Is It a Cold or Allergies?

Allergy Tests and Treatments

If your pediatrician suspects allergies, he or she will probably begin treatment by taking a detailed history of your baby's symptoms and a physical examination. It's sometimes possible to identify allergy triggers simply from the history and exam. Depending on the age of the child and severity of the symptoms, Dr. Greene says the first step in treatment is often simply avoiding whatever triggers your baby's allergic response.

Will your baby be referred to an allergy specialist? Not always, says Dr. Greene, but in some cases you can usually expect a referral. He refers patients to an allergist if there are severe allergies (such as a nut allergy), if the allergy is causing other kinds of chronic problems (such as frequent ear infections) or if the allergy diagnosis is unclear and additional testing is needed.

The two most common methods of testing children are the skin prick test and the RAST (radioallergosorbent) test. During the skin prick test, tiny drops of common allergens are placed on your baby's back, which is then lightly pricked or scratched. The area is then observed for a reaction. Results are available in about 15 minutes. The RAST is a blood test, which checks for antibodies against suspected allergens. It typically takes a few weeks to obtain results from the RAST.

There's no age limit on allergy testing, says Dr. Gillman. "The definition of when testing should be done is really a definition of when the symptoms are present," he says. A baby can be tested as soon as it becomes necessary.

Your doctor may prescribe allergy medication to ease your baby's symptoms. The most commonly used medications are antihistamines, which neutralize or modify the allergic reaction. Topical anti-inflammatories are sometimes offered in the form of nasal sprays or inhalers and are used to control inflammation in the respiratory tract.

Helping Baby Breathe Easier

The airborne substances that cause the most trouble for babies are "the ones that they are exposed to soonest and on a more continual basis," says Dr. Gillman. Dust mites top the list of offenders, followed by indoor molds, outdoor molds, and pets. Although allergies to pollens are possible in babies, they usually don't appear until the fifth or sixth year. It takes living through several seasons to become sensitized.

Some suggestions for creating a more hypoallergenic environment for your baby include:

• Reduce dust, especially where your baby sleeps. If you can, choose wood or tile flooring instead of carpeting for the nursery. Try to stay away from stuffed animals and upholstered surfaces, which collect dust. Once your baby is old enough to trade in her crib for a bed, invest in dust mite proof covers for the mattress, box springs, and pillows.
• Never allow smoking in your home or around your baby.
• Keep things clean. Cut down on household clutter, dust surfaces with a wet or oiled cloth, and vacuum with a HEPA filter once a week. Wash linens once a week in hot water.
• Avoid indoor pets and plants.

Dr. Gillman says keeping the air as free as possible from airborne allergens is key to controlling baby allergies. "In general, if the parent knows what triggers off the problem, and they can avoid these so-called triggers, then that's the rule to follow," he says.