Dr. Greene’s Answer:

Even stubborn allergies can often be brought under control. Marie, it sounds like you and your son have both been through quite a lot. He’s on a powerful arsenal of medications and already under the care of specialists.

With allergies and asthma causing this much trouble, I’m a big fan of allergy testing to identify the specific offending allergen(s), to be able to be smart about reducing exposure to the triggers, and perhaps to treat those allergies specifically.

Whether or not something specific is identified, when the symptoms are in the nose, lungs, and the rest of the respiratory system, the problem is usually something in the air. A powerful study published in the New England Journal of Medicine looking at 1000 kids with asthma serious enough to hospitalize them or send them to the ER on more than one occasion. They found that taking control of the air in the home was as powerful as steroid medications. Those kids had 34 fewer days with symptoms than their peers.

A mold problem in the home is something to consider.

Certain houseplants can be powerful ways to remove problem-causing chemicals from the air. (Chemical fragrances and other volatile compounds (VOCs) can trigger asthma or rhinitis and not show up on allergy testing. They can come from furniture, paint, carpeting, air fresheners, computers, etc.)

There are also a number of treatment alternatives for the symptoms.

For nasal allergies, I like Ortho Molecular D-Hist Jr, which uses quercetin, stinging nettle N-acetyl cysteine, and bromelain to reduce the allergic response and reduce phlegm.

For cough variant asthma I like traditional Chinese medicine herbs, such as Kan Herbals Deep Breath. The NIH Center for complementary and alternative medicines has published a statement on these herbs that the preliminary evidence for using these herbs is promising, with all the studies showing positive results.

At Stanford, my colleague who was across the hall from me for years, pulmonologist John Marks, MD, has had success with mind-body relaxation techniques in kids, such as massage or guided imagery — sometimes being able to reduce the over-active immune response enough to get kids with asthma off of controller medicines.

Both honey and dark chocolate can be powerful at reducing coughs. The dark chocolate contains a compound similar to theophylline, an asthma drug we quite using, in part, because we had to keep drawing blood tests to be sure the dose didn’t get too high. You don’t have that problem with food.

Speaking of food, how kids eat can have a major impact on asthma symptoms. If they’ll eat that way, a Mediterranean diet such as this has been much-studied and can be a great choice.

With your son’s complex medicine regimen, Marie, you’ll want to discuss any new supplements or remedies with his specialists, though clean air and healthy food are good for any child with allergies and asthma.

Finally, for my own family, I like to brew a cup of Traditional Medicinals Organic Chamomile tea to relax, loosen the phlegm and help calm the cough. It’s a simple, comforting choice you can share.

Taking a deep breath in, and out, not only relaxes me, it allows me to be mindful of the air I breathe–the interdependence, the relationship I hold with my environment. As a nurse and mother of an allergic child, teaching my son to be respectfully aware of his environment and his relationship to it, as well as to be diligently alert to his allergic triggers, keeps him in the best possible place of prevention to manage his sensitivity.

Understanding allergies Grass, food, dust, pets — common allergy triggers hide innocently around us everyday. Why is it some of us suffer while others remain completely immune? For severe allergy sufferers, like my son Sam, these type of substances affect his every action and his total health and well-being. For Sam, this ordinarily harmless “stuff” becomes silent, secret, and perhaps even deadly invaders. When these “invaders” come into contact with my son, they are capable of triggering a dangerous explosion within his immune system, which can produce an outbreak of uncomfortable, potentially severe, symptoms. These blameless culprits, often hidden from view, are a mine field of triggers for Sam to walk through every day.

Our body’s intricate and complex defense system The word allergy means “an altered reactivity”, and the antibody known as IgE (one of many our bodies produce) was discovered to be the main culprit in classic allergic conditions. An antibody is literally a personal bodyguard, a soldier cell produced naturally by the body to protect it from diseases or allergens. When these antibodies band together and attack, this is referred to as an “immune cell response.” When the response is activated, the IgE antibody (fighter cell) attaches itself to a mast cell. A mast cell’s job is to act like a bomb, causing an explosion. The newly produced IgE antibody becomes the “trip-wire” attached to the bomb, and when it is disturbed, it explodes.

Histamine bomb The explosion releases histamine into the bloodstream, which is what causes the sneezing, post-nasal drip, itchy, watering eyes. In asthma, it is the histamine’s effect on the smooth muscles of the bronchi (vital tubes that carry air to the lungs) that go into spasm, causing the classic “wheezing.”

