Allergy Relief for Your Child

Children are prone to having colds, but if the symptoms last for weeks on end, the problem may be another culprit: allergies.

Long-term episodes of runny (or stuffy) nose and sneezing are often signs of allergic rhinitis—the combination of symptoms that affect the nose when you have an allergic reaction to something you inhaled (or something that lands on the inside of your nose).

Allergies can be either seasonal or year-round (perennial). In most of the US, plant pollens cause the most cases of seasonal allergies (often known as hay fever). Mold, pet dander and dust mites often cause most cases of perennial allergies.

The National Institute of Allergy and Infectious Diseases (NIAID) reports that up to 40 percent of children suffer from allergic rhinitis, and the potential for allergies is higher in children with a family history of allergies.

Although the U.S. Food and Drug Administration (FDA) regulates prescription and over-the-counter (OTC) allergy medicines, parents still should exercise caution when giving these medicines to their children.

Immune System Reaction

Allergies occur when our immune system responds to an allergen by releasing histamine and other chemicals that causes nose, lungs, sinus, throat, eyes, ears, skin or stomach lining symptoms.

Some children are more prone to suffer from asthma episodes (periods of wheezing or breathing difficulties) when their allergies are triggered.

Doctor for the FDA’s Division of Pulmonary, Allergy, and Rheumatology, Dr. Antony Durmowicz, cautions that parents treat allergies in children who have both conditions or else the asthma treatment will not be effective.

Allergy Medicines

OTC medicines are effective for treating childhood allergies. However, prescription treatments may be needed for more stubborn and persistent allergy cases. Seven options exist for pediatric allergy relief. And even if allergy medicine can be used in children as young as 6 months, you should always check the product label to determine if the medicine covers your child’s age group. Just because it’s a children’s medicine doesn’t mean it covers all age groups.

More Child-Friendly Medicines

Current pediatric legislation and FDA regulations for pharmaceutical companies promotes research and development of children’s medicines that have friendlier ingredients on the label. Since 1997, federal regulations have prompted the study of at least 600 products for minors.

Dark Chocolate and Milk Allergies

If you like dark chocolate, but are allergic to milk, you don’t know if you can have a chocolate bar without an allergic reaction. This is what the FDA wanted to learn after getting reports that people had reaction s after they ate dark chocolate.

In dark chocolate, milk is permitted, but it’s one of weight food allergen that can cause dangerous reactions for some people. Under U.S. law, foods that have major allergens have to be labelled by manufacturers along with proteins and other major allergenic ingredients. Food that doesn’t have the allergens listed on the label are leading causes of FDA recalls of that food and undeclared milk is often the main cause. Chocolate is the most common source of undeclared milk and the source of consumer allergic reactions.

Nearly 100 dark chocolate bars were tested by the FDA for the presence of milk. Earlier on this year, the FDA released preliminary findings and is now releasing more information about the research. The FDA got the bars from various locations around the U.S. and each of the bars were unique in terms of the manufacturer and the product line. Based on the statements on the labels, the bars were divides into categories.

It’s not easy to determine by looking at the label if the dark chocolate contains milk. Out of 94 of the bars that were tested by the FDA only six had milk as an ingredient and while testing the remaining 88 bars they found that 51 of them actually contained milk. Of all of the bars they tested, the FDA found 61 of them contained milk.

Milk can get into the processing of the dark chocolate, even if it’s not actually added as an ingredient. The machinery used to make dark chocolate often makes milk chocolate as well and traces of milk end up in the dark chocolate.

May Should be Seen as Likely

To let consumers know that the dark chocolate may contain milk, manufacturers will print “advisory” messages on the ingredient list of a product. There’s many messages such as:

  • “may contain dairy”
  • “may contain milk”
  • “made on equipment shared with milk”
  • “may contain traces of milk”
  • “manufactured in a facility that uses milk”
  • “processed in a plant that processes dairy”

In products that had these advisories, the FDA found 3 out of 4 bars had milk present. Some of the products had milk levels which were as high as products that declared milk as an ingredient.

You can’t assume that the dark chocolate you want doesn’t contain any milk even if it’s not mentioned at all on the label. If you’re allergic to milk about 33% of dark chocolate that gas milk contained no mention of milk at all on the labels.

Understanding Lupin

Another word for lupin is lupine and it’s a legume which belongs to the same plant family as peanuts belong to. Many people can eat flour made from a lupin-derived ingredient or regular lupin according to senior medical advisor at the Food and Drug Administration (FDA) Stefano Luccioli, M.D. In some medical literature however, reactions to lupin for some people can be quite severe.

Some reactions can include a severe response to an allergen called anaphylaxis which may even include shock. This is life-threatening and can occur very fast. Lupin are allergens and they can cause this type of response.

People will develop an allergy to lupins over time like they do with all allergens. For people that already have a legume allergy, eating lupin could cause an allergic response even if they eat the food just once. People that are allergic to peanuts according to studies, have a greater chances of having an allergy to lupin. Parents know how to look for and to avoid peanuts if they have a child with a peanut allergy, but they may not know what a lupin is or if this is an ingredient which could harm their child.

