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Spring: When Allergies Are at Their Worst

From the Show: Healthy Children
Summary: The spring season is here, and with it comes those pesky allergies.
Air Date: 4/15/15
Duration: 10
Host: Melanie Cole, MS
Guest Bio: Jen Kim, MD
sinai headshot hi resDr. Jen Kim joined NorthShore University HealthSystems in January 2014 and is on faculty at the University of Chicago Pritzker School of Medicine. She earned her MD from Northwestern University Feinberg School of Medicine, completed internship at St. Louis Children’s Hospital at Washington University i St. Louis, and finished residency in pediatrics at Children’s Memorial Hospital, where she also completed her fellowship in Allergy & Immunology. She stayed on as faculty at Children’s Memorial Lurie (Children's of Chicago) where she served as the division’s Clinical Practice Director for 5 years. In 2010, she moved to New York City to join the Icahn School of Medicine at Mount Sinai. During her four years as part of the Jaffe Food Allergy Institute, she published studies on the effect of dietary baked milk inclusion in children with milk allergy and served as clinical investigator of the first randomized double-blind, placebo-controlled study of the use of omalizumab in milk oral immunotherapy.

Dr. Kim is a member of the American Academy of Asthma, Allergy, and Immunology and American College of Asthma, Allergy, and Immunology and is a current committee member of the Section of Allergy & Immunology of the American Academy of Pediatrics. She serves as the assistant editor of the AAP Section of Allergy & Immunology Newsletter and provides input regarding allergy and immunology content on the www.healthychildren.org website.
Spring: When Allergies Are at Their Worst
Allergies are caused by the body’s reaction to substances called “allergens,” which trigger the immune system to react to normally-harmless substances as though they were attacking the body.

Some allergies are easy to identify by the pattern of symptoms that follows exposure to a particular substance. But, others are subtler and may masquerade as other conditions.

Some common clues that could lead you to suspect your child may have an allergy are runny nose, nasal stuffiness, sneezing, throat clearing and nose rubbing.

Jen Kim, MD, discusses spring allergies and how to diagnose and treat these dreaded allergy symptoms.
Transcription:

RadioMD Presents: Healthy Children | Original Air Date: April 15, 2015
Host: Melanie Cole, MS
Guest: Jen Kim, MD

This is Healthy Children brought to you by the American Academy of Pediatrics on RadioMD.com. Here's Melanie Cole, MS.

MELANIE: Is your child sniffling? Sneezing? Stuffy nose, running nose and their eyes are a little watery, itchy? And you're not sure if they have a cold, some sort of a spring cold or whether it's spring allergies. How do you know the difference? And if it is allergies, do you do anything about it or do you just sort of wait it out?

My guest is Dr. Jen Kim. She's a pediatrician with North Shore University Health Systems.

Welcome to the show, Dr. Kim.

So, tell us a little bit about the difference between a spring allergy and a cold. How do we tell the difference and what do we do about it?

DR KIM: Well, it is sometimes difficult because they both can have runny nose, can be achy, but first of all, if you have itching, so itching of your nose, itching of your eyes, that is more likely to be allergy. Also, the timing. So, right now, in the Chicago area, anyway, we are at the height of tree pollen season. So, if you've had these symptoms for the last few weeks, and it's gradually getting worse that seems more likely to be allergies; whereas, a cold just last 7-10 days and then go away. So, the symptoms are often similar, so it can be difficult to tell.

MELANIE: So your kid is exhibiting these symptoms. They have the itchy eyes and everything. Do we do anything about it, Dr. Kim? Do we try those Claritin and various things that are over the counter or a saline mist of some sort? What do you do for them to make them more comfortable?

DR KIM: Well, I think it depends on how significant the symptoms are. If they are very mild and they don't seem bothered by it and the parent doesn't feel like the medication is necessary, you can just watch and see what happens. But, if you have more moderate to severe symptoms, yes. I would start with the oral antihistamine. Many are over the counter at this point so there's Zyrtec or Certirizine, Claritin or Loratadine, Allegra or Fexofenadine. All these things have children's formulations meaning liquid and you can try using those medications to see if this will alleviate symptoms.

MELANIE: Do they make the kids drowsy? Because I now the parents are afraid to give the kids Zyrtec or Allegra or something on a school day thinking it might make them fall asleep in school or not go to bed that night if they're non-drowsy. How do we know how they'll react to those?

DR KIM: Well, Claritin and Allegra or their generic counterparts should not cause drowsiness because the medicine does not pass the blood/brain barrier, meaning to get into the brain. Now, Zyrtec is a little bit stronger, but it can cause some drowsiness. So, I feel that Zyrtec, in my opinion, works better than the other two, but it has the potential for having more side effects. So, if you are worried about that, bedtime dosing, since these are 24 hour medications, would be recommended.