False Alarm Most of us have walked past a blaring car alarm; when we do, we know that most likely the triggered alarm was set off by an innocent event, such as a strong wind or an accidental bump. This same scenario is often true with an allergic response. The mast cell, acting as the alarm, is triggered by an innocent substance (such as pollen, grass, or dust) yet nevertheless trips the alarm to sound. The malfunctioning gene of an allergy-sensitive body thinks the harmless substance is an unwanted invader. Though it’s misinformation, our body is trying only to protect us. Unfortunately, our system is activated and our body responds to the false alarm, releasing its histamine explosion along with its annoying repercussions that we experience as allergy symptoms.

Does anyone in your family suffer with allergies? Removing triggers from your environment—dust mites, mold, pollen, animal dander, can lead to big improvements. Ordinary substances you may not realize—body care items, cleaning products, and some of the food you eat–are some of the culprits that hold chemicals and can set off an allergic alarm.

Want more?: www.elizabethirvine.com

Nasal allergies are common in children, and appear to be getting more common all the time. In Chinese medicine, acupuncture is often used to treat allergies. People report great results, but there have not been many scientific studies to verify whether this really works.

Recently, researchers evaluated a group of school-age children with chronic allergies. Half of the children received 2 sessions a week of acupuncture for 8 weeks; the other half got pretend acupuncture. In the real acupuncture group, needles were inserted to a depth of 1.2 to 2.4 cm and the needles were rotated gently every 5 minutes over a twenty minute period in order to achieve ‘qi’.

For the pretend acupuncture treatments, real needles were used by real acupuncturists at real acupuncture points, but the needles were only inserted 0.3 cm, and they were not rotated — in order to avoid ‘qi’. The children, the parents, and the people evaluating the allergy symptoms didn’t know which children were getting real acupuncture.

The results were published in the November 2004 Pediatrics. Those who got real acupuncture had better allergy symptom scores and more symptom-free days, both during the treatment period and during the months that followed. The effect lasted for about 10 weeks after the treatments ended — about a season. Interestingly, when asked what they liked, the kids in the study preferred oral medicines to acupuncture needles, but preferred acupuncture twice a week to commonly prescribed daily steroid nasal sprays. Parents preferred acupuncture to medicines for treating their children. Acupuncture for allergies is an option parents and kids deserve to know about.

Just as the banners and exhibits of the 2003 American Academy of Pediatrics meeting were coming down in New Orleans, the displays of the annual meeting of the American College of Allergy, Asthma, and Immunology were going up in the same convention center. An interesting study from Georgetown University Medical Center was presented at that meeting, looking at people who used nasal steroid spray to treat allergies, focusing on those who had frequent nosebleeds as a side effect.

When they were examined carefully, the bleeding was found to usually come from the septum (the tissue that separates the two nostrils). Here many blood vessels are close the surface. Typically, when someone squirts a nasal spray he uses the right hand to squirt into the right nostril, and vice versa. This aims most of the spray at the very spot bleeding is seen. The researchers suggested switching hands, using the left hand to spray into the right nostril, and vice versa. This naturally aims at a spot with fewer and deeper vessels. The result?

The nosebleeds disappeared!

Petasites is a shrub with incredibly huge leaves, up to 3 feet in diameter, usually found in low-lying wet areas and marshes. The plant is sometimes called butterbur, perhaps because the large, soft leaves were used to wrap butter when trying to keep it cool. Other colorful names for the plant include butterfly dock, butter-dock, bog rhubarb, flapperdock, and umbrella leaves. By whatever name, the plant is quite toxic. Butterbur was used in the Middle Ages to try to treat the plague. More recently, there has been some evidence suggesting that it might help in the treatment or prevention of migraines, asthma, ulcers, and now hay fever.

I’ve seen several headlines promoting the use of butterbur tablets (also called petasites tablets) as a gentle, natural remedy for those who want to treat hay fever without antihistamines. There are two important questions: Do they work? And are they safe? I’m excited that people have been looking into butterbur. I’m always glad to see alternative remedies evaluated. These results are particularly important.

