Transcription:
How to Help Children with Allergies

Intro: This is BayCare HealthChat, another podcast from BayCare Health System.

Maggie McKay (Host): Welcome to BayCare HealthChat. I'm Maggie McKay. We all want our children to be happy and healthy, but what if they have allergies? What can parents do to help them? To find out more, my guest today is Dr. Catherine D. Kubiak, an allergist, immunologist, and pediatrician with BayCare. Welcome.

Catherine D. Kubiak, MD (Guest): Hi.

Host: So help us navigate allergies, specifically nasal allergies in children. How do we identify the signs and what are the symptoms to look for that might point toward the fact that they have allergies?

Dr. Kubiak: Right. So I think one of the difficult things, especially for parents that I meet is knowing if their child has allergies or just a common cold. So, allergies can cause runny nose, nasal congestion, which is stuffiness, sneezing, itchiness of the nose, eyes sometimes even the skin. A lot of kids do a throat clearing behavior to try to itch the back of their throat, which actually the children don't notice as much as the parents.

And then there are some sleep symptoms I usually ask about like mouth breathing or snoring. So, the only clue we have by the history regarding the difference between allergies and colds is that allergies usually do not cause fever. So if the child has a fever, we can sort of assume that's an infection, but other than that, it's almost identical. Allergies can last a lot longer than a cold also.

Host: So Doctor, are there things to try at home before you need to visit an allergist?

Dr. Kubiak: Sure. There are a lot of over-the-counter remedies that can be tried, even medications. One of my favorite things that people try at home is just a nasal saline rinse. So, it's a non-medicated rinse for the nose. People will try exposures or avoidance. So, if they think things started with a pet, if they go on vacation, they can tell if the symptoms go away when they're away from their pet. But beyond that, it's difficult to figure out if it's allergies at home on your own.

Host: So when is it time to go to the doctor?

Dr. Kubiak: I like seeing patients at any time. So if there's any concern or question with allergy, I prefer to see them earlier. I love talking with families trying to uncover some clues. So, basically anytime is a good time to come and see an allergist. Some of the clues that I uncover would be, you know, timing, did this start, like I said before, when you got a pet or when the child started school or moved to a different home, we talk a lot about variants during the day. Is it worse in the morning when they wake up? Is it worse at school? Is it worse when they come home? Is it only during certain times of the year? Is it worse inside the home versus outside at the park? And these sorts of things, and these are actually really helpful clues for me to sort of decide like what type of testing to do or if testing is indicated.

Host: That was what I was going to ask you next. What is allergy testing? What does it involve?

Dr. Kubiak: So there are two main different ways to test for allergy and I'm speaking mainly of environmental allergy or things in the air that can cause allergy. The first is a blood test. And then the second, which is the preferred method, is an allergy skin test. So, the skin test is preferred because we can test to a variety of things. We can pick and choose what we test to, to cater it to what's in our environment or what that child is exposed to.

And that goes on the child's skin in our office. We do it on the back. I know some people do it on the arm. We draw a bunch of lines with a pen and we use a little tiny, I call it a plastic brush to just dab the allergen extract onto the skin. They call it a prick test or a scratch test.

And then that sits on the child's skin and their skin will tell us what they're allergic to. So if they react with a little itchy bump, for example, at dog, then we say, okay, your body's reacting to dog. This could be causing your symptoms. So it's, really neat. And it's a real time results. The parents see it happening right before their very eyes. And it's, it's cool. Before they leave the office, they have a list of all of the things that their body reacted to.

Host: We did it last year for my son. And I was amazed how many different things they test for. There were so many, and one of the things was olive trees, not olives, but olive trees. It’s so wild.

Dr. Kubiak: You'll find different pollens in different areas of the country. So like in Florida, we don't have olive trees, so we don't even test to them here.

Host: Oh, okay. So it's local. It depends where you live. And so why is testing so useful?

Dr. Kubiak: Testing is really helpful because, you know, when I talk to my patients, I always say, knowledge is power. If you don't know what you're allergic to, you don't really have much control or ability to prepare for this. So if you know you're allergic, for example, to a pet, you would keep that pet out of your room or rehome the pet, although I really dislike re-homing pets. The other thing is, you know, once, you know, if, for example, you're allergic to pollen, you can track pollen and you can prepare and say, okay, well maybe we won't need medicine all year round. Maybe we'll just need it during this pollen season or on days that pollen is high. And then if we don't discover allergy, it's actually really helpful because then we say, well, let's not expose your child to this medication because I didn't find allergy, let's try something else or let's look in other directions. So it can guide the treatment as well.

Host: What are allergy shots? Can you explain who would benefit from those the most and how they work and how often you need to take them?

Dr. Kubiak: Yes. So allergy shots are a very old-fashioned treatment, which I say that, but I love that because it's quite natural. So it's actual allergen extract. And we are able to make a custom mixture for each patient. It's very useful for children who have allergy symptoms that are either persistent or severe, very useful for patients who are requiring medication all the time, as a way to say, okay, well, let's try this and then maybe I won't need medication all the time.

So the allergen mixture is custom made for that patient, and the patient is exposed to it over a period of time, it starts at a very low dose. And then they get a little bit more in elevated doses, usually in a weekly what we call build-up phase. And then we get to a maintenance phase to try to eliminate allergy. So their body is exposed and becomes like immunized, if you want to say it to those allergens. We expect at least 70% improvement. And if you can do allergy shots for three to five consecutive years, we would hope and expect long lasting relief even after the shots are stopped.

Host: So it is possible for kids to outgrow nasal allergies?

Dr. Kubiak: Without allergy shots, kids can outgrow nasal allergies. I usually, you know, there's not a great study to tell us exactly who will outgrow them naturally or not. But I usually say as your immune system matures, because allergy is an overactive immune response; as your immune system matures, you can expect your allergy to maybe be more severe when your immune system is more mature, like as a teen or in your twenties. And then almost everybody will outgrow their allergies as their immune system then wanes back down. So, I would expect everyone in their eighties to be outgrown their allergies. Now we have some surprises. People say, oh, you know, I got in my twenties, my allergies went away. The cool thing about allergy shots is we can say, okay, well, you will outgrow your allergies if you can do allergy shots for three to five years. So it's an easier prediction and hopefully a lot less medication exposure over time.

Host: And you mentioned pollen and pets. Are there like top three things that are the most common for kids when they have nasal allergies, the culprit?

Dr. Kubiak: Yeah. So I guess I would say that's probably regional. So in Florida we have a lot of humidity, which you can love or hate, but dust mites love humidity. So I would say in Florida dust mite allergy is super common because dust mites will live in anything soft in a human environment that hasn't just been washed. So think pillows, mattresses, stuffed animals. So I say dust mites are probably our top one here and then pet dander would probably be the number two. And then, you know, the pollens are, sort of a mixture, some tree, grass, weed pollen, but pollens would probably be the third one.

Host: Thank you so much, Dr. Kubiak. This has been so helpful. I really appreciate your time. I know you're busy.

Dr. Kubiak: Oh, you're welcome. I have enjoyed speaking with you today.

Host: It reminds me to keep the house very clean when you talk about dust mites and pollen and the dander. So, we appreciate you being here. And that wraps up this episode of BayCare HealthChat. To find out more head on over to our website at BayCareKids.org. And please remember to subscribe, rate and review this podcast and all other BayCare podcasts. For more health tips and updates, follow us on your social channels. And if you found this podcast informative, please share on your social media and be sure to check out all the other interesting podcasts in our library. I'm Maggie McKay. Thank you for joining us and have a good day.