KidsMD Health Topics

Our Health Topics

Allergies

  • If you believe your child has an allergy, we know that you and your family may feel anxious and uncertain about what may be causing the allergic reactions. You may wonder if you have to drastically change your lifestyle, leave behind favorite family recipes or limit your child’s exposure to allergens. To ease this anxiety, it may be helpful to learn as much as you can about childhood allergies.

    About allergies

    Allergies are an overreaction of the immune system. They happen when the immune system fights harmless foreign substances called allergens, such as dust mites, pollen, pet dander and food.

    • Allergens can enter the body through breathing, through eating and contact with skin.
    • Allergies can be tested for through a skin test or blood test.  For food allergies a food challenge test may be needed.
    • Immunotherapy, antihistamines and topical steroids are a few of the more common treatment options.
    • food allergy is an allergy to a specific food.  The immune response to a food allergen is the same as the immune response to any other allergen, however, a child with a food allergy is more likely to have gastrointestinal symptoms, such as cramps, nausea and vomiting, than with an inhalant allergy.
    • Currently, there is no medication that will cure or prevent food allergies.
    • Epinephrine is the best treatment for anaphylaxis due to food or other allergies.
    • Children’s is working on ways to "reverse" food allergies through innovative new desensitization treatments.

    How Children’s Hospital Boston approaches allergies

    Children’s Hospital Boston’s Allergy Program physicians collaborate with your child’s primary care physician to provide a comprehensive and individualized treatment plan. To help treat individuals with severe atopic dermatitis , we have a multi-disciplinary Atopic Dermatitis Center  with psychologist and a nutritionist.  Additionally, our team collaborates with Children’s researchers to conduct clinical trials to evaluate new approaches to allergy treatments.

    What makes the Division of Immunology at Children’s unique is the involvement of our researchers. Our scientists see patients, as well as conduct lab research, which helps to raise the level of patient care and brings innovative discoveries directly to our young patients.

    Allergies: Reviewed by Dale Umetsu, MD and Lynda Schneider, MD

    © Children’s Hospital Boston; posted in 2011

    How do you treat allergies?

    Tell us how you treat allergies and see how others are answering on Boston Children's newest tool: MyViewPoints. We understand that coping with medical conditions, no matter what the type, can feel daunting and overwhelming. We also understand the healing power of a community; that’s why we created My View Points. We encourage you to use this space to share your experience, offer your advice and receive advice from others. Ask questions, offer answers and gain comfort in knowing there are others who have been down the same path as you.


    Allergies: Reviewed by Dale Umetsu, MD and Lynda Schneider, MD

    © Children’s Hospital Boston; posted in 2011


    Children's Hospital Boston
    300 Longwood Avenue, Fegan 6
    Boston MA 02115
    617-355-6117 
    888-IWHEEZE

    Boston Children's at Lexington
    482 Bedford Street
    Lexington MA 02420

     617-355-6117
     888-IWHEEZE
     fax: 781-672-2145
    Boston Children's North
    10 Centennial Drive
    Peabody MA 01960

     617-355-6117
     888-IWHEEZE
    Boston Children's Physicians South in Weymouth
    541 Main Street
    Weymouth MA 02190

     617-355-6117
     888-IWHEEZE
  • Here at Children’s Hospital Boston, we specialize in innovative, family-centered care. From your first visit, you’ll work with a team of professionals who are committed to supporting all of your family’s physical and psychosocial needs.

    We understand that you want to learn more about your child’s allergies to keep her safe and healthy.

    What is an allergy?

    Allergies are overreactions of the immune system. They happen when the immune system fights harmless foreign substances called allergens, such as dust mites, pollen, pet dander and food. Therefore, treatments are usually designed to suppress the allergic reaction so your child can be safely exposed to the allergens and/or treat the symptoms when they occur.

    Visible allergy symptoms are the body’s reaction to inflammatory chemicals, such as histamines, cytokines or leukotrienes. Inflammatory chemicals are released from white blood cells to fight foreign substances in the body. Each time your child sneezes, or shows some symptom of an allergic reaction, her body is reacting to the allergen. Specifically, the immune system makes immunoglobin E (IgE) antibodies to the allergens, which causes mast cells to release chemicals such as histamines, cytokines and leukotrienes to fight the allergens. Essentially, the reaction between the IgE and the allergen triggers an allergic reaction.