One study, conducted by the Petasites Study Group in Switzerland, took 125 adults with hay fever and randomly assigned then to take petasites (butterbur) 8 mg four times a day or cetrizine (Zyrtec) 10 mg once a day. The pills were disguised and dummy pills were included so that participants (and doctors) did not know at the time which treatment they were receiving. The results were published in the January 19th issue of the British Medical Journal. I was very hopeful as I began to read the study.

After 2 weeks, investigators found no difference in symptoms between the two groups – both treatments were reported to have improved hay fever allergies equally. However, I am quite skeptical of these industry-funded results. The purpose of ‘blinding’ a study is to eliminate bias. But they designed this study to show that these two treatments were the same – so interviewers would be tempted to score patients similarly, and the blinding does nothing to eliminate bias with this study design. Also – when scoring results, they did not look at patients’ reports of any allergy symptoms improved (sneezing, watery eyes, runny nose – anything!), just overall quality of life. Not a very sensitive way to find a difference. At best, this study had only 80% statistical power (a 20% chance that butterbur did not help at all), but the built-in bias and the insensitive tests used take away even that measure of confidence. I’m sad to say that this study did nothing to convince me that butterbur actually helps allergies (though it certainly may) – much less that it is as effective as cetrizine. But it is the side effect story that is of the gravest concern to me.

The total number of side effects observed in those two weeks was similar (16.4% of the petasites group and 17.2% of the cetrizine group). Those taking cetrizine most commonly reported drowsiness (even though it is supposed to be a non-sedating antihistamine). This side effect was considered significant by the investigators. Those taking petasites reported a broader range of side effects, including itching skin, itchy eyes, wheezing, diarrhea, GI upset, headache, and fatigue. The authors dismissed all of these because no single side effect occurred in more than two people. To me they suggest a pattern of potential allergic reactions, which makes sense in that butterbur is a relative of ragweed. One patient had elevated liver enzymes in the blood (enzymes that indicate the destruction of healthy liver cells). This was also dismissed. I wonder how many patients would have had elevated liver enzymes if the test went on for 4 weeks?

Natural petasites (butterbur) contains highly toxic alkaloids that are known to seriously damage the liver and to cause cancer. They have also been associated with potentially fatal blood clots and with chronic scarring of the lung. Even small traces of these alkaloids are considered quite dangerous. Some commercial preparations are available where these alkaloids have been removed. They may work as well as the natural product, but we do not know. Nevertheless, butterbur in any form should not be used by women who are pregnant or who are nursing – all the more so in countries like the United States where herbs and supplements are not well-regulated.

Of greater concern to me: does the very ingredient supposedly responsible for improving many of the symptoms cause long-term problems? The active ingredient S-petasin would be expected to have a possible impact on the reproductive system. The one study looking at this carefully, published in the September 30, 2000 Clinical Journal of Physiology, found that s-petasin caused a dramatic impairment of testicular function when given to rats at tiny trace doses. Baseline testosterone production fell.

I would certainly not recommend giving butterbur to children before puberty, unless more evidence becomes available. The evidence in the BMJ article was crafted to sound convincing, but did not prove that butterbur is either safe or effective for treating allergies (methodological flaws have long plagued butterbur research). By conducting the study in a backwards way, the investigators took the power out of their randomized, placebo-controlled, double blind study. Designing a study to find the truth yields valuable information. Designing a study to promote a product can leave you with nothing but questions. Still, the butterbur story teaches us how possible it is to manipulate statistical evidence and to convince the popular press. It also illustrates that “herbal” and “natural” do not necessarily mean “safe” or “gentle”.

Dr. Greene`s Answer:

Some people develop hives on the skin when they encounter cold temperatures. This condition, called cold urticaria, is the most common type of hives caused by a physical condition. The hives are produced by a rapid release of histamine brought about by IgE antibodies and eosinophils (the types of antibodies andwhite blood cells often involved in allergic reactions) in response to the cold. Rapid cooling, as from the evaporation when one gets out of a swimming pool, can trigger cold urticaria even on a warm day. For people with cold urticaria, swimming in very cold water is quite dangerous, sometimes even causing death.

Treatment of cold urticaria involves avoiding the cold, when possible, and taking antihistamines. Even though I do not recommend antihistamines for the common cold for most healthy children under age 6, antihistamines can be useful medications for some allergies, including cold urticaria. The antihistamines are best taken before exposure to cold temperatures to block some of the histamine release. When possible, I prefer non-sedating antihistamines for this purpose. The other antihistamines can interfere with learning even if they do not make kids drowsy. For those with severe cold urticaria, like those with other severe allergies, an Epi-Pen or other emergency kit may be life-saving in the case of severe reactions.

