Seasonal and Indoor Allergies in Kids

If your child seems to have a cold that never quite goes away, allergies may be the real cause. Allergies can make kids sneeze, sniffle and rub their eyes for weeks at a time, and they can get in the way of sleep, school and play. In San Antonio, with pollen in the air much of the year and some of it peaking in the middle of winter, allergies can be easy to mistake for one cold after another. Here is how to tell the difference, what triggers allergies indoors and out, and how to help your child feel better.

What nasal allergies look like

Nasal allergies, also called allergic rhinitis or hay fever, happen when the immune system reacts to something harmless in the air. Common signs include:

• Sneezing, often several times in a row
• A runny nose with clear, thin mucus
• A stuffy nose, mouth breathing or snoring
• Itchy nose, eyes, throat or ears
• Red, watery eyes
• Dark circles under the eyes
• Rubbing the nose upward with the palm, sometimes leaving a small crease across the nose
• Tiredness or trouble focusing, often from poor sleep

Children with allergies are also more likely to have eczema or asthma. If your child coughs or wheezes when allergies flare, let your pediatrician know.

Allergy or cold?

The two can look alike, but some clues help:

• Itching of the eyes, nose or throat points toward allergies.
• Fever and body aches point toward an infection. Allergies do not cause fever.
• Timing. A cold usually improves in about 7 to 10 days. Allergies can last weeks or months, or as long as your child is around the trigger.
• Pattern. Allergies often return at the same time each year, or flare in certain places, like a relative's house with a cat.
• Mucus. Allergy mucus tends to stay clear and thin. Cold mucus often thickens and may turn yellow or green.

Outdoor allergens and the San Antonio seasons

Pollen comes from trees, grasses and weeds. In Central Texas, something is pollinating during most months:

• Winter: mountain cedar. Ashe juniper trees, called mountain cedar, release huge amounts of pollen, usually from about December into February. Many people call the reaction "cedar fever." Despite the name, it does not usually cause a true fever, though children can feel tired, achy and miserable. If your child has a real fever, think infection and call your pediatrician.
• Spring: tree pollens such as oak.
• Late spring and summer: grass pollens.
• Fall: weed pollens such as ragweed.

Outdoor mold spores also rise after rain and in humid weather.

Indoor allergens

Indoor allergies can cause symptoms all year long. The main ones are:

• Dust mites, tiny creatures that live in bedding, mattresses, carpets, upholstered furniture and stuffed animals. They thrive in warm, humid air.
• Mold, which grows in damp spots such as bathrooms, under sinks, around leaky windows and in areas that flooded.
• Pet dander, saliva and urine from cats, dogs and other furry animals. Allergens can stay in a home for months after a pet leaves.
• Cockroaches and rodents, whose droppings can trigger allergies and asthma.

Reducing exposure

For pollen

• Check daily pollen counts and plan outdoor time when levels are lower when possible.
• Keep windows closed at home and in the car during high pollen days, and use air conditioning.
• Have your child wash hands and face, and change clothes, after outdoor play. A shower and hair rinse before bed keeps pollen off the pillow.
• Dry laundry indoors during peak season.

For dust mites

• Use allergy-proof covers on the mattress and pillows.
• Wash sheets and pillowcases weekly in hot water.
• Limit stuffed animals on the bed, and wash the favorite ones often.
• Vacuum with a HEPA filter vacuum, ideally when your child is out of the room.

For mold and pets

• Fix leaks, use bathroom fans, and keep indoor humidity down.
• Clean visible mold on hard surfaces, and get help for large areas.
• Keep pets out of your child's bedroom.
• Change air conditioner filters on schedule.

Treatment options

When avoiding triggers is not enough, there are several kinds of treatment. Your pediatrician can help you choose what fits your child's age and symptoms:

• Saline nose sprays or rinses to wash out pollen and mucus
• Antihistamines, which help with sneezing, itching and runny nose. Newer types cause less drowsiness than older ones.
• Steroid nose sprays, which calm swelling in the nose and work best when used every day during allergy season
• Allergy eye drops for itchy, watery eyes
• Allergy shots or tablets (immunotherapy), offered by an allergist for some children with ongoing symptoms

Ask your pediatrician or pharmacist which medicine to use and the right dose for your child's weight. Avoid over-the-counter decongestant nose sprays unless your pediatrician advises them, since using them for more than a few days can make congestion worse. Cough and cold medicines are not recommended for young children.

For more, visit MedlinePlus on hay fever and HealthyChildren.org.

When to call us

Call your A thru Z Pediatrics office if:

• Allergy symptoms are affecting your child's sleep, school or activities
• Over-the-counter treatment is not helping
• Your child gets frequent ear or sinus infections, or snores loudly most nights
• Your child coughs, wheezes or gets short of breath when allergies flare
• Your child has a fever, which suggests an infection rather than allergies
• You would like to talk about allergy testing or a referral to an allergist

Call 911 or go to the nearest ER if your child has severe trouble breathing, lips or face that look blue or gray, or swelling of the lips, tongue or throat.

To make a plan for allergy season, you can request a visit online.