    The process is similar for food allergies. One difference is that with a food allergy, a child is more likely to have dermatologic (skin symptoms) and gastrointestinal symptoms, such as cramps, nausea and vomiting, than with an inhalant allergy.

    Signs and symptoms

    What are some symptoms of an allergic reaction?

    • rhinitis: nasal stuffiness, sneezing, nasal itching, nasal discharge, itching in ears or roof of the mouth
    • allergic conjunctivitis: red, itchy, watery eyes
    • atopic dermatitis: red, itchy, dry skin
    • urticaria: hives or itchy welts
    • asthma: shortness of breath, coughing, wheezing
    • Food allergies can be life-threatening.  It is important to know the symptoms of a food allergic reaction. See our section on food allergies for signs and symptoms.

    Causes

    What are some allergens that may trigger an allergic reaction?

    How do allergens enter the body?

    • Allergens can be breathed in through the air and enter the nose, sinuses, throat or lungs. Additionally, allergens can enter through the skin with direct physical contact or can be ingested in the case of food allergies.

    Can I be genetically predisposed to allergies?

    Patterns of allergies have been found in families; however, the specific genetic factors are not yet fully understood.

    FAQ

    Q: What is the difference a regular allergy and a food allergy?

    A:  Food allergy is a type of allergy in which the immune system response is essentially the same.  One difference is that a food allergy is more likely to trigger a dermatologic (skin) and gastrointestinal response, such as cramps, nausea and vomiting, than with an inhalant allergy. 

    Q: How serious are most childhood allergies?

    A: Childhood allergies can have a significant impact on quality of life.  Rarely, however, they can be life threatening if they’re serious and not treated, as they can affect the body’s vital functions, such as breathing.

    Q: How do I know if my child needs treatment other than over-the-counter medication?

    A: If the child still has symptoms even after properly taking the doctor recommended dosage of over-the-counter medications, then that would indicate they need additional treatment.

    Q: What is treatment like?

    A: There are several treatment options for your child’s allergies, such as immunotherapy (allergy shots),  antihistamines, decongestants, topical steroid nasal sprays and finding ways to avoid the exposure to allergens. None of these treatment options involve hospitalization or surgery.  The key to all these treatments is being vigilant about allergens that may affect your child. 

    Q: Where will my child be treated?

    A:Children treated through our Allergy Program receive care in our clinic.

    Q: Is my child safe to eat foods with none of the allergens in the ingredients?

    A: It’s important to carefully read food labels to make sure that the product is not made in a factory with an allergen, such as peanut butter, as food cross-contamination could be a problem. Even though the allergen may not be an ingredient, it could be exposed to the allergen from another product made in the factory.

    Q: Can my child outgrow their allergies?

    A: A study in Sweden involving allergic rhinitis (hayfever) showed that participants still had the allergy 12 years later. The results of this study suggest that sometimes children may not be able to outgrow their allergies. It should be noted that hayfever allergy is not caused by hay. It is a term that includes allergies caused by pollen from trees, grasses and weeds.

    Q: Can my child develop allergies later in life?

    A: Yes, allergies can develop later in life as your child may be exposed to new allergens with a change of environment such as school or work.

    Q: Is there a cure for allergies?   

    A: Immunotherapy can change the immune system so a child no longer has symptoms. So some patients might be “cured.” Children’s milk and peanut desensitization studies are working towards creating a cure for food allergies.

    Neither Children’s Hospital Boston or the Allergy Program at Children’s unreservedly endorses the information found at other websites mentioned on our Web pages.

    Questions to ask your child’s doctor

    After your child is diagnosed with an allergy, especially if it’s a food allergy, you may feel overwhelmed with information. It can be easy to lose track of the questions that occur to you.

    Lots of parents find it helpful to jot down questions as they arise; that way, when you talk to your child’s doctors you can be sure that all of your questions are concerned. If your child is old enough, you may want to suggest that she writes down what she wants to ask her health care provider too.