Sometimes cold urticaria is a symptom of another problem, such as cryofibrinogenemia, cryoglobulinemia, or syphilis. Even when it is not, you can develop cold urticaria after receiving a blood transfusion from someone who has it. Most people don’t know that allergies can be transmitted in transfusions, but they can!

For some people, cold urticaria is a lifelong condition; for others, it is temporary — only during and after an infection, such as mycoplasma or mononucleosis. Overall, cold urticaria generally lasts about 4 to 5 years, with resolution of symptoms, or at least improvement of symptoms, in 50% of patients within 5 years (Clinical and Experimental Dermatology 32 (3), 241–245.)

Dr. Greene`s Answer:

The immune system is an intricate, interconnected network designed to protect our bodies from the dangers of the world around us, especially the danger of invasion from infectious organisms of all types or from the civil war of our own cancerous cells turned against us. The immune system includes many types of white blood cells, lymph vessels, lymph nodes, a host of specific antibodies, cilia (hair cells for sweeping away unwanted particles), the spleen, tonsils, adenoids, and our largest organ — the flexible, complex barrier we call skin.

An allergy happens when part of the immune system goes awry. In its enthusiasm to protect us, the response by the immune system is sometimes so exuberant that it is worse than whatever precipitated it. People can develop allergies to a wide variety of things, including pollen, dust, animal dander, foods, and viruses. Some individuals have an allergic response to being in cold air or water.

This allergic response can take several forms, from rashes to wheezing – and then some! The main symptoms might be on the skin, in the blood, in the urine, in the nose or in the chest. Cold allergies can even cause generalized fatigue and decreased ability to learn.

Some people develop hives on the skin when they encounter cold temperatures. This condition, called cold urticaria, is the most common type of hives caused by a physical condition. The hives are produced by a rapid release of histamine brought about by IgE antibodies and eosinophils (a type of white blood cell often involved in allergic reactions) in response to the cold. Rapid cooling, as from the evaporation when one gets out of a swimming pool, can trigger cold urticaria even on a warm day. For people with cold urticaria, swimming in very cold water is quite dangerous, sometimes even causing death.

Treatment of cold urticaria involves avoiding the cold, when possible, and taking antihistamines. The antihistamines are best taken before exposure to cold temperatures to block some of the histamine release. Many of the over-the-counter antihistamines interfere with learning. I recommend a nonsedating drug, such as loratadine (Claritin) or cetirizine (Zyrtec).

Sometimes cold urticaria is a symptom of another problem, such as cryofibrinogenemia, cryoglobulinemia, or syphilis. Even when it is not, you can develop cold urticaria after receiving a blood transfusion from someone who has it. Most people don’t know that allergies can be transmitted in transfusions, but they can (Nelson Textbook of Pediatrics, WB Saunders, 2000)! For some people, cold urticaria is a lifelong condition; for others, it is temporary — only during and after an infection, such as mycoplasma or mononucleosis.

Both mononucleosis and mycoplasma infections can produce another type of cold allergy in the blood. Following these and a variety of other viral infections, exposure to the cold can cause anemia from allergic bursting of some of the red blood cells. Anemia can result in fatigue and other symptoms, including decreased ability to learn.

Paroxysmal cold hemoglobinuria is another specific type of cold allergy, often associated with syphilis, in which cold temperatures make the urine turn red with blood. These people should avoid being chilled until the effects of the underlying infection have ended.

Breathing cold air can also trigger nasal congestion and wheezing. Sometimes this is a purely physical effect. This happens in two ways.

First, cold air affects an important defense mechanism called mucus transport. The entire respiratory system is coated with a very thin mucous blanket. Cold air stimulates an increase in mucus production, but mucus (like other substances), becomes thicker in colder temperatures.

The second area where cold air physically affects respiratory health is in the nose tissue. The hardy nose is a remarkable organ designed to condition inhaled air to protect the delicate internal structures. When breathing through the nose, you may breathe in air at 40 or 100 degrees Fahrenheit, but within a quarter of a second, the air temperature is quickly brought to 98.6. Many tiny blood vessels, known as capillaries, bring about this temperature exchange. When a person breathes cold air, the tissues lining the nose swell as the capillaries dilate, bringing warm blood to heat the cool air. Swollen capillaries in the nose are the cause of nasal congestion (nasal congestion is backed-up blood, not increased mucus). In addition to the congestion, the mucus in the nose, as we’ve said, increases and becomes thicker. This happens more in some people than in others. Thus cold air, by itself, can produce both nasal congestion and stuffiness. These can be treated with decongestants and/or antihistamines.

