By Dr. Audrey Segal
Paediatrician and allergist
The fall can be a particularly challenging time for children with allergies and their families. In addition to an increase in outdoor allergens, kids have returned to school and the potential of being exposed to allergens there as well. I hope you’ll find the advice below helpful.
From mid-August until the first frost, there is an increase in pollen in the air, especially from ragweed. For those with ragweed or other weed allergies, the fall can be a miserable time of year. Reactions can include itchy, watery eyes; a runny, itchy nose; lots of sneezing; worsening of asthma; and worsening of eczema. Avoiding pollen is impractical (and impossible!), but there are things you can do to help your child through the allergy season. If there is a known pollen allergy:
Give your child an over-the-counter antihistamine. Just make sure it is the non-drowsy variety, or your child will have a hard time staying alert during the day!
Make your home a “safe place.” Keep pollen out as much as possible, by closing windows and using air conditioning when necessary. Take your shoes off at the door, and change your clothes if you have been walking outside, especially if you have brushed against plants.
If you suspect an allergy and it hasn’t been diagnosed, start with a visit to your doctor to get a referral to an allergist. While you are waiting to see your allergist, you can follow the above tips to lessen exposure.
In addition to pollen and other environmental allergies, I also treat children with food allergies at Rouge Valley’s allergy clinic. Parents of children with food allergies can be especially worried at back-to-school time, thinking that their children may be exposed through other students’ food. Though reactions at school are rare (thanks to vigilant school policies!), there are ways to ensure that your child remains safe while outside your home:
Educate your children. Teach them what they can’t eat and not to share their food.
Always have them carry their epinephrine auto-injector (Allerject or EpiPen). Having this locked up in an office or in a teacher’s desk, does not allow your child immediate access to this life-saving injection. As soon as an allergic child is exposed to a known allergen, caregivers should be prepared to give the epinephrine immediately if symptoms appear.
Show teachers or those caring for your child how to use the epinephrine auto-injector. Not being sure how it works, or wondering if the child requires an injection, can create a delay in getting the child the life-saving epinephrine that he or she needs. Different brands of auto-injectors give instructions on how to administer the shot, whether with words and pictures, or by talking you through each step. It is a very simple process to learn. And, reassure those looking after your child, that it is always better to inject than not (the risks of untreated anaphylaxis are much greater than the risks of giving the epinephrine if it wasn’t truly necessary). Of course, once your child is old enough, he or she will know how to use the injector. Don’t forget to call 911, or visit the emergency room, after using the epinephrine.
So to sum up, if there is a known food allergy, and a child is exposed to this known trigger, be prepared to use the epinephrine auto-injector immediately if necessary. If your child has a reaction to something for the first time (with symptoms including, but not limited to: hives; swelling of the tongue, lips or face; difficulty breathing; profuse vomiting; lethargy; or any other worrisome symptoms) call 911 or see your doctor for immediate medical attention.
If you think your child has an allergy, talk to your family doctor or paediatrician about getting a referral to an allergist, who can perform skin testing to the allergic trigger in question.
In the meantime, I hope you and your family get through the fall with minimal sniffles.
Dr. Audrey Segal works in the paediatric allergy clinic at Rouge Valley Centenary hospital campus. The clinic runs weekly on Tuesdays and Wednesdays from 8:30 a.m. to 4 p.m. Patients are referred to the clinic from community physicians, through the emergency department, or after discharge from the hospital. The clinic sees more than 1,000 patients a year, from infants to age 18, with environmental, food, and/or drug allergies. For a referral to the paediatric allergy clinic, please have your doctor call 416-281-7013, or fax to 416-281-7102.