    • How did you arrive at this diagnosis?
    • How could allergy medicines impact my child’s life, including academic performance?
    • How may the allergy medicines interact with my child’s current medication regiments?
    • Will my child’s diet need to change while taking allergy medicines?
    • What are some things I can do to minimize my child’s exposure to allergens at home?
    • How can I provide my child with the tools to help herself when I’m not there?
    • How will the allergies impact their adult life?
    • How should I talk to my child about her allergies?
    • What support services are available to help educate my child about their allergies?
    • What are some steps I should take if my child suffers from a severe allergic reaction?

    For teens

    Managing your health at college

    Going to college is an exciting time, as it can be a time of freedom and personal discovery. For a teen with allergies, it could be a challenge as the environment is less controlled than in high school, and you live in close quarters with many other students. Learn some strategies for managing medical conditions at college and join this discussion on Children’s Thriving blog.

     

    Social life and allergies: Teenage dating

    Being a teenager is tough, and even tougher with allergies. Learn how teenagers are adjusting to allergies on the dating scene. Children’s Hospital Boston has a place for you to be part of the conversation on issues that matter most to you. Join this conversation on Children’s Thriving blog.

     

    Food allergy falsehoods

    Lynda Schneider, MD, director of Children’s Hospital Boston’s Allergy Program, dispels common misconceptions about food allergies.

     

  • The first step in treating your child is forming an accurate and complete diagnosis.

    How can I get my child tested for allergies?

    • Skin Testing - If you suspect that your child is allergic to something specific, skin testing can confirm it. During this test, liquid-form extracts of the allergens are placed on the top layer of the skin through a pricking device. If the suspected allergen is indeed causing the allergic reaction, the skin will turn red where the test was applied. Skin testing usually yields results faster than blood tests.
    • In some situations doctors might do intradermal testing, meaning the allergen being tested for would be injected under the top layer of the skin. For example, a child might have venom testing to see if she’s allergic to stinging insects: She’d have a histamine place on her skin, and then a small amount of venom injected under the top layer of the skin. If at either step the skin develops a red spot, it means your child has an allergy to the venom, such as from a bee or wasp.
    • Blood Test - A measurement of specific IgE can help indicate if your child has allergies based on the level of IgE antibodies in their bloodstream. In reaction to allergens, the body typically produces more IgE antibodies; thus, higher IgE antibodies levels would indicate your child has allergies.

    After any of these tests, your child’s doctor will review and discuss the results to outline the best treatment plan for your child.

    Antibiotic allergies

    As much as 10 percent of children are allergic to antibiotics. If your child has had an allergic reaction to an antibiotic, a doctor may advise an allergy test for antibiotics. The testing takes about two to four hours, most of which is time waiting between stages of testing. Learn how to test if your child is allergic to antibiotics

  • The Division of Immunology at Boston Children's Hospital diagnoses and treats children, adolescents and adults with allergic disorders and immunodeficiencies. This can include common allergy-related problems, such as food- and pet-allergies, eczema and asthma, as well as more complex and rare immunodeficiencies, such as X-linked agammaglobulinemia, in which the immune system fails to produce antibodies.

    It may be helpful to know all the treatment and prevention options to determine the best plan for your child.

    Limiting exposure to allergens

    • Remain indoors when the pollen count is high and on windy days. Pollen is especially high from 5 to 10 a.m.
    • Dust-proof your home, particularly your child's bedroom.
    • Reduce wall-to-wall carpet, Venetian blinds and down-filled blankets or pillows.
    • Wash bedding, curtains and clothing often in hot water to eliminate dust mites.
    • Keep bedding in allergen proof mattress and pillow encasings.
    • Use air conditioning instead of opening the windows.
    • Use a dehumidifier in damp areas of the home and remember to clean it often.
    • Don't leave wet clothes in the washer. Damp clothes can be a safe haven for mold.
    • Avoid secondhand cigarette smoke
    • Talk with your child's school to determine high risk areas and activities.
    • If your child plays sports, inform the coaches about your child's allergies.

