Allergies are the result of an overreaction of the immune system to a substance that’s harmless to most people. But in some, the immune system goes into overdrive when an otherwise harmless allergen invades, resulting in symptoms that can be anywhere from simply annoying to downright debilitating.
Allergies can develop at any point in a child’s life however, children from families with a history of allergies are more likely to be/become allergic. Allergies rank first among children’s chronic diseases and cost the loss of an estimated 2 million schooldays per year. Once your child starts school, it’s important to have a conversation with the principal and your child’s teacher about any allergies they might have.
Seasonal allergies and their symptoms can have an affect on a child’s performance in school. If the teacher knows that those puffy eyes, runny nose, and general malaise are because the trees, grasses, and weeds are budding outside, they can make allowances until the allergies subside. Even strong winds that kick up the dust can bring on allergy symptoms. It’s important to monitor your child’s symptoms to prevent an escalation. For example, something as simple as an itchy ear can spiral into an ear infection.
Allergic rhinitis (AR) causes nasal irritation/inflammation and develops in children by the age of ten, reaching its peak by age twenty, and usually subsiding by age 60. Symptoms include a runny/stuffy nose, itching, and sneezing, all of which can occur at any time of the year. Flair-ups occur after exposure to environmental allergens (cigarette smoke, perfume, household cleaners, chlorine, mold, etc.), temperature changes, strenuous exercise or even changes in head position. Severe congestion causes pain around the eyes, nose, cheeks and forehead, as well as dark circles under the eyes.
Most schools have a no-scent policy, restricting or disallowing the use of perfumes in the building. However, sometimes the use of highly scented dryer sheets can cause allergy and asthmatic flair-ups as well. If your child is liable to have an adverse reaction to strong scent, it’s important that the teacher knows this.
Food allergies are now so common among children that most schools have policies in place strongly suggesting that foods like peanut butter, nuts, etc., are better eaten at home than in the classroom. If your child has a food allergy, a quiet word with the teacher should do the trick. Most schools have open discussions with their students about allergies and what to do if they see a friend in the midst of an allergic reaction. If your school doesn’t, why not suggest a school-wide assembly on this very topic. Ask a local public health nurse to conduct the seminar for the children.
Symptoms of food allergies can include, but are not limited to itchy mouth/throat (sometimes referred to as Oral Allergy Syndrome), hives and/or rash, nasal symptoms, abdominal cramps, nausea, vomiting, diarrhea, difficulty breathing, shock. It’s important for all other family members/teachers/school staff to be aware of these symptoms and watch for them, especially if a new food is introduced.
Pets used to be a familiar part of classrooms however, with the rise in pet dander allergies, this is often not the case anymore. If your child’s class keeps a pet (hamster, guinea pig, etc) and it seems to be affecting your child, it’s important to let the teacher know.
Educating your child about their allergies is of the highest importance because you’re not always going to be where your children are. For instance, a birthday party can offer a whole host of allergic situations but if your child is well aware of what causes their symptoms to flair, they can self-monitor and avoid an allergic reaction. If you’re not convinced that self-monitoring is something your child can/will do, why not offer to volunteer at the event so you can be handy to advise your child?
Do you have an action plan set up for your child’s allergies? An action plan outlines the nature of the primary and secondary health concerns (such as peanuts and asthma) and how these allergies/symptoms will be managed at school.
You may wish to create an action plan and then confer with your pediatrician and have him/her sign off on the document. When you present this to your child’s school, you can have all the involved parties (teacher, school nurse, etc.) sign off on the document as well. This brings everyone necessary to your child’s best health at school into the loop and assures you that, if an allergic reaction occurs at school, everyone will know what to do. And if they don’t, there’ll be a document on file explaining how to handle the situation.
What if your child has an allergic reaction to something that’s either 1) always been unoffending in the past or 2) unknown to you? This can be caused by a food, an environmental toxin, an insect bite, or from touching vegetation. Watch for the following signs:
- Difficulty breathing
- Swelling (face, throat, lips, tongue)
- Tightness in the throat
- Hoarse voice
All these could be a sign of anaphylaxis, an extreme reaction to an allergen, which can happen in just seconds. The signs could also be delayed up to as many as two hours after exposure. Severe symptoms such as these require immediate medical attention.
This tricky condition is caused by tiny mites called Sarcoptes scabiei which burrow into the skin and set up housekeeping, reproducing and laying eggs and causing a rash of small, raised red spots, which are incredibly itchy and highly contagious. Symptoms include this rash and extreme itchiness that becomes worse at night or after a bath or shower. Excessive scratching can lead to inflammation, infection, and crusty sores on the scratched area.
