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Health Matters is a series of health and medical articles provided by Concordia International School Shanghai's community partner, United Family Hospital Pudong. 


Spring is here once again. Nice weather, green trees, blooming flowers everywhere. For some parents, as much as they want to enjoy it, is also a cause of worry because the most common problems for kids during this time are allergies and allergy-related problems. Worry no more! This article will guide you on how to identify the common springtime allergic conditions, how to treat them, how to prevent them, and when to see your doctor.

It is common knowledge that allergy flare-ups during spring time is mainly caused by blooming trees, plants, and flowers. Mainly due to the wind, pollens from flowers gets carried around and ends up in our nose, eyes and lungs. In the process, our bodies react and releases histamines. In the nose, it causes irritation, swelling and subsequent mucus production. In the eyes, this causes redness, tearing, burning and itchiness. In the lungs, this triggers swelling in the airways, wheezing and mucus production.

Let’s discuss the 4 most common spring illnesses for kids:

NASAL ALLERGIES
Achoo!! You were out on a sunny day, blue skies, colorful flowers, tall grasses in the background. Perfect. But then after a long day of the kids running wild in the park, they suddenly start sneezing, then comes the sniffles, then nasal congestion. And so on.

So how to differentiate if a child has allergies or just a simple cold??

The key is observation. The symptoms are usually hard to tell apart from the start but it is worth noting that most Viral infections lasts 3-5days, and gets better without interventions. The body will produce their own armor of antibodies to fight off the invading organism. On the other hand, nasal allergies will persist for a few weeks, resulting in persistent coughing, sneezing, and sometimes dark circles under the eyes due to exhaustion of incomplete sleep

Most common manifestation of allergies. Symptoms includes:

  • Nasal congestion
  • Clear runny nose
  • Itchy nose
  • Itchy throat and post nasal drip
  • Sneezing
  • Persistent cough
  • Dark circles under the eyes
  • Mouth breathing while asleep
  • Symptoms that last longer than a few weeks


Treatment

  1. No treatment. Usually, if symptoms are not that bad, symptoms do resolve on their own. It is important to keep the child hydrated, comfortable, and away from the potential source of the allergens.
  2. Saline nasal spray. These are over the counter medications that are so easy to use. It only entails squirting up the spray in the nostrils to wash the nasal cavity. Most kids don’t like it because of the pressure, so do try to be gentle.
  3. Nasal decongestants. They usually help a lot especially at night time when kids can’t sleep because of blocked nose. These are available as nasal spray or pills, so you have a choice which one works better for your kids.
  4. Anti-histamine medications. Some are available as over the counter medications, and some are prescription medications. It is better to consult your doctor before starting them on medications because frequency and timing are some important factors to ensure the success of the treatment of symptoms.

** Blood tests work-ups to identify the allergens called Allergy Testing Panel works fairly well in kids 3yrs and older , but not very reliable in children younger than that. We will be discussing more of these in the latter part of the article


Prevention
How to prevent allergies? Know the source, find the trigger. 

Most common sources:

  • Food
  • Pets
  • Pollens
  • Pet danders
  • Dust
  • Mold
  • Environmental irritants (cigarette smoke, perfumes, aerosols)


What you can do:

  1. You may use dust mite proof cover on beds and cribs
  2. Get rid of stuffed animals if you think this is the one causing the symptoms
  3. Remove carpets and heavy drapes
  4. Use vacuum with a Hepa filter
  5. Clean with wet rag
  6. Use air conditioners to filter allergens from outside
  7. Avoid smoking in the house
  8. Remove pets

SEASONAL ALLERGIES AND POLLENS
Spring and pollens. You know it’s seasonal if there are repeated or chronic cold-like symptoms that lasts more than a week or two or that develop at about the same time every year. That’s how you know which season gives you the most troubles.

