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by Scott Schroeder, M.D.


Besides the changing foliage, two sure signs that fall is approaching are the reappearance of yellow school buses and the red shiny noses of mouth-breathing children as they head back to school. We know why the school buses have emerged from their summer hibernation, but red noses could be either a cold or allergies. Often it is hard to determine the cause of the congestion, especially in some parts of New York City, where 25 percent of children have asthma, nearly 100 percent get colds, and up to one-third may have allergies. How can we differentiate between the overlapping symptoms? And is there anything we can do to alleviate them?

Diagnosing allergies

Clearly identifying agents that your child is allergic to is critical to avoiding or reducing her exposure to those allergens, thereby reducing her symptoms. If allergies are undiagnosed, left untreated, or mistreated, there is the possibility that they may cause the child to develop asthma.

In the past, diagnosing allergies to foods or indoor or outdoor airborne allergens meant taking your child to a specialist for painful and time-consuming skin testing. Today there is an alternative — pediatricians and family practitioners have access to the ImmunoCAP® Specific IgE blood test that uses a blood sample to diagnose children’s allergies. The test can be performed on children of any age, regardless of their skin condition, with no need to stop any of their medications.

Results are available in a few days. If they confirm allergies, the report will specify tree pollen, molds, animal dander, food, and/or other types of allergens. The child’s physician can then discuss with the family non-pharmacological approaches to controlling the allergies, or if necessary, prescribe medication to help the child lead a normal life and not sound as if he were constantly studying for a French test.

Distinguishing allergy symptoms from colds

Children with allergies often have a combination of runny nose, itchy eyes, throat clearing, sneezing, and cough. Allergies can also cause or contribute to eczema, infant colic, and recurrent ear infections. Allergies are caused by a combination of genetic factors as well as exposure. If one parent has allergies, his or her child has a 25 percent chance of developing allergies; if both parents have allergies, the risk increases to 50 percent.

The common cold, or viral rhinosinusitis, is an infection of the nasal passages, sinuses, and throat caused by any of a number of viruses. While a cold may slow your child down for the first few days, she should bounce back quickly even before the coughing and sneezing completely resolve. The symptoms of sneezing, cough, fever, and nasal congestion usually last seven to 10 days. Most children get six colds per winter, and if they live with a smoker, the number increases to nine per winter. This averages out to at least 60 days of goopy noses and sniffles every winter.

If you suspect your child might have allergies, discuss your concerns with your pediatrician or family physician and ask if allergy testing might be appropriate. And trust your instincts, because nobody knows your child better than you do.

One website where further information is available is the Quest Diagnostics Patient Health Library at www.questdiagnostics.com.

Dr. Scott Schroeder is associate professor of pediatrics, SUNY-Stony Brook College of Medicine, and chief of the division of pulmonary medicine, Winthrop-University Hospital Department of Pediatrics.


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