    Immunotherapy (allergy shots):

    • Used for children with hay fever and/or asthma.
    • Also called desensitization, hyposensitization and allergy shots.
    • The shots are a mixture of the various pollens, molds, animal dander and dust mites to which your child is allergic. They contain no medication such as antihistamines or corticosteroids.
    • Injected into the fatty tissue in the back of the arm. It isn't painful like an injection into the muscle, such as a penicillin shot.
    • Given weekly or twice a week until a maximum dose is tolerated. This is called the maintenance dose. It may take about one year to reach the maintenance dose. At this point, the frequency of injections may be decreased to every other week and finally to once a month.
    • About 80 to 90 percent of children improve with immunotherapy. It usually takes 12 to 18 months before definite reduction in allergy symptoms is noticed, but can take as few as six months. It's important to continue allergy medications and avoidance in the meantime.

    Are there side-effects to immunotherapy?

    • Local: redness and swelling at the injection site. If this happens, your doctor will change the extract strength or schedule.
    • Systemic: involves a site other than the injection site. Symptoms may include nasal congestion, sneezing, hives, swelling, wheezing and low blood pressure. Such reactions can be serious and life threatening (deaths related to immunotherapy are rare). If a serious reaction occurs, your doctor will lower the dosage.

    Medication: The American Academy of Pediatrics recommends against some over-the-counter medicines for infants and young children. Always consult your child's physician before giving your child any over-the-counter medications.

    Antihistamines:

    • Used to relieve or prevent the symptoms of allergic rhinitis (hay fever) and other allergies.
    • Prevent the effects of histamine, a substance produced by the body during an allergic reaction.
    • Come in tablet, capsule, liquid or injection form and are available both over-the-counter and by prescription.

    Decongestants

    • Cause the blood vessels to narrow, leading to the clearing of nasal congestion.
    • Come in tablet, liquid and nose spray or drops, and are available both over the counter and by prescription.
    • The American Academy of Family Physicians does not recommend decongestants for children ages 4 and younger.
      100 Years of allergen immunotherapy:  From pollen to milk

       “If I have seen further it is by standing on the shoulder of giants”

      - Sir Isaac Newton, English  physicist, mathematician, astronomer, natural philosopher, alchemist, and theologian (1642-1727)

      Over three centuries ago, Newton recognized that scientific discoveries are a continuation of previous accomplishments. This pattern of success is also illustrated in biomedical research and carried on by Children's research. In 1911, Leonard Noon used pollen injections to help people build immunity against hay fever, much like how Dr. Jenner created the smallpox vaccine in 1796. Building on Noon's work, Dale Umetsu, MD, PhD, and Lynda Schneider, MD, director of the Allergy Program, have successfully cured a child's milk allergy. Learn more, and join the conversation on Children's Thriving blog.

     

    Coping & support

    Having an allergy is a difficult condition for children and their families to manage, requiring a vigilant awareness and planning to avoid allergens. This constant heightened state of awareness can be mentally and emotionally draining for children and parents.

    To help educate children and their families to manage the psychological effects of managing allergies, Lynda Schneider, MD, director of Allergy Program, and her colleagues have created a workshop for children to learn how to express their feelings about allergies, and for parents to learn how to handle the stress, support their children emotionally and teach allergy management skills to their child. Read more about this allergy workshop.

    There's a lot of support available here at Children's for you and your family, and here are some of the ways we can help:

    Patient education: From the office visit to pre-op to the recovery room, our nurses will be on hand to walk you through your child's treatment and help answer any questions you may have.   They will also reach out to you by phone, continuing the care and support you received while at Children's.

    Parent to parent: Want to talk with someone whose child has been treated for allergies? We can often put you in touch with other families who have been through similar experiences and can share with you their experience at Children's.

    Faith-based support: If you are in need of spiritual support, we will help connect you with the Children's chaplaincy. Our program includes nearly a dozen clergy representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian and United Church of Christ traditions who will listen to you, pray with you and help you observe your own faith practices during your hospital experience.

    Social work: Our clinical social workers have helped many other families in your situation. Your social worker can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness and dealing with financial difficulties. 