Scabies are transmitted via extensive close contact and through sharing infested clothes or bedding. The mites can survive on clothing for two to three days after the clothing has been removed from the body. Because it can take weeks for the rash to show up after the mites have initially taken up residence, scabies infestations can spread quickly because they’re not detected right away. Environments such as nursing homes, schools, and hospitals are top of the list places for scabies to proliferate due to the close proximity of the people frequenting these areas.
The rash is typically found between the fingers/toes, in the groin or underarm area, or on wrists and elbows but can appear on any area of the body. Scabies needs to be diagnosed by a doctor who will, upon confirmation, prescribe a cream or lotion to apply to the affected area. One treatment is normally all it takes, however sometimes two is necessary. And the treatment won’t be confined to the affected member of the family; the whole family will need to be treated at the same time. All clothes and bedding should be washed in the hottest water possible as this heat will kill the mites. It can take weeks for the itchiness to clear, even after treatment(s). Left untreated, an infestation can last indefinitely.
A healthy immune system interferes with the reproductive cycle of the mites; a weaker immune system helps them out. Particularly at risk are patients who already have an immunodeficiency, a neurological disorder, or Down’s syndrome. If the infection reaches the point where the spots crust over, the condition becomes more difficult to diagnose and can be misdiagnosed as psoriasis or eczema. Unfortunately, the crust protects the mites, thereby making the condition worse.
If you suspect that your child has scabies, you need to get to your doctor without delay for a diagnosis and treatment options.
Another easily contained common childhood issue is head lice. These are tiny insects that live on the scalp and, again, set up housekeeping if not caught and evicted.
Emerging in three stages, the first thing you’ll see is tan/white-ish ovals called nits that will stay in this form for approximately ten days. They then emerge as nymphs, baby lice who grow into adults and live for roughly thirty days on the scalp. They are about the size of a sesame seed and can survive away from the scalp for up to three days. Head lice are spread through close contact so school-aged children and children attending day care are at risk for contracting head lice. They can also be spread by sharing items such as hats, combs, hair ornaments, and/or headphones.
Head lice can be seen under good lighting when combing your child’s hair or if your child complains of an itchy scalp. Live lice move very quickly so you have to be observant and look at the bottom of the neck and behind the ears at the scalp level. If you don’t find any live lice the first time, keeping looking at one-week intervals for approximately three weeks. You can find nits by parting your child’s hair and carefully moving it to one side, working across the head in one direction.
Head lice are generally treated with a non-prescription shampoo (available from a drug store) which should not be used on children under the age of two years old. Sometimes the shampoo itself can cause a slight scalp itch. Just remember to keep an eye on the situation and follow the directions on the shampoo bottle. Wash your child’s hair in a sink so that the sink can be disinfected after the shampooing.
The whole family should be checked if you find a case of head lice on one member of the family. Never treat an uninfected head with lice shampoo; only treat those members who show active signs. Because the lice cannot live for more than three days off the scalp, washing bed linens in the hottest water you can generally takes care of any that might be “lying around”.
It’s important to remember that head lice are common among children and that they don’t spread disease. If your child has head lice and is being treated, check with the school policy first, but generally there shouldn’t be any reason why your child can’t attend school.
Ringworm gets its name from the early belief that this infection was caused by a worm. We now know that it is not, but the name stuck.
Medically referred to as tinea, ringworm is not caused by a worm, but in fact is caused by a fungus; the same fungus that causes Athlete’s Foot (tinea pedis). Children are especially susceptible to catching ringworm, most often in late childhood or adolescence. Tinea can also occur on the nails (tinea unguium), on the hand (tinea manus), on the groin (tinea cruris), and on the body (tinea corporis).
On the body, the ringworm rash is characterized by a raised ring of small, itchy, flaky blisters that grows outward as the infection spreads. On the foot, it may cause scaling, blisters, and inflammation in the toe webs. It can also cause a thickening or scaling of the skin on the heels and soles of the foot. Under the nails, it causes yellowing and brittleness. On the face, it causes a red, scaly patch with indistinct edges. On the hand, it causes thickening of the skin on the palms and spaces between the fingers. If ringworm occurs on the scalp (tinea capitis), there is a possibility of baldness in the area of infection.
Highly contagious, ringworm is spread via an infected person, animal, object and even from soil. Heat and moisture help the fungus to grow which is why it can be spread via clothing, pool surfaces, showers, and changing/locker rooms. Children should avoid sharing clothing, sporting gear, towels, personal grooming items, and/or sheets (as at summer camp). Flip-flops worn at the pool help prevent you from picking it up off the surface poolside or in the shower. Children should shower well after sports which induce sweating and involve physical contact, drying their skin off well after cleansing and rinsing. They should change their socks and undergarments every day.