For many Europeans, lupin is a staple food and they may be more aware of the allergenic properties of it and are more accustomed to seeing it as a food ingredient, but it’s quite new to the U.S. market. Many Americans may not even have heard of the legume. It may be found at Italian or other ethnic stores as lupini beans or it can be found in packaged products.

It can be Found Often in Gluten-Free Products

Lupin may become more popular because foods made with lupin-derived ingredients are the perfect substitutes for gluten-containing flours and it’s often used in gluten-free products. Today, there are more gluten-free products on store shelves and people that have an awareness about gluten are buying them. These buyers need to know that lupin may be a potential allergen for them.

You need to Read the Label

Food labels are required by law to list the ingredients of the product. When lupin is found in a food then it has to be listed on the label. Consumers that are looking to avoid lupin and those that have allergies to peanuts need to be careful and need to look for “lupine” or “lupin on their food labels and avoid the food if it’s there.

If you feel that you’re having an allergic reaction to lupin then you need to stop eating the product and seek medical care. You may have symptoms like hives, vomiting, swelling of your lips, or difficulty breathing according to Luccioli.

Fighting Allergy Season with Medications

You’re sneezing, your eyes are itchy and you feel miserable. Seasonal allergies aren’t just a nuisance, they are real diseases that can interfere with work, school or recreation, and can range from mild to severe.

May is National Asthma and Allergy Awareness Month, and many allergy treatment options are approved by the Food and Drug Administration (FDA). For the first time, these include three sublingual (under the tongue) prescription products to treat hay fever (also called “allergic rhinitis”)—with or without eye inflammation (called “conjunctivitis”)—caused by certain grass pollens and short ragweed pollen. The new products—Grastek, Oralair and Ragwitek—can be taken at home, but the first dose must be taken in a health care provider’s office.

About Allergies

An allergy is a heightened immune system reaction to a substance that your body has identified as an invader. If you have allergies and encounter a trigger—called an “allergen”—your immune system fights it by making antibodies, which causes your body to release chemicals called histamines. Histamines are responsible for symptoms such as repetitive sneezing and itchy, watery eyes.

Allergic rhinitis affects more than 30 million children and adults in the United States and more than 500 million people worldwide. It may be seasonal or year-round.

The seasonal allergy, often called “hay fever,“ typically occurs in the spring, summer or fall. If you have this, you may suffer from repetitive sneezing, and stuffy or runny nose and itching in the nose, eyes or on the roof of the mouth. Eye inflammation can occur when your eyes react to allergens with symptoms of reddening, itching and swelling.

Plant pollens usually cause seasonal allergies. Pollen allergies are common, and allergy-causing pollen can come from trees, weeds and grasses, according to the National Institute of Allergy and Infectious Diseases. Trees and grasses are typical spring culprits in the United States, while ragweed and other weeds ramp up in late summer and early fall.

Indoor substances, such as dust mites, often cause the year-round type of allergies. Molds can cause seasonal and year-round allergies.


If you suspect an allergy, see your health care provider, as conditions such as upper respiratory infections, sinus infections and eye infections can have similar symptoms.

“The first step is to get appropriate testing to determine what you’re actually reacting to,” says Jay Slater, M.D., an allergist and director of FDA’s Division of Bacterial, Parasitic and Allergenic Products.

Your health care provider can test you using injectable allergen extracts. Allergen extracts are sterile liquids made from natural substances such as molds, pollens or animal hair. FDA has licensed these products. Tests include:

  • a skin prick test, which involves placing the allergen extract on your skin and pricking so it goes under the skin’s surface. Your skin is studied for swelling or other signs of a reaction, which usually occurs in about 15 minutes.
  • an injection of a small amount of an allergen, or
  • a blood test, which can detect and measure antibodies to certain allergens.

Medications to Treat Symptoms

“After testing, you need to sort out results with your health care provider,” Slater says. “Take the results of the test and combine it with reflective thinking about when and where you’re experiencing symptoms. Then determine the best course of action.”

For instance, if you have a spring oak tree allergy you can try to avoid the allergen by limiting outdoor activities on high pollen-count days and keeping your windows closed. But airborne pollen can be hard to avoid, so your health care provider may also recommend prescription or over-the-counter medications to relieve symptoms.

Antihistamines reduce or block symptom-causing histamines and are available in many forms, including tablets and liquids.

“There are several different antihistamines. First-generation antihistamines include medications such as diphenhydramine, marketed under the brand name Benadryl. They have been available over the counter for a long time,” says Narayan Nair, M.D., a medical officer at FDA. “Newer second generation antihistamines have not been available over the counter as long. They include medications such as fexofenadine and loratadine, which are marketed under the brand names Allegra and Claritin, respectively.”

When choosing an over-the-counter antihistamine, patients should read the Drug Facts label closely and follow dosing instructions, Nair says. “Some antihistamines can cause drowsiness and interfere with the ability to drive or operate heavy machinery. The drowsiness can be made worse by taking sedatives or consuming alcohol,” he explains. “Also, patients with chronic conditions such as glaucoma, or an enlarged prostate should talk to their health care provider before taking certain antihistamines.”