Sometimes the runny nose, congestion, and/or wheezing are a true allergic response to cold temperatures. If this is the case, preventive medicines such as cromolyn (Nasalcrom) or fluticasone (Flonase) can work well for the nose, and cromolyn (Intal), nedocromil (Tilade), fluticasone (Flovent) or the like, can work well to prevent wheezing. A variety of natural remedies have also been proven to help prevent these types of allergies, including quercetin/vitamin C, stinging nettle, saline nose drops, saline eye drops, and a nightly massage.

The most important step in treating allergies is to identify what triggers them. You are on your way, Pam, with the observation that cold causes your symptoms. Now that you know this, you can work with you doctor to find the best combination of treatments to keep your allergic response in check and allow your immune system to get on with more important business.

Dr. Greene’s Answer:

Preventing exposure to airborne allergies is another powerful way to treat allergies at home. To this end, a HEPA filter can be an excellent investment. These High Efficiency Particulate Arresting filters, available at discount drug stores for about $60 – $100, can remove 99.97+% of the pollen, dust, and animal dander from the air. I highly recommend placing one in the room where a child with hayfever sleeps.

When kids are playing outside during hayfever season, pollen from grasses, weeds, and trees clings to their clothes and hair. Taking off the outside clothes as they enter the house, and perhaps rinsing the hair, can greatly reduce the pollen they are exposed to that night as they sleep. Every little bit of exposure reduction helps. If a child is allergic to pollen, dust, and cats, minimizing exposure to pollen and dust will make the cat allergies less severe by cooling down the allergic response.

The Old Farmer’s Almanac advises tying a bag of onions around the neck or around the bedpost as a good home remedy for allergies. My guess is that this works by stimulating tear production, which naturally washes pollen particles out of the eyes and nose. A less smelly way to accomplish the same thing is the liberal use of saline nose drops or saline eye drops (artificial tears). Saline drops are not the same as the eye drops that are advertised to “get the red out.” While “get the red out” drops do help to reduce the red appearance of irritated eyes, they are not a good choice for preventing or treating allergies.

The Almanac also suggests turning a piece of orange rind inside out and inserting it in the nose. We now know that some of the ingredients in citrus fruits (including vitamin C) block the histamine response in a safe and natural way. The most potent of these appears to be a vitamin-like compound called quercitin that is found in citrus fruits and buckwheat. Increasing these foods in the diet makes sense. Quercitin/vitamin C supplements are available in health food stores. We know that these reduce hayfever symptoms in rats, but their effect in human children have not been established. They do appear to be safe and gentle, however, and many people report success with them.

Stinging nettle is the other natural remedy that shows a lot of promise. Also available in health food stores, this herbal supplement is now known to reduce the histamine response in test tube experiments. But again, although I have heard many testimonials, the scientific evidence in support of its effectiveness in humans is sparse.

The last remedy suggested by the Old Farmer’s Almanac is swallowing a spider. Yuck–the cure is worse than the disease!

Dr. Greene’s Answer:

Allergic triggers such as pollen prompt mast cells (frontline defenders of the body) to release a chemical called histamine that sets in motion a cascade of symptoms to repel the invaders. We call it ‘allergies’ when this response is triggered by something that would not otherwise be harmful for the body.

Antihistamines reduce allergy symptoms by blocking the action of the histamine. These can be very effective, but all of the over-the-counter antihistamines cause some change in kids’ levels of alertness. Most of the time, they produce drowsiness in children (which can be quite welcome — especially at night), but around 5% of kids act hyper instead.

Of far greater concern is the effect of over-the-counter antihistamines on thinking and learning. We know that kids who are experiencing allergy symptoms don’t think or learn or remember as well as kids who are feeling well (Annals of Allergy, Aug 1993). Careful studies have now been performed to determine whether this reduction in learning ability could be reversed by using over-the-counter antihistamines to relieve the allergy symptoms. The surprising results were that even though kids felt better on the antihistamines, their learning abilities were even worse than with no treatment (Annals of Allergy, Asthma, and Immunology, Mar 1996). They’re learning and mental agility is reduced whether or not they are drowsy. When it comes to learning, children are better off congested than drugged. (Better yet is relieving the symptoms in less problematic ways!)