Ringworm is simple to diagnose thanks to its distinctive appearance. However, sometimes a sample is required from the infected area, such as a nail bed, to confirm a diagnosis. It is treated with topical antifungal creams. In chronic, or more resistant cases (such as with the scalp and nails), it is treated with oral medications.
Treating the Flu
Kids are in close quarters with each other all day, sharing toys, playground equipment, and washrooms. It’s no surprise then when your child comes home with a cold or the flu. However, while both are caused by viruses, influenza, or the flu, is different than the common cold in that there is usually a fever involved and the symptoms are more severe.
Flu is an acute infection of the airway tract in the nose and throat that can sometimes spread down into the lungs. Children are among the groups most at risk for developing flu and its complications and are more likely to spread the infection to others.1
Like Spring or Winter, influenza has its own season which runs anywhere from November through to March. You can expect to see a spike in absenteeism in schools during this period thanks to the flu, but this is not necessarily a bad thing because the flu is highly contagious. It’s a win/win situation to keep your child at home to recover if they have the flu. You’ll be preventing the spread of the virus and giving your child a quiet and comfortable atmosphere to recover in. Once the fever is gone, your child can return to school.
Symptoms of the flu include the usual; chills, muscle aches, headaches, sore throat, dry cough, and a general malaise. The signature symptom is a high fever of up to 104F/40C. In younger children, the flu can mimic other infections such as croup, bronchitis, or pneumonia. If the symptoms worsen, the fever starts to climb above 104F/40C, or sickness lasts more than four to five days, it’s prudent to have your child checked by your pediatrician to ensure the lungs have not become more involved (as in the case of pneumonia or “walking pneumonia”). Never be worried about taking your child to a medical professional “just for the flu”; better to know that nothing’s wrong than to let things go unchecked. Always seek medical help if your child stops drinking fluids (as dehydration can set in) or has difficulty breathing at any point.
Younger children can also experience cramping, vomiting, diarrhea, and overall irritability. Further complications can include ear or sinus infections and can worsen a child’s asthma.
Just because your child is home recovering does not mean it’s a holiday from school. Rest in bed and quiet is very important to your child’s recovery. Have a supply of fluids at the ready – water, low-acid juice, Pedialyte (especially if your child is vomiting), and clear soups are all appropriate. Stay away from milk as it tends to inspire the production of mucous.
Support your child by giving them acetaminophen or ibuprofen for aches, pains, and fever. NEVER give your child aspirin as it has been associated with the occurrence of Reye’s syndrome. A humidifier in your child’s room can make it easier for them to breathe. Suction your child’s nose if it becomes difficult for them to breathe, especially before meals and bedtime. If your child can blow their nose, go easy. The tissues on the inside of the nose are delicate and nose bleeds can occur if you blow too hard or poke around too much. (Yuck!) If your child’s nose is dry or stuffy, saline drops or sprays work wonders.
Flu prevention just comes down to common sense; teach your children to wash their hands often, to cough or sneeze into their sleeve or a tissue, to use a tissue once and then throw it in the trash, not to share eating utensils or cups, and to avoid close contact with those who already have the flu. It’s also important not to touch your face with your hands or fingers as you can spread the virus to your nasal passages from a contaminated surface. Another choice parents have is the annual flu vaccine. This is something you can discuss with your partner and/or your pediatrician.
This infection can be caused by either a virus or bacteria but can also be brought on by allergies, exposure to environmental toxins, injury, or just from rubbing the eye incessantly. It starts with a “scratchy” feeling in the eye which inspires rubbing. Because the covering of the eyeball and the inside of the eyelid are involved, it can cause pain and excessive tearing. Pinkeye gets its name from the color the eye turns when infected; the whites become pinkish-red. Overnight discharge from the eye can make it feel sticky in the morning.
The bad news is that pinkeye is highly contagious and is spread via coming into contact with the discharge from an infected eye either through hand contact or touching a contaminated tissue and then touching your eyes. It’s probably best to keep your child isolated from others until you have had a medical professional confirm whether it has been caused by a virus or bacteria. If bacterial pinkeye is confirmed (pink/red eyeball, yellow discharge, sticky, painful), your child can be started on a course of antibiotics and can return to school after being on the prescription for 24 hours. If it is viral pinkeye (pink/red eyeball, clear discharge, no pain, no stickiness) your child can return to school right away as antibiotics will not work in the case of a virus.
