An estimated 40-45 million Americans (15-20% of the population) have some type of allergy and, in most people; these allergies first appear during infancy or childhood. It is not surprising, then, that allergic disorders rank first among children’s chronic diseases.
Any child may become allergic, but children from families with a history of allergy are more likely to be allergic. Children may inherit the tendency to become allergic from their parents, but only some of them will develop active allergic disease. Allergies can show up in different ways in children. Some children get skin rashes (atopic dermatitis) from allergy, some develop asthma, and some get allergic rhinitis, or hay fever.
Hay fever, also known as allergic rhinitis, is the most common of all allergy problems. It is characterized by a runny, itchy nose, sneezing, postnasal drip and nasal congestion. The child with allergies may also have itchy, watery and red eyes and chronic ear problems. Despite its common name, “hay fever” these allergy problems can occur at any time of the year — seasonally or year-round.
The following are just a few points on potential problems for children with allergic rhinitis. Early identification of allergic problems in your child will improve their quality of life, decrease missed school days and keep you at work.
Nasal Congestion
Allergies are the most common cause of chronic nasal congestion in children. Sometimes a child’s nose is congested (obstructed) to the point that he or she breathes through the mouth, especially while sleeping.
If the congestion is left untreated, this mouth breathing forces air currents through the mouth. The force of the air then changes the way the soft bones of the face grow. The face may actually become abnormally elongated in a pattern called “adenoidal face.” This causes the teeth to come in at an improper angle as well as creating an overbite. Braces or other dental treatments may be necessary to correct these problems. Early treatment of the allergies causing the nasal congestion may prevent these problems.
Allergy and ear infections
Allergies lead to inflammation in the ear and may cause fluid accumulation that can promote ear infections and decreased hearing. If this happens when the child is learning to talk, poor speech development may result. Clinically, allergies can cause earaches as well as ear itching, popping and fullness (“stopped up ears”). Anyone with these symptoms should be considered for testing and treatment.
Allergies at School
Fall means going back to school. For allergic children, that may mean absences due to problems related to hay fever. The following are some of the problems to look for so that allergy can be properly diagnosed and treated, as well as several suggestions for helping the allergic child.
| · | Dust irritation: Reducing dust in the home will be helpful to most allergic family members. At school, children with allergic problems should sit away from the blackboards to avoid irritation from chalk dust. |
| · | School pets: Furry animals in school may cause problems for allergic children. If your child has more problems while at school, it could be the class pet. |
| · | Asthma and physical education: Physical education and sports are a big part of the school day for many children. Having asthma does not mean eliminating these activities. Often medication administered by using an inhaler is prescribed before exercise to control their symptoms. Children with asthma and other allergic diseases should be able to participate in any sport the child chooses — provided the doctor’s advice is followed. |
| · | Dry air: With the onset of cold weather, using a humidifier to accompany forced air heating systems may be helpful in some regions of the country. Adding small amount of moisture to dry air makes breathing easier for most people. However, care should be taken not to allow the humidity above 40%, which promotes the growth of dust mites and mold. |
| · | Change in behavior: Since children cannot always express their annoying or painful symptoms, they may exhibit behavior problems in school and at home. Be on the alert for possible allergies if your child has bouts of irritability, temper tantrums or decreased ability to concentrate in school. These are all signs of “allergic irritability syndrome” often caused by nose, ear and sinus symptoms in allergic children. Sometimes allergic children manifest overactive behavior and usually, their schoolwork suffers. This should NOT imply that attention deficit disorder is caused by allergies! When a child’s allergies are properly treated, his symptoms, behavior and school performance can improve. |
Allergic Diseases and Cognitive Impairment
Sneezing, wheezing, watery eyes and runny nose aren’t the only symptoms of allergic diseases. Many people with allergic rhinitis also report feeling “slower” and drowsy. When their allergies are acting up, they have trouble concentrating and remembering.
For instance, allergic rhinitis can be associated with:
| · | Decreased ability to concentrate and function |
| · | Activity limitation |
| · | Decreased decision-making capacity |
| · | Impaired hand-eye coordination |
| · | Problems remembering things |
| · | Irritability |
| · | Sleep disorders |
| · | Fatigue |
| · | Missed days at work or school |
| · | More motor vehicle accidents |
| · | More school or work injuries |
Many parents of children with allergic rhinitis observe increased bad moods and irritability in their child’s behavior during the allergy season. Since children cannot always express their uncomfortable or painful symptoms verbally, they may express their discomfort by acting up at school and at home. In addition, some kids feel that having an allergic disease is a stigma that separates them from other kids.
