Ah Choo! My Child Always Has A Cold!

This week's column is from Dr. Susila Shanmuganathan, a family practice resident at the University Hospital and Clinics here in Lafayette.   Another runny nose?  Don't they know this is an Emergency Department, and cold viruses are hardly an emergency?  When we finally interview mom though, her frustration comes through.  Her child has been sneezing, rubbing her eyes and face for weeks, and mom is fed up.  The kid coughs all night and none of the cold remedies have touched it.  Maybe its not just a virus that should have gone away weeks ago. Does your little one always have the sniffles?  Is she constantly rubbing her eyes and wiping her nose?  Your child may have Allergic Rhinitis, also known as seasonal allergies or hay fever. Allergic rhinitis is a common problem in infants and children.  The symptoms can vary, the most common being a clear runny nose, sneezing, and itchy red eyes.  Kids may have dark circles under their eyes ("allergic shiners") or a crease across their nasal bridge caused by constantly wiping their noses upwards (the "allergic salute").   Children may also have a cough that is worse at night.  These symptoms are often worse at certain times of the year when there are more pollens and other allergens in the air.  Some people have allergies to year-round, indoor allergens like dust, pets, and molds. So what the heck is an "allergen?"  What is pollen exactly?  Allergens and pollen are tiny bits of plants or animals that are so small they cannot be seen.  Often they are so small and light that they float through the air.  When they get up some kids' noses or in their eyes or in their lungs, the kids' immune systems react against the allergens and try to flush them out. The body makes extra mucus and tears to wash them away.  The body also makes sneezing and coughing to blow the allergens out. Allergies can be a real burden.  All that itching and sneezing and coughing- it really irritates. It's harder to play, it's harder to pay attention in school, it's harder to sleep- life is a lot less fun!  So what can you do to control these symptoms?  First, there is no need to get frazzled.  There are some simple things you can try at home before visiting your doctor or allergist.  The easiest thing is to avoid exposure to allergens that seem to make your kid worse- pets, dusty areas, certain plants.  Look for weather reports with pollen counts. If the day's pollen counts will be high, avoid outdoor activities. For medicines, you can start with an over-the-counter antihistamine like loratidine (Claritin) or cetirizine (Zyrtec).  Though you can use these medications on an "as needed" basis, it may actually be nicer for your child to use them every day so you don't end up chasing symptoms.  It's best to start these medicines right before your child's allergy season and use them every day throughout that season.  As stated before though, some kids have year-round allergies and need to be on medicine every day all year. If your kid needs better medicine than those, see your doctor about nasal steroids such as Nasonex, Flonase, or Nasacort.  They are a little more trouble to use, but they work better than the antihistamine syrups.  If those don't cut it, then it is time for allergy testing to better find out what allergens to avoid.  Your child may need more medicine, or allergy shots. Many parents worry that their child won't tolerate getting an injection every week.  It's a judgement call between the parent and the allergist: sometimes the shots are a whole lot better than living with constant itching and sneezing and sleep deprivation. But remember, there are simple things you can do at home and symptoms to look for before you worry and head to your doctor or the ER.  Avoid the pet dander and pollen.  Try the first-line antihistamines.  Although our kids might love animals and the outdoors, sometimes it may take their breath away...Ah choo!