Saturday, February 05, 2011

Does Your Child Have Allergies or Asthma? Answers to the Most Common Questions Parents Ask (Part 1)

[NOTE FROM SUSAN: Since this article provides so much valuable information, I’ve decided to run it in two parts.]

Allergists are trained to look for certain symptoms that are not obvious to parents or even to pediatricians or general practitioners.

Paul Ehrlich, M.D., and Larry Chiaramonte, M.D. are the authors of Asthma Allergies Children: A Parent's Guide. Here are their answers to the most common situations and questions they hear from parents asking about the problems that plague their children:

1. If your child rubs the tip of his or her nose with her index finger and then with the palm of the hand upward towards her forehead, it means:

A. She is coming down with a cold.
B. She has disobeyed mommy and put beans in her nose.
C. She is performing what allergists call an “allergic salute.”

This is a classic “allergic salute.” It is a specific behavior that all trained allergists recognize, but that might look like nothing out of the ordinary to a parent or pediatrician.

2. If your 5-year-old has no history of respiratory problems but starts scratching his or her nose persistently in the evening before bed, it means:

A. The child is thinking deeply.
B. He or she is working up to picking it after he goes to bed when no one is watching.
C. The child should be tested for sensitivity to milk, cats, dust mites, molds, trees, ragweed, and grass.

While your child is undoubtedly a deep thinker, these symptoms are typical of any number of common sensitivities, and your child should be tested.

3. If your 4-year-old has recurring bronchiolitis and develops dark circles around the eyes, it means:

A. Congestion has made him irritable, and the child got into a fight.
B. School difficulties are causing a loss of sleep.
C. He has allergies.

Congestion may be a symptom of many childhood conditions, but the dark circles are a tip-off: They are caused by chronic nasal congestion.

4. Your 2-month-old, born in July, starts getting red, rosy cheeks, and the skin starts to itch at the height of ragweed season in September. Your child is probably:

A. Allergic to pollen.
B. Allergic to house dust mites.
C. Reacting to changes in the weather.

Allergic to house dust mites. How can we be so sure? Because your child is encountering ragweed pollen for the first time at the age of 2 months, and thus has not been sensitized to it. The current problems are due to the household dust that he or she has been breathing for the past two months, unless there’s a dog or cat in the house, in which case it might be the pet.

5. Your 3-year-old starts getting congested at the end of ragweed season in the fall. She is probably:

A. Allergic to pollen.
B. Allergic to house dust mites.
C. Reacting to changes in the weather.

A: She is allergic to pollen. Unlike the 2-month-old in the previous problem, your 3-year-old is now experiencing her second ragweed season. She was exposed last year, developed antibodies, and is now allergic.

6. Your child has “hay fever” in the spring when there is no hay, but not in the fall when there is. Why is that?

A: Hay fever is a term that describes symptoms, not specific causes, and so is misunderstood. There is a well-defined seasonal pollen cycle. In the Northern U.S., tree pollen appears early in the spring, before the leaves unfold. Grass pollen appears later in the spring and early summer. Finally, there is a late summer peak of weeds and ragweed. Hay fever is named for the period when grasses mature and are mown for hay, although the pollens may have nothing to do with agriculture. In warmer areas of the U.S., such as the Southeast or Southern California, the grass season may last six months or more. Also, areas such as Southern California, much of which is essentially desert, are devoid of ragweed, and do not have a hay-fever season.

7. Children sneeze a lot at night. What can a parent do about it?

A: Keep your house as free as possible from any dust. This is the single most important step in treatment of asthma and allergies. Remove any furry or feathered animals from the bedroom, permanently. Discard any feather (or down) pillows or quilts. Use hypoallergenic (polyester) pillows and washable blankets. Forced-air ventilation is very bad for patients. Buy filter material and install in the bedroom air vents. Wash or change filters monthly. Do not use humidifiers of any kind. Increased humidity increases the growth of dust mites and molds. The most effective way to keep your air passages comfortable during the night is to keep the bedroom very cool (55˚F –60˚F). Use plastic covers that completely encase any pillows, the mattress, and box spring even if the mattress and pillows are new. Remove rugs and carpets except for washable throw rugs. If it is impossible to remove carpeting, vigorous vacuuming must be performed daily. Vacuum cleaners blow a lot of fine dust out the back. Purchase special allergen-proof vacuum cleaner bags. HEPA air purifiers are very useful for pet dander, mold spores, or cigarette smoke, or if you have forced-air ventilation. Avoid ion air purifiers. Clean regularly.

[Click here for Part 2 of this article!]

This information and more can be found in Asthma Allergies Children: A Parent's Guide, by Paul Ehrlich, M.D., Larry Chiaramonte, M.D. with Henry Ehrlich. Available in bookstores nationwide and online at Amazon (in paperback or for Kindle) and Barnes & Noble (paperback). For more information, visit


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