Spring has sprung a little early this year, and along with spring comes seasonal allergies. Le Bonheur allergist Dr. Christie Michael offers our readers some helpful tips for dealing with allergies. Many children suffer from seasonal allergy symptoms especially in the spring when pollen counts can be exceptionally high.  Here, Dr. Michael has addressed some commonly asked questions regarding allergies.

How do you know symptoms are from allergies?
Sometimes it is hard to know without seeing a specialist and undergoing some allergy testing.  However, there are circumstances that increase the risk of allergic disease.  If your child gets symptoms of itching, sneezing, nose dripping/draining the same time every year or, for example, every time they are around a cat, allergies may be implicated.  Usually the common cold will last about a week, so another sign is congestion that lasts longer than a week.  A family history of allergies, a personal history of eczema or a food allergy also increases the risk. Eye itching and swelling are more common in allergies as well.

How can you get relief?
If you know your child's triggers for symptoms, avoiding them when possible and practical is ideal.  If your child has been outside, showering and changing as soon as you come in will help. Also, rinsing your child's nose or sinuses with a saltwater rinse (available at drug stores without prescription) can help. As far as medication, many children with allergies can get relief with over-the-counter antihistamines. These medicines are safe, effective and the dosage is by age so they are easy for parents to use. Diphenhydramine (Benadryl) is an older medication that can cause some sedation but is very effective.  The newer antihistamines - like loratadine (Claritin) and cetirizine (Zyrtec) - are also very good and less likely to make you sleepy. 

If your child has a lot of congestion, your pediatrican can prescribe a nose spray.  Over-the-counter nose sprays should be used for only a few days at a time as they can be addicting and cause worse “rebound” congestion.  Ask your pediatrician which ones are safe to use and for how long.  For eye symptoms, your child's doctor can prescribe eye drops to be used once or twice daily.  If there are only a few days out of the year that your child suffers from eye symptoms, the over-the-counter allergy eye drops are fine (usually have a capital A at the end of the name).  Artificial tears can provide relief from irritation, especially if refrigerated, and are a great alternative to rubbing.  Again, if you are not sure, ask your pediatrician or pharmacist.

When should you see a specialist?
If the usual measures above do not adequately relieve your child's symptoms, then you should see an allergy/immunology specialist for further evaluation.  Also, if your child suffers from asthma you should consider a specialist evaluation as allergies can trigger asthma attacks and lead to more frequent asthma symptoms, both interfering with daily life and putting you at risk for a severe attack requiring hospitalization. Your allergy doctor may recommend a course of "allergy shots" to desensitize you to the things that trigger your allergy symptoms.

What are the signs and symptoms of asthma?
Family history of asthma and personal history of allergies again increase the risk of asthma.  The cough and wheeze are “cousins,” so any bad spells, especially with exertion or during the night, may be a sign of asthma. Chest discomfort or atypical shortness of breath (occurring with little or no exertion or causing a child to seek rest long before peers) should always be discussed with your child's pediatrician.

A recent study suggests food allergies are more common in kids than we may have thought. Christie Michael, MD, an allergy and immunology physician at Le Bonheur, tells parents what they need to know about food allergies below.

Signs and Symptoms
Allergy to food can develop at any age, even in adulthood.  There are different ways an allergy may present – hives, swelling, itching, drop in blood pressure and wheezing – with the most dramatic symptom being anaphylaxis. Some patients may have only some of those symptoms. Usually the first symptom to present is itching and rash.  Some people will vomit or have diarrhea, which is possibly the body's way of clearing out a food that can cause a reaction.  Keep in mind the reaction to the food allergy can be immediate or delayed a few hours.

Treatment and Evaluation
If someone is having a slight reaction, maybe itching, then Benadryl (Diphenhydramine) should be given.  If it is progressing or other symptoms, like throat tightness or wheezing, present, give epinephrine if you have it and call 911.

A specialist should evaluate your child if he or she has had a severe reaction. Usually first step in testing is blood work, which can determine which food caused the reaction. The patient should be taught to avoid that food and be given epinephrine (more commonly referred to as an Epi pen) to keep on hand.

Children with eczema are at higher risk for severe reactions to a food allergy. With eczema, it can be harder to recognize initial signs the allergy -- worsening of skin symptoms. If the allergy causes the eczema to worsen, strict avoidance of the food is recommended for at least one year. A specialist can help determine which foods he should or should not eat, while maintaining a balanced diet.