By Dr Natalie Caristo MBBS, BSc (Hons), FRACGP
The majority of the patients I see when I’m making home visits in the after hours are children. And parents often say to me, “Doctor, he seems to have a cough all the time”, or “She’s always got a blocked nose”. Does your child seem to be constantly coughing (especially at night time), sneezing, or suffering from a blocked nose and waking up feeling tired?
It is possible they may have enlarged adenoids. The adenoids are immune tissue, just like the tonsils, located at the back of the nose. They swell up during a viral illness and produce lots of mucous which runs down the back of the throat and causes kids to cough. After an illness they can take a few weeks to shrink back down, but if a child gets exposed to another virus in this time, adenoids are the optimal breeding ground and so the cycle continues.
Some other kids have persistent runny noses even if they haven’t been sick, especially at this time of year and that could be secondary to an allergy. Allergies are far more common than you may realise, with allergies such as allergic rhinitis (hay fever), asthma, eczema, bee sting allergy and food allergies affecting almost 20% of the Australian population.
Detecting allergies early is important, because it can help you understand the problem, improve your child’s quality of life and reduce the number of days your child will be absent from school or miss out on holiday fun.
With symptoms similar to the common cold, allergic rhinitis (hay fever) is the most common childhood ailment triggered by allergies. A runny nose, itchy nose, sneezing, nasal congestion, itchy watery eyes, and chronic ear problems are all symptoms of hay fever. Hay fever also impacts people with asthma, as it can make the asthma worse and more difficult to control. Early identification and treatment of allergic rhinitis can help kids to cope with this debilitating condition.
Nasal congestion can lead to breathing through the mouth while sleeping, which can lead to the child having poor sleep and also affect the healthy growth of teeth and facial bones. Early treatment of allergies can help prevent these problems. The swollen adenoids can also make it difficult for kids to clear the fluid from their ears which makes them prone to ear infections and can affect their speech development.
If this sounds like your child – first place to start is your GP. They can discuss the symptoms with you, examine your child and confirm the diagnosis. If the symptoms are seasonal then it is likely to be related to pollens and grasses and most of the time we don’t need formal skin prick testing and treatment can be initiated with a nasal spray. Dust mites are also another common allergen, particularly kids with asthma, and thus we recommend house dust mite minimisation strategies which include washing sheets and bedding weekly in hot water, covering mattresses and pillows with dust mite protectors and if possible replacing carpet with floorboards or tiles.
Babies and young children can have food allergies, some of which can trigger a life-threatening reaction (anaphylaxis). It is thought that approximately 1 in 10 babies and 1 in 20 children will have a food allergy, usually not severe, which they may grow out of. Common triggers include egg, peanuts, tree nuts, sesame, soy, seafood and wheat. Mild to moderate symptoms include: swelling of the face, lips and/or eyes; hives or welts on the skin; and abdominal pain or vomiting.
Children with food allergies should be referred to a paediatric allergist for further investigation as skin prick testing alone can give false positives and negatives. This will ensure patients who require avoidance of foods do so appropriately and other kids are not avoiding foods unnecessarily.
Symptoms of a severe allergic reaction (anaphylaxis) include: difficulty breathing; swelling of the tongue and /or throat; hoarseness or difficulty talking; wheeze or persistent cough; persistent dizziness; and a pale and floppy appearance (in young children). If you think your child is showing these symptoms, call an ambulance or go to hospital immediately.
Stinging insect allergies
The sting from wasps, bees, hornets and certain ants can cause an allergic reaction in some people. The reaction can range from mild to severe, and it is important to have this allergy diagnosed so you can be prepared for an emergency.
In a small number of cases, children can be allergic to common medications such as antibiotics, anaesthetic agents, aspirin or other non-steroidal anti-inflammatory drugs. If your child has an adverse reaction to medication, your doctor may try and pinpoint the problem or recommend you to see an allergy specialist. For severe allergic reactions, (such as anaphylaxis – see above for symptoms) go straight to hospital.
If you think your child may suffer from allergies, it is important to see medical help. Your doctor can help to confirm suspected allergies and give you the right advice to manage the allergy.
Worried sick? GP closed?
If your child becomes ill in the after hours, and it’s not life-threatening, 13SICK can help with a bulk billed home doctor visit. You can arrange the doctor’s visit by visiting 13SICK.com.au, downloading the 13SICK App, or calling 13SICK (13 7425).
Dr Natalie Caristo MBBS, BSc(Hons), FRACGP, is a Medical Director with 13SICK, National Home Doctor Service. She has worked as an emergency Doctor in the hospital system, and in General Practice, and has a special interest in women’s health, paediatrics and aged care.