Supportive measures include a lot of hand-washing by yourself and your child and no sharing towels or bed linens. Try to get your child to keep their hands away from their eye, touching it only with a tissue and then disposing of the tissue right away. When using a tissue to wipe your child’s eye, wipe in one direction only, from the nose to the outside corner of the eye, and again, throw the tissue away, only using it once. If the eye is painful and your doctor approves, you can treat this symptom with acetaminophen or ibuprofen, NEVER aspirin.
Moving back into the realm of bacteria, strep throat is caused by group A streptococcus and is more common in children because of the close quarters of the classroom. If not treated in a timely fashion, strep throat can develop into scarlet fever.
The bacteria take up residence in the throat and nose so it’s easily spread via coughing or sneezing. It’s also spread through hand contact; if an infected child touches their mouth or nose and then touches another child’s hand who, in turn, touches their own mouth or nose, the pesky bacteria makes the leap from child to child. That’s why hand washing and coughing/sneezing into a tissue or your sleeve is so very important when children are in close proximity to each other. It’s also important to teach children to keep their hands away from their face so as not to transmit the bacteria to their nose or mouth.
Symptoms of strep throat include sore throat, headache, swollen/tender neck lymph nodes, fever, nausea and/or stomach ache. These are also symptoms of a simple sore throat so how can you tell the difference? Strep throat will develop more symptoms within three days of the initial symptoms appearing and include red and white patches in the throat, difficulty swallowing, red and enlarged tonsils, loss of appetite, chills, and a full-body rash.
If you think your child’s sore throat has developed into strep throat, call your primary health care professional. He/she can do an in-office swab test to see if it is, in fact, strep throat. If it is, a course of antibiotics is generally prescribed. A child is most infectious when strep symptoms are at their worst. If left untreated, a child can remain contagious for up to twenty-one days. Once a child is on antibiotics, their symptoms should begin to disappear after twenty-four hours and even more so by the third day after treatment has begun. It is very important to finish the course of antibiotics, even if your child is feeling better. The good news is, your child should be back at school within three to four days after beginning the antibiotics.
While convalescing, keep your child home from school, on the quiet side, and make sure to keep him/her well-hydrated with low-acid beverages like water, ginger ale, soup broth, and tea. Sometimes even hot chocolate can feel really good going down! If your child’s throat is really sore, a salt-water gargle can help make it feel better. You can treat your child’s discomfort with acetaminophen or ibuprofen, but never with aspirin. Ensure your child’s eating utensils are washed separately from everyone else’s, in hot soapy water after each use. Don’t allow your child to share food, drinks, or linens with other members of the family and throw away tissues after each use. You’ll also want to replace their toothbrush after the infection has passed.
When a child is being bullied, it’s not a “health” issue per sae, but it can lead to health complications if it goes on for too long. And unfortunately, bullying seldom ever happens just once. Emotional trauma in a child can lead to the same effects as chronic stress in an adult; insomnia, recurrent illnesses that take longer than normal to recover from, weight loss, weight gain, digestive upset, and skin conditions, to mention just a few. Let’s take a look at how your child’s behaviour and attitudes might change, because it’s not always obvious, and which health complications it might lead to.
A child who is being bullied is less likely to tell an adult because of the embarrassment or humiliation they are feeling. A parent needs to be vigilant and look for the following patterns and indicators which seem to have no explanation:
Health complications from stress tend to have a “catch-22” effect, e.g., grades drop from distraction/worry, worry leads to insomnia, insomnia leads to a lack of attention in class, grades drop, which leads to more worry, etc., etc. And, as a parent, you feel like you should be able to “fix” the situation but the key here is patience. That seems a little backwards; to be patient when your child is being bullied, but excessive reaction in this instance will only make matters worse and make your child retreat further into themselves.
Start a conversation with your child and, if you feel it’s necessary, talk with the appropriate school officials (if it’s happening at school) or supervisory adults (if it’s happening on a sports team, etc.). Above everything else, support your child and find a professional they can speak with about the situation as soon as possible; a family doctor, child psychologist, professional counsellor, etc. Helping your child realize that they are not the cause of this upset, that they are never alone, that it’s not “just teasing”, and that they didn’t do/say anything to make themselves the target of the bully, is paramount to their health, mentally and physically. Stay attentive to your child’s behaviour, but don’t hover. Simply monitor the situation and step in when you feel it’s necessary to support your child through this difficult time. KidsHelpPhone.ca provides children with free, confidential, anonymous counselling any time of the day or night. Their toll-free, Canada-wide telephone number is 1-800-668-6868.
Books that might be of assistance include:
The Essential Guide to Bullying, Prevention and Intervention
Cindy Miller LCSW
How To Deal
Dr. Jerry Weichman
Also by Barbara Coloroso: The Bully, The Bullied, And The Bystander