In addition to the antihistamines, nasal sprays and eye drops can help improve some allergic symptoms. “Nasal sprays can help relieve nasal symptoms but they should only be used for a limited time without talking to a health care provider. If some nasal sprays are used longer than intended they can make the congestion worse,” Nair notes.

Children and Asthma

The news about children and asthma is both good and bad. Better treatments have banished the stereotype of the asthmatic child as frail and inactive, heavily relying on an inhaler to breathe. Children with asthma are now living active, independent lives.

The Food and Drug Administration (FDA) is working to make sure that the drugs and devices used to treat asthma—a chronic lung disease that inflames and narrows the airways—are safe and effective.

The bad news is that the number of reported cases of asthma in children has been rising. In 2010, there were 7 million children with asthma, 9.4% of Americans under 18, according to the Centers for Disease Control and Prevention, up from 6.5 million, or 8.9%, in 2005.

One reason may be that doctors are diagnosing more kids; illnesses once known as bronchitis or a croupy cough are now being recognized as asthma. Its symptoms may include coughing, wheezing (a whistling sound when you breathe), chest tightness and shortness of breath, according to the National Heart, Lung and Blood Institute (NHLBI).

Uncontrolled asthma can lead to chronic lung disease and a poor quality of life, and may slow growth. Benjamin Ortiz, M.D., a medical officer in FDA’s Office of Pediatric Therapeutics, recommends that parents work with a pediatrician, and an allergist or pulmonologist (lung specialist) if needed, to develop and follow an asthma action plan that details the treatment options when certain symptoms occur.


“We know what makes asthma worse or better, but don’t know the primary cause,” Ortiz says. The things that make asthma worse are known as “triggers.” They include:

  • Season and climate changes
  • High levels of air pollutants
  • Tobacco smoke
  • Mold
  • Mites, roaches
  • Plant pollen
  • Pet dander
  • Strong scents, like perfumes

In addition, certain factors may increase a child’s risk of developing asthma:

  • Family history of asthma
  • Multiple episodes of wheezing before age 2
  • Living in crowded housing
  • A family member who smokes
  • Obesity
  • Early development of allergies or eczema


Food Allergy

Since 2006, it has been much easier for people allergic to certain foods to avoid packaged products that contain them, says Rhonda Kane, a registered dietitian and consumer safety officer at the Food and Drug Administration.

This is because a federal law requires that the labels of most packaged foods marketed in the U.S. disclose—in simple-to-understand terms—when they are made with a “major food allergen.”

Eight foods, and ingredients containing their proteins, are defined as major food allergens. These foods account for 90 percent of all food allergies:

  • milk
  • egg
  • fish, such as bass, flounder, or cod
  • crustacean shellfish, such as crab, lobster, or shrimp
  • tree nuts, such as almonds, pecans, or walnuts
  • wheat
  • peanuts
  • soybeans

The law allows manufacturers a choice in how they identify the specific “food source names,” such as “milk,” “cod,” “shrimp,” or “walnuts,” of the major food allergens on the label. They must be declared either in:

  • the ingredient list, such as “casein (milk)” or “nonfat dry milk,” or
  • a separate “Contains” statement, such as “Contains milk,” placed immediately after or next to the ingredient list.

“So first look for the ‘Contains’ statement and if your allergen is listed, put the product back on the shelf,” says Kane. “If there is no ‘Contains’ statement, it’s very important to read the entire ingredient list to see if your allergen is present. If you see its name even once, it’s back to the shelf for that food too.”

There are many different ingredients that contain the same major food allergen, but sometimes the ingredients’ names do not indicate their specific food sources. For example, casein, sodium caseinate, and whey are all milk proteins. Although the same allergen can be present in multiple ingredients, its “food source name” (for example, milk) must appear in the ingredient list just once to comply with labeling requirements.

Manufacturers can change their products’ ingredients at any time, so Kane says it’s a good idea to check the ingredient list every time you buy the product—even if you have eaten it before and didn’t have an allergy.

“If you’re unsure about whether a food contains any ingredient to which you are sensitive, don’t buy the product, or check with the manufacturer first to ask what it contains,” says Kane. “We all want convenience, but it’s not worth playing Russian roulette with your life or that of someone under your care.”

Pain Medications

The Food and Drug Administration (FDA) has taken new steps to reduce the risk of severe liver injury associated with acetaminophen, a widely used pain– and fever-reducing medication.

FDA is requiring a Warning on labels of all prescription products that contain acetaminophen that highlights the potential for allergic reactions. These allergic reactions include swelling of the face, mouth, and throat; difficulty breathing; itching; and rash.

Used effectively in both prescription and over-the-counter (OTC) products, acetaminophen is among the most commonly used drugs in the United States.

Over-the-counter pain and fever medications, such as Tylenol, that contain acetaminophen are already required to change the dosage labeling to include information about the potential for safety risks, including liver injury.

In addition, FDA continues to evaluate ways to reduce the risk of acetaminophen-related liver injury from OTC products.