Allergies happen when your immune system overreacts to a normally harmless substance like dust or pollen. Hay fever, hives and anaphylaxis are all types of allergic reactions.

Many of those affected reach quickly for antihistamines to treat mild to moderate allergies (though adrenaline, not antihistamines, should always be used to treat anaphylaxis).

If you’re using oral antihistamines very often, you might have wondered if it’s OK to keep relying on antihistamines to control symptoms of allergies. The good news is there’s no research evidence to suggest regular, long-term use of modern antihistamines is a problem.

But while they’re good at targeting the early symptoms of a mild to moderate allergic reaction (sneezing, for example), oral antihistamines aren’t as effective as steroid nose sprays for managing hay fever. This is because nasal steroid sprays target the underlying inflammation of hay fever, not just the symptoms.

Here are the top six antihistamines myths – busted.

Myth 1. Oral antihistamines are the best way to control hay fever symptoms

Wrong. In fact, the recommended first line medical treatment for most patients with moderate to severe hay fever is intranasal steroids. This might include steroid nose sprays (ask your doctor or pharmacist if you’d like to know more).

Studies have shown intranasal steroids relieve hay fever symptoms better than antihistamine tablets or syrups.

To be effective, nasal steroids need to be used regularly, and importantly, with the correct technique.

In Australia, you can buy intranasal steroids without a doctor’s script at your pharmacy. They work well to relieve a blocked nose and itchy, watery eyes, as well as improve chronic nasal blockage (however, antihistamine tablets or syrups do not improve chronic nasal blockage).

Some newer nose sprays contain both steroids and antihistamines. These can provide more rapid and comprehensive relief from hay fever symptoms than just oral antihistamines or intranasal steroids alone. But patients need to keep using them regularly for between two and four weeks to yield the maximum effect.

For people with seasonal allergic rhinitis (hayfever), it may be best to start using intranasal steroids a few weeks before the pollen season in your regions hits. Taking an antihistamine tablet as well can help.

Antihistamine eye drops work better than oral antihistamines to relieve acutely itchy eyes (allergic conjunctivitis).

Myth 2. My body will ‘get used to’ antihistamines

Some believe this myth so strongly they may switch antihistamines. But there’s no scientific reason to swap antihistamines if the one you’re using is working for you. Studies show antihistamines continue to work even after six months of sustained use.

Myth 3. Long-term antihistamine use is dangerous

There are two main types of antihistamines – first-generation and second-generation.

First-generation antihistamines, such as chlorphenamine or promethazine, are short-acting. Side effects include drowsiness, dry mouth and blurred vision. You shouldn’t drive or operate machinery if you are taking them, or mix them with alcohol or other medications.

Most doctors no longer recommend first-generation antihistamines. The risks outweigh the benefits.

The newer second-generation antihistamines, such as cetirizine, fexofenadine, or loratadine, have been extensively studied in clinical trials. They are generally non-sedating and have very few side effects. Interactions with other medications appear to be uncommon and they don’t interact badly with alcohol. They are longer acting, so can be taken once a day.

Although rare, some side effects (such as photosensitivity or stomach upset) can happen. At higher doses, cetirizine can make some people feel drowsy. However, research conducted over a period of six months showed taking second-generation antihistamines is safe and effective. Talk to your doctor or pharmacist if you’re concerned.

Myth 4. Antihistamines aren’t safe for children or pregnant people

As long as it’s the second-generation antihistamine, it’s fine. You can buy child versions of second-generation antihistamines as syrups for kids under 12.

Though still used, some studies have shown certain first-generation antihistamines can impair childrens’ ability to learn and retain information.

Studies on second-generation antihistamines for children have found them to be safer and better than the first-generation drugs. They may even improve academic performance (perhaps by allowing kids who would otherwise be distracted by their allergy symptoms to focus). There’s no good evidence they stop working in children, even after long-term use.

For all these reasons, doctors say it’s better for children to use second-generation than first-generation antihistimines.

What about using antihistimines while you’re pregnant? One meta analysis of combined study data including over 200,000 women found no increase in fetal abnormalities.

Many doctors recommend the second-generation antihistamines loratadine or cetirizine for pregnant people. They have not been associated with any adverse pregnancy outcomes. Both can be used during breastfeeding, too.

Myth 5. It is unsafe to use higher than the recommended dose of antihistamines

Higher than standard doses of antihistamines can be safely used over extended periods of time for adults, if required.

But speak to your doctor first. These higher doses are generally recommended for a skin condition called chronic urticaria (a kind of chronic hives).

