below the skin, so that patients just feel a pinch, unlike flu shots or other vaccines that target muscles with larger needles. Over time, these injections reduce the immune system reaction that causes symptoms, and can even cure a person – especially if treatment starts at a young age – through a process called desensitization. Parents often ask how young is too young for these treatments. I have successfully administered allergy shots to a patient as young as four years old with effective results that vastly improved that child's quality of life.

There are also several FDA-approved immunotherapy tablets available for treatment of specific allergies like: grass, ragweed and dust mites. After the initial dose, these can be taken at home, but must be given daily for the best outcome. Some are approved down to 5 years of age, and can be an option for those children who are extremely fearful of injections, or who are not a candidate for injections. I recommend discussing all options with your allergist for a personalized treatment plan.

ARE THERE ANY SPECIAL CONSIDERATIONS FOR CHILDREN WITH DISABILITIES?

I have worked very closely with children who have disabilities throughout my pediatric and allergy career. I have helped many allergy patients who have developmental and behavioral diagnoses, including autism and ADHD, among others.

As you look for an allergist to treat your child, I always suggest reaching out to the provider directly and making sure the group is equipped to see children, especially children with disabilities. We know visiting a doctor can be scary, although many children who have been diagnosed with physical or developmental challenges may be fairly accustomed to visits with doctors and being

examined. However, sometimes when working with children who have disabilities or struggle with communication, it can be more difficult to isolate issues and diagnose what is going on. With patience, it can be quite successful.

In our offices, I invite patients and their caregivers to come in, meet our staff and get comfortable. We discuss health concerns, do the examination and talk through treatment options. If parents feel more comfortable, we can also break up the initial discussion into a couple of visits, to help the children become more familiar with the office and the staff.

I have found that kids are very resilient when it comes to allergy treatment. It's worth emphasizing that the shots do not feel the same as an immunization, like a flu shot, because they are not inserted into the muscle, and the kids respond well, once the visits to our office become routine.

It is good to go to a place where the doctor and staff are very familiar with children, and know how to make each one feel as comfortable as possible – this is the key to success. You and your child need to feel safe, heard and relaxed before choosing a provider and starting any treatment. •

ABOUT THE AUTHOR:

Dr. Jeanne Lomas is a board-certified allergist and Director of Allergy & Immunology at WellNow Allergy. She began her career in pediatrics then completed a fellowship in allergy and immunology, where she found her passion. She sees herself as a "detective," working to get a thorough understanding of each patient's lifestyle and individual health to identify, treat and educate them. She is active in clinical practice and patient care, as well as a leader in clinical operations and provider of education.