The return to school, after the long summer break is usually greeted with relief, by parents and children alike. But with the return to school, comes a host of other worries, for the parent of an asthmatic or allergic child. How can you help your allergic child avoid a reaction to some of the very common allergens that they will encounter within school? You cannot protect your child from going out into the world, and enjoying a balanced and happy school life. But with the dramatic increases in asthma and other allergies, and the effect it can have on education, some measures need to be taken. Thankfully, most schools have an asthma policy, where named inhalers are kept safe in the office, and children leaving the school for any activities are required to carry their inhalers with them. Specific medication details are kept on file for all children, including emergency contacts in case of an attack. But how do you overcome the problem of the child that has listened to your nagging, has bben through the frightening experience of serious allergic reaction and hospitalisation, but still feel stigmatised by their ailment?

Here we have listed potential problem areas in returning to school after the long summer break and ways in which the school and parents can work together to help.

By Adekunbi Balogun [Kingston University]

Bedding is an important habitat for house dust mites (HDM), and indeed acts as a sink for mite allergens. Dust from the bed often has higher allergen concentrations than other parts of the house. They are also the only site where allergen levels are associated with severity of asthma. Beds have for a long time been suggested as the most important source of house dust mite allergen exposure for children, due to the fact that infants and children alike spend more than half their time in close contact with bedding.

HDMs feed on human skin scale in locations where it collects. We shed dead skin at a daily rate of 0.5 to 1.0g per person; this is more than enough for several thousand dust mites as they can survive for months on just 0.25g of dead skin. As such, the more children spend in bed, the more likely they are to develop sensitisation to dust mites, which could lead to the development of asthma. As the start of the school year draws ever closer, the importance of proper care and consideration of bedding for children in particular cannot be over-emphasized as the result of negligence could adversely affect their health and consequently their overall performance.

Important tips to consider for successful reduction of the amount of house dust mites and their allergens in your child's bed.

1. Mattresses, duvets and pillows should be covered with dust mite proof covers. Use bedding that can be washed often, cotton sheets, washable bottom sheets and blankets or duvets that can be washed and tumble dried.

2. Do not use woollen blankets or quilts, if however you have to use woollen blankets or quilts, wash them at least every 2 months to remove allergens. Dry cleaning of these and other bedding will kill the mites but does not remove the allergens.

3. Even if you use dust mite proof covers, you should wash all sheets, pillowcases, quilt or duvet covers and cotton blankets once a week to remove both mites and allergens.

4. Vacuum your mattress each time you strip the bed. Even if your mattress is sealed, you want to prevent a new dust mite colony from forming between the mattress cover and the bed sheets.

5. Wash bedding in hot water (55°C or more), sustained for at least 12 min (or above 60°C for 8 min). This is sufficient to kill >80% of dust mites. If you can only wash in cooler water, use a product containing essential oils, such as tea tree or eucalyptus oil. Or launder in Allergymatters Allergy neutralizing laundry detergent.

6. Leave the child's bed unmade during the day so as to release moisture from the mattress. This causes the mites to dehydrate and eventually die.

7. Keep the house and the child's room well ventilated, cool and dry. Dust mites hate dry and cold air, so try to air the house everyday. If the lower edge of the window is moist when you wake up in the morning, there is too much humidity in the air. Dehumidifiers are excellent at reducing the level of humidity indoors.

From our experience we have selected a special range of bedding products for your children as they prepare to return to school and to ensure the school year starts stress free. Use this opportunity to check out our special Back To School offers on anti-allergy bedding sets

Tal to the head teacher and ask if regular newsletters could be circulated to the parents to ensure that they understand the policy of excluding certain foods from their children's lunch boxes, such as peanut butter. Clearly explain the reasons for these requests and ask for their understanding and support. If appropriate, supply your child with an Epi-pen case or an inhaler case, that they can clip onto their waistband. This will ensure that they always have their medication close at hand.

Become an active school committee member, so that you will be able to raise particularly important issues effectively. Try not to become overly obsessed though!

If your school is particularly disorganised or messy with the school clutter, ask if some of the money raised for the school could be used for plastic lidded crates for storage, instead of leaving things on shelves. This will cut down on a lot of dust and will make the cleaners job easier too.

As the incidence of allergies is only going to increase, the only way forward is to make the medication and treatment as inconspicuous, stylish, and even cool as possible. After all, it could be your child that has to carry around spacers, puffers, cream, allergy shots and so on. They don't want to look un-cool in front of their friends, but you need their compliance to ensure that they carry and use them at all times- at school - at home - at play.

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