It is important that the irritability or other symptoms caused by ear, nose or throat trouble are not mistaken for attention deficit disorder. With proper treatment, symptoms can be kept under control and disruptions in learning and behavior can be avoided.
Causes
Experts believe the top two culprits contributing to cognitive impairment of people with allergic rhinitis are sleep interruptions and over the counter (OTC) medications.
Secondary factors, such as blockage of the Eustachian tube (ear canal), also can cause hearing problems that have a negative impact on learning and comprehension. Constant nose blowing and coughing can interrupt concentration and the learning process, and allergy-related absences can cause people to miss school or work and subsequently fall behind.
Sleep Disruption
Chronic nasal congestion can cause difficulty in breathing, especially at night. Waking is a hard-wired reflex to make you start breathing again. If you have bad allergic rhinitis, you may waken a dozen times a night. Falling back asleep can be difficult, cutting your total number of sleep hours short.
The average person needs about eight hours of sleep per night to function normally the next day. Losing just a few hours of sleep can lead to a significant decrease in your ability to function. Prolonged loss of sleep can cause difficulty in concentration, inability to remember things, and can contribute to automotive accidents. Night after night of interrupted sleep can cause serious decreases in learning ability and performance in school or on the job.
Over-the-Counter Medications
Most allergy therapies don’t take into account the effects of allergic rhinitis on mental functioning – they treat the more obvious physical symptoms. Some allergy therapies may even cause some cognitive or mental impairment.
In a recent poll in which allergy sufferers were asked how they treat their symptoms, about 50 percent responded that they use over-the-counter (OTC) medications. The most commonly used OTC medications for allergy symptoms are decongestants and antihistamines – both of which can cause sleep disturbances.
Antihistamines
Antihistamines block the effects of histamine, a chemical produced by the body in response to allergens. Histamine is responsible for the symptoms of allergic rhinitis, including an itchy runny nose, sneezing and itchy eyes. OTC antihistamines are an inexpensive choice when it comes to treating the symptoms of an allergy – but all OTC antihistamines available in the United States also can cause drowsiness. Regularly taking OTC antihistamines can lead to a feeling of constant sluggishness, affecting learning, memory and performance.
Non-sedating antihistamines, such as Allegra(r) and Claritin(r), are available with a prescription. These antihistamines are designed to minimize drowsiness while still blocking the effects of histamine.
Solutions
With all the allergic diseases, the best way to control your symptoms is to avoid coming into contact with your triggers – the substances that cause you to have an allergic reaction. This is often easier said than done. Sometimes it is impossible to avoid the substances that cause symptoms, especially when you are not in control of your environment.
If your allergens can’t be avoided, your doctor can help you to create an allergy treatment plan. People who are allergic to indoor things like dust mites or animal dander may need medication on a daily basis, while people who have seasonal symptoms may only need treatment at certain times during the year. An allergist-immunologist can help you determine to which substances you are allergic.
Several types of non-sedating medications are available to help control allergies. One nonsedating nasal spray, Nasalcrom(r) (cromolyn), is available without a prescription. In addition to the newer antihistamines discussed above, your doctor may also prescribe nasal steroid sprays to treat nasal inflammation. Nasal steroid sprays are highly effective in treating allergy symptoms. The most common side effect associated with nasal sprays is headache.
If medications are not effective or cause unwanted side effects, your doctor may suggest immunotherapy, or “allergy shots”. Immunotherapy is used to treat allergy to pollen, ragweed, dust mites, animal dander and other allergens. This process gradually desensitizes you to these substances by changing the way that your body’s immune system responds to them. For example, if you are allergic to ragweed, immunotherapy treatments would involve injecting a tiny amount of ragweed pollen extract under your skin every week. Immunotherapy treatments usually last three to five years or longer. Once your body is able to tolerate the substance without producing the symptoms of an allergy, immunotherapy can be stopped, and the need for oral medications should be gone or greatly reduced.
Remember
If allergies are affecting your ability to concentrate or function, several treatment options may be beneficial. Getting allergy symptoms under control can help you sleep at night and function during the day.
If you suspect that you or a family member may have an allergic disorder, make an appointment with your doctor for proper diagnosis. Treating allergies sooner rather than later can help prevent disruptions in learning and behavior.