MELANIE: Okay. Now, what about the triggers and the things. I mean spring is spring. You want your kids outside and they're walking to school and they're done with the whole hermiting-up of the winter time, so how can we help them along with these or even prevent them?

DR KIM: Well, I think first of all is being diagnosed. I would recommend if you are interested or if you have these symptoms to verify them with an allergist by doing some testing. Right now, we are in the middle of tree pollen season in a lot of parts of the country and pollen, in general, peaks first thing in the morning, so 5:00-10:00 in the morning, so I would not recommend opening the windows, for example, to get in that fresh air, because you're just going to increase the exposure. If they've been outside all day and exposed to the tree pollen, probably leaving your shoes at the door and then changing your clothes or even taking a shower so that all that pollen in your hair, in your clothes, is removed. Certainly, you want to shower before bed so that it doesn't stick on your pillow and you're breathing in that pollen in all night long.

MELANIE: That's a really good point to make because I know some kids with allergies, maybe they shower in the morning or whatever, but then, meanwhile, after they've been out in it all day, it's on their pillowcase. Do you recommend those kind of allergy-free or is that for more like asthma and other kinds of allergies, not just these seasonal allergies?

DR KIM: Well, like the dust mite-proof cover, the allergy-proof covers are for dust mite allergies which is a different allergen. So, that's more of an indoor allergen. Again, it would be helpful to know if you have to do those things if you're sensitized to dust mites but dust mite allergy probably, although you're exposed to it year round, you're probably going to be more symptomatic in the winter because you're indoors more. So, dust mites tend to, it's gross, but they feed on dead human skin. So, that's how they survive. So that's why we suggest putting dust mite covers over the pillow and the bed to really reduce the exposure that you could have to dust mites.

MELANIE: What do you think about nasal lavage or irrigation? Doing something to help clear out your sinuses, some of the home remedies, Dr. Kim.

DR KIM: I think it's fantastic. There are nettie pots. There's sinus rinse. All these things can help not only remove the mucous and the stuff in your nose, but also, if you are breathing in all this pollen all day long, it will remove whatever pollen is still stuck in there. So, I do think that especially for more moderate to severe symptoms, if you're really stuffed up, especially if you are feeling like, “Ew! I may be developing a sinus infection”, I would highly recommend using these things because that can really be helpful.

MELANIE: Dr. Kim, a listener question that's come into a few times: “Can spring allergies turn into a cold or if a child is wiping their nose because they have allergies and then they touch a doorknob and somebody else touches that, then will they get a cold or runny nose from it? Can this be passed that way?

DR KIM: Allergies cannot be passed that way. So, if someone has allergies, the mucous that is produced will not cause someone else to have allergy symptoms. However, you will not necessarily know if someone who has a runny nose, has a cold or allergies. So, I would probably still treat it the same way. You know, be careful. Make sure you wash your hands and wipe your hands. Don't put your hands to your face after touching surfaces that kind of thing. But, technically speaking, no, allergies are not infectious or they're not passed on. They're not contagious. That being said, you're not going to necessarily know, any individual person, if they have a cold or allergies.

MELANIE: Once the season's over, then should we notice the allergy symptoms going away? Is it going to last the 3-4 weeks of the spring or 6 weeks? And then, as the summer approaches and everything's really up and everything, we should see those symptoms go away?

DR KIM: Yes, you should, assuming you do not have other pollen allergies that are starting to ramp up in the summer. So, grass pollen peaks in the summer and then ragweed pollen peaks in the late summer, like August, September. So, potentially, if you are allergic to tree, grass and ragweed, you could be symptomatic from spring through fall.

MELANIE: Ew! That would be awful for kids or adults, even. In the last 30 seconds or so, best advice for those suffering with spring and seasonal allergies.

DR KIM: I would first try an antihistamine. There are intranasal steroids now are over the counter, Flonase and Nasocort. I do suggest using the sinus/nasal lavage, sinus rinse nettie pot. Lastly, consult an allergist if you feel like none of those things are helpful.

MELANIE: Absolutely. It can be quite annoying. It can be a nuisance or it can be something you really are concerned about with your kids. So, as Dr. Kim says, if it's really concerning you, then definitely seek treatment.

This is Melanie Cole. You're listening to Healthy Children. Our expert guests are provided by the American Academy of Pediatrics. Their consumer website is HealthyChildren.org.

Thanks so much for listening and stay well.

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