Can asthma be prevented?

Recent studies would suggest that by reducing a child's exposure to allergy triggers, not only are you helping get rid of annoying nasal symptoms like a stuffy, runny, itchy nose, but you may be preventing the development of asthma. 

Researchers describe the progression of symptoms from skin allergies (eczema) in babies to nasal allergies in toddlers and kindergarteners (allergic rhinitis) to asthma in older children as "the atopic march".  This tends to happen when there is continuing exposure to things that the child is allergic to, such as dust mites or pollens.  The better the environmental control of these allergens, the less likely symptoms will progress to more severe conditions such as asthma.

5th Grader Saved by an Epi-Pen

A fifth grader experienced a severe allergic reaction while eating candy containing peanuts at school.  Luckily, he was treated with auto-injectable epinephrine by the school nurse and survived. Read the full story here http://bit.ly/wrhkoC

How Do Kids Describe Their Asthma Symptoms?

It is often difficult to tell what a child is feeling, and they may have a hard time describing symptoms to a parent or the doctor.  A recent study published in the medical journal, Chest, looked at the most common words used by children with moderate to severe asthma, ages 8-15 years, to describe their symptoms of moderate to severe asthma.

The most common descriptions were "My chest feels tight" and "I cannot get enough air in".  This is very similar to the way adults describe their breathlessness.  

But it is important to watch for nonverbal cues that asthma is causing trouble for your child.  Look out for night cough, or a cough triggered by cold drinks, laughter, or running.   Remember also that cough is a more common symptom of asthma than wheezing, which may or may not be heard without the aid of a stethoscope.

Harver A, Schwartzstein RM, Kotses H, et al: Descriptors of breathlessness in children with persistent asthma.  Chest. 2011; 139: 832-838.

The Tricks to Treats

An all-ages guide to ensuring that food-allergic ghosts and goblins have a spookily great Halloween.

1. Have a nice dinner first. On a full stomach, there will be less temptation to sneak a piece of candy.

2. Stash a few pieces of safe candy (Tootsie Rolls are peanut-, nut- and gluten-free) in your pocket. When the other kids inevitably indulge along their route, your child will have something safe to enjoy and won't feel left out.

3.Keep the essentials with you. Don't leave home without a cell phone, flashlight, wet wipes and, of course, the epinephrine auto-injector and an emergency dose of Benadryl (diphenhydramine) in a chewable, liquid, or meltaway form in case of accidental ingestion of a food allergen.

4. Consider supplying a few neighbors with pre-filled sealed treat bags. When your child rings the doorbell, the neighbor can pass out the safe loot and you'll be certain that he'll get to keep some of what he has collected.

5. Choose costumes with gloves if your child is extrememly contact-sensitive.

6. At home, pass out low-cost toys or trinkets.

Different approaches may need to be used for different ages:

0-2 year-olds: It's a treat just to answer the door and pass out trinkets.

2-4 year-olds: Make sure your child knows that all candy should be checked for safety by a parent. We prefer that even young kids be trained from the start to not dive into the goodies before they are checked (not only for allergy reasons but to make sure they are sealed, wrapped candies that have not been tampered with).

5-8 year-olds: Use the "Trade Up" tactic. Buy a variety of safe candy, as well as a few inexpensive toys. When your child returns home from trick-or-treating, trade unsafe candy for safe candy, toys and trinkets.

8 and up: Cash is king at this age. Trade their unsafe candy for nickels, times, quarters or even dollars. Some kids might be more excited by a larger-ticket item, like a doll or game that can be traded for an entire bag of candy.

Siblings: Offer to trade siblings' candy too or consider saving a stash in a safe place and promise to take your non-allergic child on a "peanut date" where they can indulge in the forbidden candy without endangering their brother or sister.

Source: Allergic Living, Fall 2011

Tips to Help Navigate Elementary School with Food Allergies

We don't want your child to feel different or be defined as "the kid with food allergies" at school. Here are a few tips that can ensure your child has a safe school year.

• Befriend the school nurse. Take your child to meet the school nurse before school begins so they can establish a relationship. Provide the nurse with your child's emergency medications and a list of what foods your child is allergic to, along with the action to be taken if the child were to accidentally eat that food. A Food Allergy Action Plan is available for download at http://bit.ly/alLobw . With the nurse you can identify important guidelines for your child's snack, lunch and class activities.


• Talk with your child's teacher. Request a conference with your child's teacher and provide them with basic information about your childs food allergies. It is important to leave additional copies of the infomation for substitutes.


• Send in reinforcements. There may be parties, science projects, and other celebrations that invariably include food. At the beginning of the school year, provide your child's teacher with an allergy-friendly snack box so your child can choose something from it during these special celebrations and not feel left out.


• Encourage extra-curricular activities. Don't shy away from birthday parties, play-dates, sports or scouts because of food allergies. These are all great oppportunities for social skill building and there should be no holding back if you do a little extra legwork and planning ahead.


