Treatment for a Child's Allergy
Specific treatment for allergies will be determined by your child's physician based on the following:
Your child's age, overall health, and medical history
Severity of the allergic reaction
Your child's tolerance for specific medications, procedures, or therapies
Expectations for the course of the allergic reaction
Your opinion or preference
The three most effective ways to treat allergies are avoidance, immunotherapy, and medication.
What is avoidance?
Avoidance is staying away from a substance that causes an allergic reaction.
Suggestions for avoiding (some) allergens:
Remain indoors when the pollen count is high and on windy days.
Dustproof the home, particularly your child's bedroom.
Eliminate, when possible, wall-to-wall carpet, venetian blinds, and down-filled blankets or pillows.
Wash bedding, curtains, and clothing often and in hot water to eliminate dust mites.
When possible, keep bedding in dust covers.
Use air conditioning instead of opening the windows.
Consider putting a dehumidifier in damp areas of the home, but remember to clean it often.
Have your child wear a face mask if playing outside when the pollen count is high.
Take vacations in areas where pollen is not as prevalent—such as locations near the ocean.
Your child's physician will also have suggestions for avoiding the allergens that cause reactions.
What is immunotherapy (allergy shots)?
Immunotherapy is a type of treatment for allergic children with hay fever and/or asthma. It is also called desensitization, hyposensitization, and allergy shots. A mixture of the various pollens, mold spores, animal danders, and dust mites to which the child is allergic is formulated. This mixture is called an allergy extract. This extract contains no medication such as antihistamines or corticosteroids.
How is immunotherapy administered?
Immunotherapy is given by injection under the skin, usually into the fatty tissue in the back of the arm. It is not painful like an injection into the muscle, such as a tetanus shot.
How often are immunotherapy injections necessary?
Injections may be given weekly or twice a week until a maximum dose is tolerated. This is called the maintenance dose. It may take about one year to reach the maintenance dose. At this point, the frequency of injections may be decreased to every other week and finally to once a month. Your child's physician will establish the appropriate schedule of injections to meet your child's medical needs.
Symptom improvement and immunotherapy
About 80 to 90 percent of children improve with immunotherapy. It usually takes 12 to 18 months before definite reduction in allergy symptoms is noticed. In some children, a reduction in symptoms is evident in as soon as six to eight months.
Immunotherapy is only part of the treatment plan for allergic children. Since it takes time for immunotherapy to become effective, your child will need to continue the allergy medications, as prescribed by his or her physician. It is also important to continue eliminating allergens (such as dust mites) from your child's environment.
Are there side effects to immunotherapy?
There are two types of reactions to immunotherapy: local and systemic. The local reaction is redness and swelling at the injection site. If this condition occurs repeatedly, then the extract strength or schedule is changed.
A systemic reaction is one that involves a different site, not the injection site. The symptoms may include nasal congestion, sneezing, hives, swelling, wheezing, and low blood pressure. Such reactions can be serious and even life threatening. However, deaths related to immunotherapy are rare. If a systemic reaction occurs, your child may continue taking shots, but of a lower dosage.
If you have any questions concerning immunotherapy, always consult your child's physician or allergist.
Medication as treatment for allergy
For children who suffer from allergies, there are many effective medications. This is a brief overview of the most commonly used types of medications. The American Academy of Pediatrics recommends against some over-the-counter medicines for infants and young children. Always consult your child's physician before giving your child any over-the-counter medications.
What are antihistamines?
Antihistamines are used to relieve or prevent the symptoms of allergic rhinitis (hay fever) and other allergies. They prevent the effects of histamine, a substance produced by the body during an allergic reaction. Antihistamines come in tablet, capsule, liquid, or injection form and are available both over the counter and by prescription.
What are decongestants?
Decongestants are used to treat nasal congestion and other symptoms associated with colds and allergies. Decongestants cause the blood vessels to narrow, leading to the clearing of nasal congestion. Decongestants are available both over the counter and by prescription. The most commonly used forms are liquid and tablet. However, nose sprays or drops may be prescribed by your child's physician. The American Academy of Family Physicians does not recommend decongestants for children younger than age 4.
What types of medications are used for asthma and respiratory symptoms resulting from an allergic reaction?
The use of medications for asthma or respiratory symptoms from allergies is highly individualized based on the severity of the symptoms. The following are the most commonly used medications:
Bronchodilators. These medications are used to help open the narrowed airway and may relieve coughing, wheezing, shortness of breath, or difficulty in breathing. These are usually considered "rescue medications" for acute attacks of asthma. Types of bronchodilators are beta agonists, and anticholinergics. These medications come in inhalers, or in pill form, liquid, or injectables.
The short-acting bronchodilators are used as needed, as symptoms occur. Longer-acting bronchodilators may be used for maintenance or on a daily basis to help control flare-ups.
Anti-inflammatory medications. These medications help to decrease the inflammation that occurs in the airways with asthma. These include two types of medications:
Nonsteroidal anti-inflammatory medications. Cromolyn and nedocromil are two types of nonsteroidal medications that are usually inhaled.
Corticosteroids. These medications can be given in a variety of ways. Some of them are inhaled, while others may be taken as a pill or liquid, or even injected. The steroids taken by mouth can have more side effects than those that are inhaled. Consult your child's physician regarding the best choice for your child.
Antileukotrienes. These are a relatively new type of medication being used to help control the symptoms of asthma. These medications help to decrease the narrowing of the lung and decrease the chance of fluid in the lungs. These are usually given by mouth.
Immunotherapy. Omalizumab (Xolair), a monoclonal antibody that attacks an immunoglobulin associated with allergic reactions, can be used for severe asthma attacks in adults and children older than age 12.
Consult your child's physician for more information concerning allergy medications.