House CallApr/May 2011 Issue

Pediatric Allergies Q & A -Stuffy Nose, Bed Bugs Bite,

Pediatric specialists answer your questions about allergies and sensitivities

<br>©2011Thinkstock/istockPhoto


©2011Thinkstock/istockPhoto

Stuffy Nose

What's a neti pot? Is it effective treatment for allergic symptoms?

Dr. Jain A neti pot is one of several similar devices that are used to flush the nose and sinuses with salt water. Nasal irrigation can be a very effective treatment for the uncomfortable symptoms associated with seasonal allergies and hay fever, such as excessive mucous, sinus congestion, popping or plugging of the ears and the post-nasal drainage which can lead to sore throat and cough.

This “natural” treatment can be performed daily and doesn’t require prescription medication. Instead, salt and a little baking soda are mixed with water and squeezed up into the nose and sinuses to loosen and flush out mucous and anything trapped in it.

The big challenge is getting used to the feeling of water going up your nose. With a little practice, however, even young children learn to tolerate it.

A word of caution: Although it’s rare, a bit of the saltwater rinse can become trapped in the sinuses or ears, causing discomfort. Consult your doctor or allergist before starting nasal irrigation. Then take it slowly to see how you respond to the treatment.

Bedbugs Bite

Can someone be allergic to bedbugs?

Dr. Leo The unfortunate comeback of bedbugs in the United States has been in the news a lot recently. These tiny insects, which like to infest mattresses and upholstered furniture, feed off human blood while we’re sleeping.

Bedbug bites cause very itchy bumps that are frustrating and uncomfortable but the insects rarely carry pathologic disease. A physician diagnoses the problem by taking an oral history and examining the bites. The adage, “breakfast, lunch and dinner,” refers to the tri-linear rows of bites, which often appear on the arms and shoulders but can show up anywhere on the body.

Reported cases of anaphylactic-type reactions to the bites are extremely rare. Some individuals are hypersensitive and, when bitten, they develop swollen welts and severe itching that can last for weeks. In these cases, medical treatment can include anti-itch lotions, oral antihistamines, topical or oral corticosteroids and other comfort techniques prescribed by a doctor. Of course, elimination of the insects by appropriate means is paramount.

Breathe Easy

Can I control my asthma with vitamin D?

Dr. Jain No studies confirm that vitamin D supplementation alone is sufficient to control asthma and reduce asthma attacks. There is, however, growing evidence that low vitamin D levels in the blood are associated with a variety of inflammatory conditions, including eczema, childhood food allergies and asthma. In addition, vitamin D may help boost the immune system and reduce the risk of certain types of viral infections.

Our skin naturally produces vitamin D when exposed to sunshine or UVB light. People who live in northern latitudes of the United States are unlikely to get sufficient sunlight during the winter months. These folks and those with darker complexions are at higher risk for being vitamin D deficient.

It’s good practice for doctors to check vitamin D levels during routine medical examinations, as deficiency is widespread and easily corrected.

If you’re looking for a “natural” way to help control your asthma symptoms, take a vitamin D supplement in addition to your other treatment. Supplementing is particularly important for those whose blood tests reveal a vitamin D deficiency. I generally recommend that patients supplement with 2000 to 4000 units of vitamin D3 daily, depending on test results. Check with your doctor before taking supplements.

Bleach Baths

My daughter has pretty severe eczema over a large portion of her body. She’s on steroid medication, which I’d love to reduce or eliminate if at all possible. I saw an article that said a weekly bleach bath improves eczema. Do bleach baths work? Is this safe for my toddler?

Dr. Leo Eczema (atopic dermatitis) is an allergic skin condition. Research conducted at National Jewish Health in Denver revealed that the skin of people with eczema lacks important anti-infection barriers found on normal skin. Thus, people with mild or moderate eczema tend to get more skin infections. Those with severe eczema are more likely to develop super-infections; they’re more vulnerable when exposed to common organisms, like Staphylococcus aurerus, that pose minimal threat to healthy skin.

These infections produce bacterial endo-toxins, which can prompt allergic antibodies and further exacerbate the inflammation associated with eczema. Aggressive anti-infection techniques can reduce the frequency and intensity of these flares up.

Dermatologists, allergists and eczema groups like the National Eczema Association recommend diluted bleach baths as treatment to reduce the colonization of staph bacteria that are commonly associated with atopic dermatitis. Studies show that bleach baths can lower the need for antibiotics and topical steroids for those with eczema. Generally, the baths are well tolerated by young children.

In my practice, I suggest that families mix ¼ cup household bleach into a full bathtub of warm water (about 40 gallons). A child can soak in this diluted bath for 15 to 20 minutes once a week. Rinse the skin quickly with clear water afterwards and apply a hypoallergenic moisturizing lotion. Generally, the amount of chlorine in a bleach bath is not sufficient to irritate the eyes of the bather but be careful when treating young children who have scalp and facial eczema.

I’m often asked if soaking in a bleach bath is similar to swimming in a chlorinated pool. Perhaps. But a bleach bath is a simple, regulated treatment while swimming pools contain varying amounts of a number of different chemicals.

Remember the bath addresses symptoms. Ultimately, the best treatment for eczema is to determine its cause and then to avoid or eliminate triggers, if possible.

Consult your allergist before using a bleach bath. And remember to keep household bleach in a safe place away from children.

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