Over-the-counter antihistamines are a reasonable choice for nighttime use, or for an occasional day or two when a child is home from school. I do not recommend them, however, as a long-term solution. Learning –even during play — is too important a part of childhood to blunt with drugs. Some of the prescription antihistamines do not decrease alertness or learning.

Antihistamines are found in almost all allergy preparations that are not specifically advertised as non-drowsy. Diphenhydramine is the most powerful, but it also makes kids the sleepiest (or most wired). Chlorpheniramine and brompheniramine both are a little less potent but have fewer side effects.

Nasalcrom (cromolyn sodium) is an over-the-counter allergy medicine that is more effective and far safer than either decongestants or antihistamines. Nasalcrom is a nasal spray that creates a protective barrier around the allergy cells in the nose so that pollen, mold, dust, and animal dander can’t stick to them. It stops the allergic response before it starts–without causing any drowsiness, irritability, or decreased learning. It doesn’t reverse allergy symptoms that are already present, but prevents new allergen exposures from causing symptoms. Unlike decongestant nasal sprays, this gentle medicine can be used for weeks or months at a time with no fear of rebound effects or addiction.

Dr. Greene’s Answer:

Let’s begin by considering together the birds and the bees…

Pollen is used by plants to reproduce. Come springtime, many plants dress themselves with beautiful, vibrant flowers in an effort to attract birds and bees. These curious visitors carry the pollen from flower to flower, and magic happens.

Many less flashy plants use a different strategy to reproduce. Grasses, weeds, and trees often make smaller, lighter, grains of pollen and depend on the wind to scatter it widely. This windborne pollen, not that produced by flowers, is responsible for most hayfever symptoms.

During their mating season, some trees pump out millions and millions of grains of pollen each day. On dry days after the spring rains, the pollen count is at its highest — especially on windy days.

The lining of our noses contains tiny guardians called mast cells, whose purpose is to protect us from harmful particles in the air we breathe. People with allergies have hypersensitive mast cells that sound the alert in response to relatively harmless particles such as pollen, dust, or pet dander.

When pollen sticks to the membrane of a mast cell of someone with pollen allergies, the cell begins to swell and swell. Finally the mast cell bursts, spilling histamine and many other potent chemicals into the surrounding tissue. These produce the sneezing, swelling, itching, and congestion associated with allergies.

Parents often ask me whether their children’s constantly runny noses are the result of allergies, sinus infections, or of one cold after another. Allergies typically feature a clear nasal discharge with sneezing. There may be itchy, watery eyes and/or a dry cough. Often parents notice a “rabbit nose” — a child crinkling her nose to relieve the itchy sensation inside. The “allergic salute” — rubbing the nose with the hand, sometimes leaving a horizontal crease on the nose — is another common sign. “Allergic shiners” — dark circles under the eyes — have long been associated with allergies, but are less predictive than the other symptoms. Often there is a family history of allergies.

Colds will often begin with a clear nasal discharge, but after several days it usually turns creamy, yellow, or green for a time. Symptoms typically start suddenly and resolve within 7 to 14 days. Sneezes tend to be more productive, and coughs sound wetter than with allergies. If the eyes are involved, one or both of them usually turn pink, with a discharge that matches that in the nose. A fever may be present.  Often people in close contact with the child have similar symptoms.

A sinus infection in a child often begins like a cold but lasts for greater than 10 to 14 days with no period of improvement. Sometimes a sinus infection begins with a high fever (>103 F), facial swelling, or facial pain.

Since children with allergies often get more colds, sinus infections, and ear infections than their counterparts, it can be difficult to tease apart what is going on. The experience of other family members offers a big clue. Allergies often run in families. Eczema and asthma are also more common in allergic families.

What if your child does have allergies?

Walking into a drugstore, you are confronted with an overwhelming display of brightly packaged allergy products, each promising greater allergy relief than its neighbors. Many of these products can actually harm your child and make the effects of allergies even worse. The right choices, however, used in the right ways, can dramatically improve your child’s springtime.

I will guide you through the confusing maze of home allergy treatments for your child.

In the meantime, “gesundheit!”