Allergy & Immunology

Pediatric allergy symptoms include sneezing

When it comes to asthma and allergies in kids (and conditions related to the immune system), Nemours’ highly trained and experienced pediatric allergy, asthma and immunology teams can help. Our goals are simple: To relieve symptoms as quickly as possible and give you the tools you’ll need to best manage your child’s allergy condition at home.

Read More About Pediatric Allergy & Immunology

Nemours’ pediatric allergists diagnose and treat asthma and all types of allergies in children, from hay fever to food allergies. Our immunologists (doctors who specialize in malfunctions of the immune system such as autoimmune diseases, hypersensitivities, immune deficiency and transplant rejection) have a high level of expertise in diagnosing and treating immune system conditions in children, such as immune deficiency.

We’ll perform a complete exam and ask about symptoms, severity and timing. And we’ll work closely with Nemours’ experts from other pediatric specialty areas to provide a long-term management plan tailored to your pediatric allergy, asthma, or immunology needs.

Common Pediatric Allergy Signs, Symptoms, and Conditions

Some of the reasons families like yours often come to us include:

  • wheezing
  • asthma
  • eczema (an itchy rash, also called “atopic dermatitis”)
  • hives
  • food reactions
  • allergies affecting the nose and eyes
  • allergies affecting the stomach and intestines
  • drug reactions
  • exercise intolerance
  • recurrent infections
  • recurrent cold-like symptoms
  • recurrent fever

Nemours Children's Hospital, Orlando

13535 Nemours Parkway
Orlando, FL 32827
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For Appointments: (407) 650-7715

Clinic Location: Fourth Floor

Hours: Monday–Friday, 8 a.m. to 5 p.m.

Schedule a new patient allergy appointment.
How to Prepare

Here are some important tips to follow before your child’s test appointment with our allergy and immunology team:

  • Stop all antihistamines, if possible, 7 days before your appointment — they interfere with skin testing. This includes medicines such as Zyrtec, Claritin, Clarinex, Allegra, Benadryl, Hydoxyzine, Periactin, Chlorpheniramine and most over-the-counter cold medicines.
  • Continue all asthma medicines, especially any inhalers. DO NOT STOP medicines such as Flovent, Advair, Singulair or Pulmicort.
  • If your child is on antidepressants, please call us because some antidepressants will interfere with skin tests. DO NOT STOP these medicines without speaking to us.

What to Bring
  • photo ID
  • medical and pharmacy insurance cards
  • preferred pharmacy name and phone number
  • names and dosage of all medications, including over-the-counter medication, your child is currently taking
  • guardianship and custody papers, if a legal guardian rather than a parent accompanies your child
  • any forms required for school, camp, sports, etc.
  • a list of prior immunizations
New Patients

Bring these forms for your first appointment:

Returning Patients
  • Patient Presents Without Legal Guardian (PDF)
    English | Spanish
    Note: A parent or legal guardian must be with a child for a first visit.
Forms & Resources
New Patient Forms
Returning Patient Forms
  • Patient Presents Without Legal Guardian (PDF)
    English | Spanish
    Note: A parent or legal guardian must be with a child for a first visit.
Resources for Patients & Families
Online Support Service
  • CaringBridge: visit this free site offering support and communication to help your family through your child's medical journey

At Nemours Children’s Hospital (NCH), we do whatever it takes to make sure pediatric allergy, asthma and immune problems don’t slow your child down. Our highly trained pediatric allergy & immunology team diagnoses and treats all types of allergic and immune system conditions in children.

If your child is experiencing asthma or allergy symptoms, we’ll work to relieve them as quickly as possible and give you the tools and know-how you need to manage ongoing care of pediatric allergies. And, if your child has an immune system disorder, we’ll use the most effective medicines and immunotherapy (such as allergy shots and target therapy) for treatment.