Signs and symptoms includes: runny nose, nasal stuffiness, sneezing, throat clearing, sniffling, sneezing, itchy, runny eyes

Steps to minimize exposure:

  1. Stay indoors on windy days during pollen season. In some countries, they provide pollen count, so be sure to be armed with knowledge before planning your activities
  2. Don’t allow your child to play on flower beds and tall grasses
  3. Keep the pollen out by keeping window and doors closed 
  4. Wash clothes frequently. This includes hats and scarves.
  5. Take a shower to clean off any allergens that the child may have picked up while playing outdoors
  6. Wear a mask which can reduce the allergens that the child can inhale
  7. May use tight fitting sunglasses to protect the eyes from pollens
  8. Drink extra fluids to help prevent mucus production in the airways
  9. May use a special filter that circulates the air indoors


Treatment:

  • Avoidance of known allergens
  • Antihistamines—Cetirizine/Loratadine
  • Nasal spray


ALLERGIC CONJUNCTIVITIS
As mothers, we have all received that one phone call from the school nurse telling you to pick up your kid from school because of red eyes. So is it pink eye? Or just simply allergies? How to know the difference?

  1. Bacteria—eyes are red with yellowish or greenish discharge throughout day and night. Eyelids may also swollen.
  2. Virus—eyes red but no drainage or very small amount of drainage or crusting upon waking up
  3. Allergy—usually seasonal, mostly in the spring, eyes usually red with increased tears and unusually itchy


Most common causes:

  • Pollens
  • Molds
  • Dust mites
  • Animal dander


Treatment:

  1. Cold compress
  2. Minimize contact with the allergen
  3. Avoid rubbing the eyes
  4. Saline eye drops
  5. Allergy eye drops

When to see a doctor:

  • Intense pain in the eye
  • Extreme redness in the eye
  • Inability to open the eyes
  • Severe sensitivity to light
  • Difficulty seeing, blurring of vision
  • Spots or blisters developing near the eye or on the eyelid

ASTHMA
Asthma always deserve a dedicated full article to discuss everything in full, from symptoms, to treatment, and prevention. In this article, we will just have a quick overview. 

Asthma is also an important illness to be aware of during the spring time because different allergens can trigger an Asthma attack in which airways are inflamed or swollen, resulting to chest tightness and subsequent difficulty of breathing.

There are some kids whose asthma has more of an allergic trigger and may suffer flare-ups during springtime. Common triggers includes: 

  • Pollens
  • Temperature changes
  • Fertilizers
  • Insect repellants
  • Dust and cleaning chemicals

Symptoms of asthma:

  • Wheezing
  • Night time coughing
  • Chest tightness
  • Shortness of breathing

Treatment:

  1. Nebulization
  2. Inhalers
  3. Anti-histamines


Now that we have enumerated and discussed the 4 most common conditions affecting kids during the springtime, then you can be more confident to schedule those picnic in the parks without worrying too much.

If symptoms of allergies are getting worst, the doctor may recommend to have skin tests and blood tests to determine what allergens triggers your symptoms. Testing can help determine what steps you need to take to avoid your specific triggers and identify which treatments are likely to work best for you. The Allergy Panel includes a list of food or inhalation particles that are mostly the common allergens that causes symptoms. It would require a small amount of blood to be sent to the laboratory.

Once the allergen is identified, we can proceed to plan a treatment that is suitable for the child. This maybe an anti-histamine to be taken for a certain number of days, or a maintenance medication that needs to be completed for a few weeks. Your doctor may also recommend Allergen Immunotherapy. Also known as desensitization, this treatment involves regular injections containing tiny amounts of substances that cause your allergies. Over time, these injections reduce the immune system reaction that causes symptoms.

Sublingual Allergy Therapy is also a new intervention with promising results. Small amounts of allergens are placed under the tongue, using the same concept as the allergy shots but with a different and more convenient delivery system. 

Pudong United Hospital is committed to a high standard quality of care. We have Pediatricians and subspecialty doctors like ENT (Ear, Nose, Throat) Doctors who are ready to guide and help you anytime. Allergen Immunotherapy is available in our facility, and our Pharmacy is fully stocked with all the over-the-counter and prescription medications. Please feel free to reach us anytime via our Hotline or by simply scanning our QR code.