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Expert Opinion: What you need to know about childhood allergies and asthma

If you suspect your child might have allergies, what's the first thing you should do?

Ask yourself a few questions to help distinguish between the signs and symptoms of allergies and the common cold:

• When your child gets a cold, does it seem like it takes much longer for him or her to shake it than other kids? Does the cough linger for weeks?

• Does your child frequently sneeze or have itchy and watery eyes?

• Does your child always have dark circles under her eyes — even when well rested ("allergic shiners")?

• Is your child often rubbing or itching his nose ("allergic salute")?

There are so many over-the-counter drugs. Should you go with those or see the doc first?

It is reasonable to try over-the-counter medications in your children who are at least 6 months old. Try nonsedating antihistamines like Loratadine or Benadryl to help with itchy, runny or sneezy symptoms.

What's the right age to get your kid tested for allergies?

Allergy skin testing is the gold standard for diagnosing allergies, and it can be done on children who are at least 6 months old. The testing becomes more reliable as the child gets older.

So many studies show that asthma is on the increase in our kids, but there are many reasons bandied about. Can you tell us what might be causing this increase in cases?

About 20 million Americans suffer from asthma, and approximately half of asthma cases are caused by allergies ("allergic-asthma"). Asthma is the most common chronic condition among children and accounts for most missed school days. The prevalence of asthma has been increasing since the early 1980s. Many hypotheses have been proposed for this phenomenon. One that I find very interesting is the hygiene hypothesis. This simply states that a lack of early childhood exposure to bacterial and parasitic infections due to improved hygiene and the overuse of antibiotics shifts our developing immune system toward developing allergic diseases like asthma.

What is the age when you generally see pediatric asthma sufferers growing out of it?

It is impossible to predict whether a child will "grow out" of asthma. We do often see symptoms lessen or disappear for many years. Children are more likely to remain asthmatic throughout their life if they suffer from allergies and are continually exposed to that which they are allergic to, have parents who smoke, or have a strong family history of asthma and allergies. An allergist can intervene early and identify children who are at high risk for having persistent asthma.

The "allergic march" describes a subset of allergic diseases that present in childhood — eczema, food allergies, allergic rhinitis, hay fever and allergic asthma. The goal of allergic intervention is to halt this progression so we can prevent many children from developing asthma.

What can parents do to help their asthmatic child?

Stop smoking — even smoking outside of the house. Do your best to keep your child from any avoidable allergen he or she is allergic to (such as dust mites or animals). Be compliant with prescribed controller medications. And, remember that with proper treatment, a child with asthma should be able to participate in sports and play outside just like a child without asthma.

Dr. Mona Mangat of Bay Area Allergy and Asthma is board certified in pediatric and adult allergy/immunology.

What is asthma?

Asthma is a chronic inflammatory condition of the lungs. It involves:

• A narrowing of air passages that causes wheezing, coughing and shortness of breath.

• Excess mucus production in the lungs that can cause a wet, productive cough.

• Infiltration of the lining of the lungs with inflammatory cells that cause the air passages to be more sensitive and irritable to allergens, viral infections, cold weather, exercise.

Expert Opinion: What you need to know about childhood allergies and asthma 04/10/09 [Last modified: Friday, April 10, 2009 4:30am]
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