Common Signs, Symptoms and Conditions We See
Some of the reasons families often come to us include:
  • wheezing
  • asthma
  • eczema (an itchy rash, also called “atopic dermatitis”)
  • hives
  • food allergies
  • environmental allergies
  • drug (medication) reactions
  • allergies affecting the nose and eyes
  • allergies affecting the stomach and intestines
  • immune system disorders
  • exercise intolerance
  • recurring infections, cold-like symptoms, or fever

Read More About Allergy & Immunology Conditions in Children »

Taking a Team Approach to Pediatric Allergies & Immunology

Pediatric specialists at Nemours Children’s Hospital bring highly specialized, leading-edge expertise from some of the nation’s top pediatric asthma, allergy and immunology programs to Central Florida.

Working closely with Nemours experts from other pediatric specialty areas, we help families find answers, and relief from symptoms.

Our pediatric allergy, asthma and immunology team works closely with Nemours experts from other pediatric specialty areas including:
  • Rheumatology: helps children with muscle pain, joint stiffness, and unusual rashes or fever
  • Gastroenterology (Digestive Health): diagnoses symptoms affecting the digestive tract
  • Infectious Diseases: helps children with recurring infections
  • Hematology (Blood Disorders): treats blood disorders in children, including sickle cell anemia
  • Otolaryngology (Ear, Nose, and Throat/ENT): treats kids with chronic sinusitis (sinus infections)
  • Pulmonology (Respiratory Care): diagnoses and treats children with breathing and lung diseases
  • Pathology (Lab Services): helps diagnose diseases by analyzing specimens for microscopic changes in cells or tissues

Whether your child has asthma, an allergy, or an immune system condition, know that at Nemours, we do whatever it takes to give your child the very best, most comprehensive and compassionate treatment possible. We treat every child as we would our own.

Partnering With You to Help Manage a Pediatric Allergy Condition

At Nemours, we understand that when your child has allergy or immune problems not only impacts your family, it affects your child’s entire life. Going to parties, visiting friends — and even eating lunch at school can be difficult, and dangerous. That’s why our experienced allergists take a systematic diagnostic approach to help pinpoint, and successfully treat, even the most complex causes of allergies in children.

We also know that no one knows your child better than you do and that you’re one of the most important members of your child’s care team. It’s our goal to include you in the process and to create a close relationship with you and your child.

We’ll make sure you understand:
  • how your child’s allergy or asthma is triggered
  • how to avoid those triggers (or allergens, which can cause or worsen asthma or allergy symptoms)
  • what treatment options are available
  • how to use any treatment devices we may prescribe (such as inhalers or epinephrine injectors)
  • how you and your child can best manage the condition, every day

Our nurses and respiratory therapists also are available to answer any questions you or your child may have.

What to Expect at Your Child's Pediatric Allergy Visit

Diagnosing Allergies and Immune Disorders in Children

At your first pediatric allergy & immunology visit at NCH, our board-certified doctors, physician assistants and nurse practitioners will perform a complete medical and family history assessment, as well as a comprehensive physical exam. We’ll also ask many questions about your child’s symptoms, their severity and timing. (For example, do they appear or tend to get worse at a certain time of the year, after eating a certain food or during exercise?)

Based on our findings, and to help diagnose your child's problem, we may then perform further tests, such as:

Skin and Patch Testing

Skin testing involves lightly scratching the skin with a potential allergen (such as pet dander, dust, pollen and foods) and then evaluating the response within 60 minutes. For testing that requires a longer time period (days instead of minutes), we’ll use patch testing.

What You Should Know About Patch Testing

Patch testing involves applying various adhesive patches, each containing a potential allergen, to the skin and then checking the reaction 48 hours later.

Here’s how it works:
  • We’ll apply the patches onto your child’s skin, usually on the back.
  • We’ll place patches with suspected allergens onto your child’s back and secure them with tape.
  • Your child will wear the patches for 48 hours. Showers, swimming and strenuous activity should be avoided so the patches stay in place. (Sponge baths are OK, as long as the back is not disturbed.)

Your child will then come back to see us at or after 72 hours to have the patch testing area read.

