Ask the pediatrician

Q1: My kids all have pretty bad allergies beginning in late summer. What can I do to minimize their symptoms of sneezing, runny noses, and itching eyes?

Seasonal allergies are very common in children and teens. They can range from a mild inconvenience to a major disruption in day-to-day life. The symptoms described above are the most common indicators, but they can also include asthma, eczema (drying and redness of the skin), and even recurrent and persistent hives. The allergens most commonly associated with late summer and fall are grass-related pollens (ragweed is one of the most common offenders). Tree-related pollens, on the other hand, are usually more of a problem in spring and early summer, as trees release pollens into the air. Animal dander, mold, and dust mites are year-round causes of allergy irritants and can add to the symptoms caused by these seasonal irritants.

Allergies tend to be an inherited condition, so chances are that one or both parents are at least mildly affected by allergies, as well. The good news is that there are a number of ways to safely and effectively treat the symptoms. Minimize exposure to the allergens if possible, which may include closing the windows and turning on the air conditioner, especially during dry and windy conditions. Showering before bed can work to rinse off adhering pollens. There are a number of over-the-counter oral and eye-related medications available, some of which are much less sedating than the old standby of diphenhydramine (Benadryl, others). Prescription medications are the next level of treatment that can significantly reduce the misery. Finally, allergy shots can be a very effective treatment if nothing else seems to be working.

As always, this is just general information and does not constitute specific medical advice. Please talk to your health care clinician if you have additional questions.

Q2: My sons, ages five and seven are fighting a lot lately. How do I deal with sibling rivalry?

Sibling rivalry—competition between children—is very common and generally cannot be completely prevented, even under the best of circumstances. Children of the same gender and closeness in age seem to be risk factors. 

While not avoidable, there are some interventions that you can use to try to manage and minimize their fighting. One big triggering factor can be trying to get the attention of parents. Ignoring the unwanted behaviors can go a long way to minimize these skirmishes. Separating the children as appropriate can be an effective intervention for some siblings. Consistent imposing of a consequence may be needed for some situations. Rewarding more cooperative behavior—catching them being good—can work to improve cooperation. The rule here is to try a variety of things until you find something helpful.

You will also do well to refrain from any type of comparative statements, such as “if only you were like a good reader like your brother,” or “your sister won first place in track when she was your age; I’m surprised you didn’t even place.” Comparing across a few years is generally unfair to your younger child, regardless of the behavior. In addition, children have different skills, different talents, and different developmental timelines. A comparison of this nature usually does not help your position as a parent and only frustrates your kids.

Finally, if there is a lot of stress or disruption in your family—loss of a grandparent, loss of a job, a new move, and so on—fighting between siblings can reflect that increased stress 

Q3: I have a six-month-old who has begun teething. What do I do to take care of my baby’s teeth, and what age does he need to go to the dentist?

When teeth first come in, simply wiping them off before naps and bedtime is the best way to prevent cavities. Actual brushing of the teeth with a soft tooth brush usually begins when six to eight teeth have erupted—certainly by the time the first molars come in. Fluoride varnishing is something that may be available through your child’s health clinic and does a good job of preventing cavities. Not having your infant or toddler go to bed with a bottle is very essential.

Finally, there are two general opinions regarding when children should first see the dentist. The traditional recommendation has been about three years of age, when the second molars are generally well established, and cooperation with the exam is more likely. More recently the recommended first visit has been changed to one year of age by some professional organizations. Please consult your child’s care professional for a recommendation on that first trip to the dentist’s chair.

This column is intended to provide general information only and not medical advice. Contact your health care provider with questions about your child. Dr. Peter Dehnel is a board-certified pediatrician and medical director with Blue Cross Blue Shield of Minnesota. Send questions to