Families of kids with allergies should use environmental control measures that reduce exposure to the child's allergy triggers. Some require few changes in the home, while others can be costly or fairly time-consuming.

Talk with your doctor or health care provider about starting with environmental control measures that will limit those allergens and irritants causing immediate problems for a child. But know that allergies develop over time with continued exposure to allergens — dust mites may not be a trigger now, but with continued uncontrolled exposure, could become one. The doctor may suggest taking proactive steps now so your child doesn't develop new allergies.

The following are suggested environmental control measures for different allergens and irritants:

Indoor Controls

To control dust mites:

• Use only synthetic polyester-fill pillows and comforters (never feather or down). Encase pillows, mattresses, and box springs in zippered dust mite-proof covers (available at allergy-supply stores and many department and discount stores). Keep covers clean by vacuuming or wiping them down once a week.
• Wash sheets and blankets a child sleeps on once a week in very hot water (130? Fahrenheit or higher) to kill dust mites. Young children should never be left alone in a bathtub or near faucets when hot water heaters are set to this degree since scalding can occur. When possible, a safe alternative is to set water temperature lower at home and wash the child's bedding at a laundromat where hot water is set to 130? F.
• Avoid upholstered furniture, window mini-blinds, and carpeting in a child's bedroom and playroom as much as possible. They can collect dust and harbor dust mites (especially carpets).
• Use washable throw rugs on vinyl or hardwood floors, and wash rugs in hot water weekly.
• Use washable curtains and vinyl window shades that can be wiped down. Wash curtains in hot water weekly.
• Dust and vacuum weekly. If possible, use a vacuum cleaner with a HEPA (high-efficiency particulate) filter to collect and trap dust mites.
• Reduce the number of dust-collecting houseplants, books, knickknacks, and non-washable stuffed animals in your home.
• Remove all stuffed animals from your child's bed. Only a few washable stuffed animals should be allowed in your child's room, and these should be washed weekly. (Let your child pick which washable stuffed animals can stay.)
• Avoid humidifiers when possible because moist air promotes dust mite infestation. Humidity in the air should stay below 50%. The amount of humidity in a room can be easily checked with a humidity gauge (hygrometer) that can be purchased in most hardware and home improvement stores.

To control pollens and molds:

• Avoid humidifiers, since humidity promotes mold growth. If you must use a humidifier, change the water every day and clean the inside 2–3 times a week to prevent mold growth.
• Ventilate bathrooms, basements, and other dark, moist places that commonly grow mold. Consider keeping a light on in closets and using a dehumidifier in basements to remove air moisture.
• Use air conditioning: it removes excess air moisture, filters out pollens from the outside, and provides air circulation throughout your home. Filters should be changed once a month.
• Avoid wallpaper and carpets in bathrooms, as mold can grow under them.
• Use a weak bleach solution consisting of 1 cup of bleach per gallon of water to kill mold in bathrooms and other areas.
• Keep windows and doors shut during pollen season.

To control irritants:

• Do not smoke (or allow others to smoke) in the house — even when a child is not present (the smoke gets trapped in the upholstery and carpets).
• Do not burn wood fires in fireplaces or wood stoves.
• Avoid strong odors from paint, perfume, hair spray, disinfectants, chemical cleaners, air fresheners, and glues.
• Some kids develop symptoms or have increased symptoms during the Christmas holidays when exposed to live Christmas trees.

To control animal dander:

• If a child is allergic to a pet, discuss with your doctor the advisability of finding a new home for the animal, especially if your child has symptoms not controlled by medication alone, needs a combination of medications for symptoms, or has symptoms even when receiving allergy injections.
• It may help (but not always) to wash the animal at least once a week to remove excess dander and collected pollens.
• Never allow the pet into the allergic child's bedroom and keep the door closed at all times. Consider keeping the pet outdoors.
• If your child has asthma and you don't own a pet, don't acquire one. Even if not allergic to animals now, kids with asthma can become allergic with continued exposure.

The use of air filters such as HEPA filters or electrostatic filters alone have not been proven to reduce indoor allergens although they might be helpful when used along with other environmental control measures. If using such filters, the appropriate size should be used to filter the entire room. Ozone air purifiers or ionizers are not effective and inhaling the ozone that they produce may be harmful.

Outdoor Controls

• When mold or pollen counts are high, premedicate the child as directed by your doctor. After playing outdoors, the child should bathe and change clothes.
• Drive with the car windows shut and air conditioning on during mold and pollen seasons.
• Don't let a child mow the grass or rake leaves.

In some cases, the doctor may recommend allergy shots (immunotherapy) when control measures and medications are not effective. Speak with your child's doctor about these options.

Reviewed by: Kathleen Trzcinski, RN, MSN
Date reviewed: November 2007