Frequently Asked Questions About Skin Testing
Q: Does it hurt?

Skin testing may sound scary, but it’s actually pretty simple and painless. Small plastic applicators are used to scratch the skin’s surface with the allergens. There might be some itchiness that goes away quickly.

Q: How do you know which allergens to test for?

Your child’s medical history will help your doctor or nurse determine which type(s) of skin testing your child might need.

Q: Where does my child have to go for skin testing?

The testing is usually done in our office. A nurse generally administers the test and your doctor interprets the results.

Q: How long does it take?

Testing typically takes between 30 and 60 minutes. Tests usually detect immediate allergic reactions, which develop within minutes of exposure to
an allergen.

Q: Where on the skin is the testing done?

The tests will be applied to your child’s forearm or back, depending on your child’s age.

Q: How is the testing done?

The nurse will apply drops of allergen extracts (pet dander, dust, pollen, foods, etc.) on your child’s skin. These will then be scratched into the
skin's surface. After we’ve looked over the test results, the nurse or doctor
will talk to you about what the allergies are and how to best avoid the
related allergens.

If you have any questions or concerns before or after skin testing, please call our allergy nurses.

Food Challenges

Depending on your child’s history, test results, and readiness, we may recommend a food challenge, the most definitive way to diagnose food allergies. Administered at NCH by specialists who helped build the first food challenge program in the country, this test involves feeding your child small amounts of suspected food allergens and evaluating the reaction.

What to Expect at a Food Challenge

A food challenge is always performed under careful watch at the hospital where our physicians can evaluate and, if necessary, safely counteract any allergic response. We only do this if we’ve determined it’s safe for your child. (This kind of testing should never be done at home.)

The challenge involves giving your child increasing amounts of a specific food (dairy, foods containing gluten, etc.) every 10-15 minutes. The physician assesses your child’s tolerance at each interval before continuing. If a reaction occurs, we’ll immediately treat your child and observe whether the symptoms recur or persist. You can expect to be at the hospital for 4 to 8 hours.

Your physician will give you specific instructions to help you prepare your child for the test, but generally you’ll be asked to:

  • Week Before: Stop oral antihistamine medications (like Benadryl, Zyrtec, Claritin, etc.). Please do not discontinue inhaled medications or nasal sprays like Singulair, Flovent, Nasonex, etc.
  • Evening Before: Children over 6 years old must stop eating solid foods at 12 midnight. Children 6 and under can eat a small meal 6 hours before the test, and clear liquids (water, Gatorade, fruit juice, popsicles, etc.) up to 2 hours before the test.
  • Day of the Test: Plan to stay with your child during the entire challenge. You might be asked to bring specific foods for the test, but please don’t bring in or feed your child other foods. Parents must eat outside of the testing area.

While we have televisions and fun interactive activities in the testing area, feel free to bring something from home (a favorite toy, game, or puzzle) to provide comfort and pass the time.

Please note: If your child has a fever or infection within 48 hours of the appointment, please call us to reschedule.

Depending on the results of these tests, we may also order:
  • tests for drug allergies (allergies to various medicines)
  • blood tests that check for specific antibodies (cells made by the immune system in response to certain allergens)
  • tests that evaluate the overall function of the immune system breathing tests, chest X-rays, and other diagnostic evaluations to check your child’s lung function
Can Kids With an Egg Allergy Get Vaccines?

Because certain vaccines are made by growing viruses on chicken egg cells, some children can have a reaction.

  • Flu vaccine: If your child has had a severe reaction after eating eggs or a reaction to the flu shot itself, you should have your child evaluated by our allergists. We can then administer any flu shots, if needed.
  • MMR (measles, mumps, rubella) or varicella (chickenpox) vaccines: According to standard vaccination guidelines, children with an egg allergy should be able to get the MMR or varicella vaccines with little or no risks. However, if your child’s primary care pediatrician is uncomfortable administering the vaccinations, we can give them at our office.