    Visit our For Patients and Families page for all you need to know about:

    • getting to Children's
    • accommodations
    • navigating the hospital experience
    • resources that are available for your family
      “Helping Your Child with Medical Experiences: A Practical Parent Guide”
      Download a free booklet, “Helping Your Child with Medical Experiences: A Practical Parent Guide”(.pdf) and read about topics including:
      • talking to your child about his condition
      • supporting siblings
      • taking care of yourself during your child's illness
      • adjusting to life after treatment
      • adjusting to life after treatment
  • Children’s Hospital Boston’s Allergy Program develops treatments informed by our research. Children’s is home to the world’s most extensive research enterprise at a pediatric hospital.

    We’re known for our science- driven approach – we have the world’s most extensive research enterprise located in a hospital, and we’ve partnered with a number of top biotech and health care organizations. But our physicians never forget your child is a child, and not just another patient.

    Children’s is science-driven, but always patient-centered.

    Research: One EpiPen may not be enough

    Connecting research directly with patients, Children’s and Massachusetts General Hospital found that children with food allergies may need to carry more than one EpiPen. The six-year study (Pediatrics, April) involving 1,255 children who visited the emergency room for food-related reactions found that 12 percent needed a second dose of epinephrine. Over half of the children had anaphylaxis, a dangerous reaction to an allergen. Susan Rudders, MD of Children’s Division of Allergy and Immunology says, "Until we're able to clearly define risk factors for the most severe reactions, it may be safest to have all children at risk for food-related anaphylaxis carry two doses of epinephrine."

    Asthma Research

    The Asthma Clinical Research Center at Children’s Hospital Boston conducts numerous asthma research studies for all ages. For more information on current studies, please visit the links below.

    http://asthmanetresearch.net/Boston_MA_peds.cfm

    http://asthmanetresearch.net/Studies_Children.cfm

    http://www.severeasthma.org/

    If you or your child is interested in participating, please email: Asthma@childrens.harvard.edu or call 857-218-5336

    Allergy Researchers

    Research is a priority at the Allergy Program, crucial to developing new testing and treatment approaches.  The team of allergy researchers include:

    Dr. Raif Geha

    • basic science atopic dermatitis and allergy research

    Dr. Lynda Schneider

    • clinical research on atopic dermatitis and food allergy

    Dr. Dale Umetsu

    • clinical and basic science research on food allergy
    • basic science research on asthma

    Dr. Talal Chatila

    • basic science food allergy research

    Dr. Wanda Phipatanukal 

    • asthma
    • environmental allergens
    • food allergens in the environment
    • food allergy

    Dr. Rima Rachid

    • food allergy research

    Dr. John Lee

    • eosinophilic esophagititis research

    Ari Fried

    • eosinophilic esophagititis research

    Dr. William Sheehan

    • food allergy, asthma research

    Dr. Lisa Stutius

    • food allergy research

    Dr. Anahita Dioun

    • drug allergy research

    Neither Children’s Hospital Boston or the Allergy Program at Children’s unreservedly endorses the information found at other websites mentioned on our Web pages.

    Oettgen Laboratory
    Hans Oettgen, MD, PhD, is leading the Oettgen Laboratory in researching the regulation of immune responses by IgE antibodies, immunobiology of eczema vaccinatum and basophils in early responses to allergens. Currently, they are researching the effects of IgE levels on the growth and function of mast cells of the lungs and intestine. Read more about the Oettgen Laboratory.

      

Request an Appointment

If this is a medical emergency, please dial 9-1-1. This form should not be used in an emergency.

Patient Information
Date of Birth:
Contact Information
Appointment Details
Send RequestIf you do not see the specialty you are looking for, please call us at: 617-355-6000.International visitors should call International Health Services at +1-617-355-5209.
Please complete all required fieldsThis department is currently not accepting appointment requests onlineThis department is currently not accepting appointment requests online

Thank you.

Your request has been successfully submitted

You will be contacted within 1 business day.

If you have questions or would like more information, please call:

617-355-6000 +1-617-355-6000
close
Find a Doctor
Search by Clinician's Last Name or Specialty:
Select by Location:
Search by First Letter of Clinician's Last Name: *ABCDEFGHIJKLMNOPQRSTUVWXYZ
More optionsSearch
Condition & Treatments
Search for a Condition or Treatment:
Show Items Starting With: *ABCDEFGHIJKLMNOPQRSTUVWXYZ
View allSearch
Visitor Information
The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO
Close