still have an allergy to mold. Only a positive result is helpful because it proves an allergy.

A RAST test is the most common blood test used to check for allergies. Blood is drawn from a vein (not a finger or heel stick), then checked for evidence of various allergies. Blood testing is helpful if the skin is so severely irritated that skin testing cannot be done or if there is concern that a skin test will cause a severe reaction. Like skin tests, RAST tests are not always reliable, espe­cially in younger children.

Both skin and RAST tests give a range of responses. When a test is positive, the degree of positivity will vary. Therefore, it is possible to distinguish mild from severe allergies using either test.

It is important to remember that antihistamines can interfere with allergy test results. If your child is taking any medicines, dis­cuss this with your doctor several days before allergy testing. The medicine may need to be stopped prior to testing.