• Volunteer. Volunteering in your child's classroom will allow for your input in class parties so you can help select safe foods. Attending class field trips will also ease your mind so you can oversee your child's food and medication needs rather than relying on chaperones.


• Say thanks! Nurses and teachers work hard throughout the year to ensure your child's safety, remember to show your thanks.

FAAN Food Allergy News 2011:20:6. Navigating Elementary School with Food Allergies. Pellicore K.

Study Up For A Sneeze and Wheeze-Free School Year

Make the Grade by Avoiding Asthma, Allergy Triggers Lurking in the Classroom

The new school year means new clothes, new classes, new teachers - and the same old misery due to sneezing and wheezing for children who have allergies or asthma. From the class hamster to dust mites residing in carpet to germs from cold and flu viruses, asthma and allergy triggers lurk throughout the classroom.

It's not suprising, then, that back-to-school season is associated with a 46 percent increase in asthma-related emergency department visits by grade school children. And allergies and asthma account for more than 14 million school day absences. But seeing an allergist can keep kids in the classroom: studies show that patients treated by allergists for asthma have better symptom control, including less wheezing and fewer absences, at lower cost.

To keep kids focused on their studies instead of their allergy and asthma symptoms, it's important that they recieve proper diagnosis and treatment, as well as work with their parents to develop a plan for avoiding classroom triggers.

Make sure your child doesn't suffer or miss school by following the advice, below, from South Bay Allergy and Asthma and the American Colelge of Allergy, Asthma and Immunology (ACAAI):

• Dust and mold and pollen, oh my - Many common triggers lie in wait for the allergic student. Dust mites and other allergens multiply in the class carpet, so suggset your child sit in a chair to read a book. Mold can grow in bathrooms and other dank areas, but are easily cleaned if brought to the janitor's attention. And ask teachers to keep windows closed this fall and next spring to keep sneeze-prompting pollens out of the classroom.



• The germ incubator - It's tough for the child with asthma to avoid germs at school, since they are pretty much everywhere from the pencil sharpener to the edge of the teacher's desk. Washing hands regularly and using tissues and antibacterial hand sanitizers also can help.



• Tag, you're - huff, puff - it - Jumping jacks during gym, tag during recess, soccer after school - these and other common school activities can trigger expercise-induced bronchoconstiction (EIB), commonly referred to as exercrised induced asthma. About 80 percent to 90 percent of those with asthma have EIB and 10 percent of people without asthma have EIB. If your child has difficulty breathing during or after exercise, see an allergist who can work with you on a prevention and treatment plan. Be sure to give teachers, from gym to homeroom, a heads up and make sure your child has medication available at school.



• Fear of furry friends - Kids love class pets, but many have allergies to the hairy or furry variety. Allergic children should be reminded not to touch the pet. You also might suggest the teacher consider a non-furry pet, such as a fish or hermit crab, which offer plenty of learning opportunities without the allergy-triggering dander. Children who have pets at home also may have pet dander on their clothes, triggering symptoms in a pet-allergic child. A new seat assignement may help.



• Food safety patrol - If your child has food allergies, potential problems can crop up almost anywhere, from the lunchroom to the classroom. Tell the teacher about foods that cause problems for your child. Also be sure to alert scouting and other club leaders, and suggest an allergen-free snack policy. It's also important to teach your child about what foods might trigger a reaction and advise them to ask a teacher or adult before eating food they are unsure about. Share a plan with teachers, coaches and the school nurse for dealing with an allergic emergency and make sure your child has medications with them like injectable epinephrine.



• The back of the class - Sitting at the front of the classroom - near the chalkboard - is a bad idea for kids whose allergies or asthma are triggered by chalk dust. And washing hands after writing on the chalk board is a must.

If your child is sneezing, wheezing and itching at school and you're not sure why, see an allergist to find out what's causing the problem and find relief. For more information about allergies in children, asthma in children, or take a self-relief test visit http://www.allergyandasthmarelief.org/.

Mothers' Weight Tied to Youths' Asthma

Women who are overweight when they become pregnant may be more likely to have children who develop asthma as teenagers. Read the whole story from the New York Times here http://nyti.ms/oi82Qu.

Early daycare increases risk of wheezing in 0-2 yr old children

Anyone with small children in daycare or preschool can tell you that exposure to respiratory infections is rampant among young classmates. Many children also develop respiratory symptoms such as cough, wheezing, or difficulty breathing – a condition called “reactive airways disease” which may herald the onset of asthma. In children aged 0-2 yrs, there is more wheezing if they are placed in daycare, during a time when respiratory problems can be much more difficult to treat and more troublesome to the child and family.

Am J Respir Crit Care Med 2009;180(6): 491-8. Caudri D, Wijga A, Scholtens S, Kerkhof M, Gerritsen J, Ruskamp JM, Brunekreef B, Smit HA, de Jongste JC. Early daycare is associate with an increase in airway symptoms in early childhood but is no protection against asthma or atopy at 8 years.