Surviving the Allergy Season

How often have you heard “my allergies are really bad this year?”  Children who suffer with seasonal allergies (or allergic rhinitis) can have a harder time concentrating in school, be more irritable, or be more tired.  Symptoms are often more severe in the spring or fall.  Children who have allergies to things like dust, mold, or pets which are often indoors, or who are exposed to second hand smoke, can experience allergy symptoms all year round.  The symptoms include:  sneezing, runny nose, nasal congestion, itchy eyes, or itchy nose.  Sometimes symptoms are associated with a cough.  In this case, you may want to have your child evaluated for asthma since about 40% of children with allergic rhinitis have asthma as well.  It is unlikely that children under age 2 have developed seasonal allergies because it takes multiple exposures to allergens to develop a sensitivity.

The recommended treatment for allergies includes avoiding the things that trigger the symptoms and the use of medications.  For more severe symptoms, referral to an allergy specialist for allergen immunotherapy may be needed.

            Eliminating things that trigger allergies includes things like:

Staying indoors as much as possible

Keeping windows closed and using air conditioning to filter the air

Using saline nasal spray to wash out allergens in the nose after being outdoors 

Keeping pets out of sleeping areas

Cleaning regularly by dusting, vacuuming (with HEPA filter) and cleaning bed sheets and pillow cases weekly

For mild symptoms, over the counter medications can be tried.  To get the best effect, it is important to use these medications regularly (daily) during the allergy season which can last 8-12 weeks.   The fall allergy season usually ends with the first frost.

Some over the counter medications called antihistamines you can try include:  Claritin, Zyrtec, or Allegra which should be given at bedtime if given only once daily.  These medications should not make your child sleepy like Benadryl.  Benadryl can cause some side effects in young children such as agitation or decrease school performance in school age children because of sleepiness, so is not recommended for long term use.   

Decongestants can have a number of side effects and are not usually recommended for use in young children.  Decongestant nasal sprays such as Afrin should not be used longer than 3 days because there can be a rebound reaction of nasal congestion if it is stopped after longer use. 

For watery, itchy eyes, over the counter eye drops called Zaditor can be used in children age 3 or older.

If your child’s symptoms do not improve with avoiding allergens or the regular use of over the counter medications, be sure to make an appointment to see us for an evaluation of the symptoms and recommendations for treatment that are not available over the counter.  Research has shown that steroid nasal sprays can be very effective in controlling the symptoms of allergic rhinitis, but these are not available without a prescription.  Any child with persistent or moderate to severe symptoms should also be evaluated by your doctor.

Julie Averbeck, RN, MS, CPNP

Julie Averbeck, RN, MS, CPNP

Eating Right

The United States Department of Agriculture (USDA) recently came out with the “Choose My Plate” campaign to encourage healthy eating.  You can visit for more information.  They recommend that half your plate be fruits and vegetables.  When I talk with children and adolescents about their diets, I find many of them are having trouble getting enough servings of fruits and vegetables in their diet.  The recommendation is 5 servings a day.  That means a fruit or vegetable at every meal, maybe even both, and probably fruits or vegetables for snacks as well to be able to meet that goal.  Fruits and vegetables are high in essential nutrients for good health, have fiber for digestive health, and are often lower in calories than other food choices.

Many children tell me that they don’t like vegetables.  I always encourage them to try at least a taste.  Vegetables that they thought they didn’t like, may taste better to them if made in a new way.  The parent’s job is to offer their kids healthy choices at each meal and for snacks.  It is the child’s job to choose to eat them.  Some ways to encourage children to eat vegetables:

  • Model eating vegetables on a regular basis.
  • Have them help you plant and take care of a vegetable garden.  They may be more willing to eat something they helped grow.
  • Use dips or sauces to add flavor (many children like ranch dressing or melted cheese).
  • Have them participate making foods with vegetables.  One idea to make it fun is to make a 3 inch slice of celery into a car.  Use peanut butter in the center for protein, this will hold raisins upright in the “car” as drivers and passengers, and place round slices of carrots on toothpicks pushed through the piece of celery to make the wheels.
  • Cook shavings or small pieces of vegetable in foods that children like such as spaghetti sauce to add nutrients (e.g. carrots, green pepper).
  • Try the “Cheetos Cheat” (recently seen on Dr. Oz).  Crumble Cheetos on steamed broccoli to add flavor and crunch.
  • Experiment with child friendly recipes.  See the “Choose My Plate” web site for ideas.  The Healthy Lunch Challenge Cookbook has 54 recipes from America’s Jr. Chefs sponsored by an event at the White House hosted by the President and Mrs. Obama.
  • For older kids, have a contest on preparing the tastiest veggies.


Julie Averbeck, RN, MS, CPNP

Julie Averbeck, RN, MS, CPNP



A,B,C’s of Safe Sleep

Children’s Hospital of Wisconsin is committed to educating families about safe sleep practices.  The A,B,C’s of Safe Sleep stands for A = Alone, B = on the Back, C = in a Crib.  During 2006-2009 more infant deaths occurred due to unsafe sleep practices than because of SIDS.  Some of the unsafe practices included use of soft bedding such as pillows, blankets, quilts, or bumper pads; bed- sharing with adults or siblings; infants placed on tummies or sides when put to sleep; or infants placed on a couch, chair, car …Continue reading →

Tylenol (acetaminophen) Concentration Changes in Over-the-Counter Medications

Starting this summer, manufacturers of Tylenol (acetaminophen), and combination medications such as cold and cough medications that contain acetaminophen (there are more than 200), will change the liquid forms of the drug to only one concentration: 160 mg per 5 ml (1 teaspoon). Until now, infant drops have been available in a more concentrated form: 80 mg per 0.8 ml. This dosage has been eliminated.

While this change is taking place, both forms may still be available. Please be sure to take extra care before giving these types of medications to your children. Check the …Continue reading →

Getting enough vitamin D

The American Academy  of Pediatrics recommends that infants, children and adolescents receive 400 international units or 10 micrograms of vitamin D daily. The biggest source of vitamin D is found in infant formula and in milk fortified with vitamin D. A child would need to drink at least 1 quart or 4 cups of formula or milk daily to get a total of 400 international …Continue reading →

Preparing kids for procedures

Young children sometimes experience anxiety during procedures, such as immunizations, throat swabs and even the exam (especially ears). Here are some tips to help your child come through the procedures successfully:

Prepare your child in a simple straightforward way.

Explain what will happen in terms of his or her personal experience. For example, “Mommy …Continue reading →