Myth 6. You can use antihistamines instead of adrenaline for anaphylaxis

No. Adrenaline (delivered via an epipen, for example) is always the first choice. Antihistamines don’t work fast enough, nor address all the problems caused by anaphylaxis.

Antihistamines may be used later on to calm any hives and itching, once the very serious and acute phase of anaphylaxis has been resolved.

In general, oral antihistamines are not the best treatment to control hay fever – you’re better off with steroid nose sprays. That said, second-generation oral antihistamines can be used to treat mild to moderate allergy symptoms safely on a regular basis over the long term.

Janet Davies, Respiratory Allergy Stream Co-chair, National Allergy Centre of Excellence; Professor and Head, Allergy Research Group, Queensland University of Technology; Connie Katelaris, Professor of Immunology and Allergy, Western Sydney University, and Joy Lee, Respiratory Allergy Stream member, National Allergy Centre of Excellence; Associate Professor, School of Public Health and Preventive Medicine, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Parents are often advised to burp their babies after feeding them. Some people think burping after feeding is important to reduce or prevent discomfort crying, or to reduce how much a baby regurgitates milk after a feed.

It is true babies, like adults, swallow air when they eat. Burping releases this air from the top part of our digestive tracts. So when a baby cries after a feed, many assume it’s because the child needs to “be burped”. However, this is not necessarily true.

Why do babies cry or ‘spit up’ after a feed?

Babies cry for a whole host of reasons that have nothing to do with “trapped air”.

They cry when they are hungry, cold, hot, scared, tired, lonely, overwhelmed, needing adult help to calm, in discomfort or pain, or for no identifiable reason. In fact, we have a name for crying with no known cause; it’s called “colic”.

“Spitting up” – where a baby gently regurgitates a bit of milk after a feed – is common because the muscle at the top of a newborn baby’s stomach is not fully mature. This means what goes down can all too easily go back up.

Spitting up frequently happens when a baby’s stomach is very full, there is pressure on their tummy or they are picked up after lying down.

Spitting up after feeding decreases as babies get older. Three-quarters of babies one month old spit up after feeding at least once a day. Only half of babies still spit up at five months and almost all (96%) stop by their first birthdays.

Does burping help reduce crying or spitting up?

Despite parents being advised to burp their babies, there’s not much research evidence on the topic.

One study conducted in India encouraged caregivers of 35 newborns to burp their babies, while caregivers of 36 newborns were not given any information about burping.

For the next three months, mothers and caregivers recorded whether their baby would spit up after feeding and whether they showed signs of intense crying.

This study found burping did not reduce crying and actually increased spitting up.

When should I be concerned about spitting up or crying?

Most crying and spitting up is normal. However, these behaviours are not:

• refusing to feed
• vomiting so much milk weight gain is slow
• coughing or wheezing distress while feeding
• bloody vomit.

If your baby has any of these symptoms, see a doctor or child health nurse.

If your baby seems unbothered by vomiting and does not have any other symptoms it is a laundry problem rather than something that needs medical attention.

It is also normal for babies to cry and fuss quite a lot; two hours a day, for about the first six weeks is the average.

This has usually reduced to about one hour a day by the time they are three months of age.

Crying more than this doesn’t necessarily mean there is something wrong. The intense, inconsolable crying of colic is experienced by up to one-quarter of young babies but goes away with time on its own .

If your baby is crying more than average or if you are worried there might be something wrong, you should see your doctor or child health nurse.

Not everyone burps their baby

Burping babies seems to be traditional practice in some parts of the world and not in others.

For example, research in Indonesia found most breastfeeding mothers rarely or never burped their babies after feeding.

One factor that may influence whether a culture encourages burping babies may be related to another aspect of infant care: how much babies are carried.

Carrying a baby in a sling or baby carrier can reduce the amount of time babies cry.

Babies who are carried upright on their mother or another caregiver’s front undoubtedly find comfort in that closeness and movement.

Babies in slings are also being held firmly and upright, which would help any swallowed air to rise up and escape via a burp if needed.

Using slings can make caring for a baby easier. Studies (including randomised controlled trials) have also shown women have lower rates of post-natal depression and breastfeed for longer when they use a baby sling.

It is important baby carriers and slings are used safely, so make sure you’re up to date on the latest advice on how to do it.

So, should I burp my baby?

The bottom line is: it’s up to you.

Gently burping a baby is not harmful. If you feel burping is helpful to your baby, then keep doing what you’re doing.

If trying to burp your baby after every feed is stressing you or your baby out, then you don’t have to keep doing it.

Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University and Nina Jane Chad, Research Fellow, University of Sydney School of Public Health, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.