For nearly nine million American children, are there peanuts in that birthday treat from a friend? Will running trigger asthma? Could a bee sting cause anaphylactic shock?

Despite all the things confronting them, you can take steps to ensure your kids don't fall prey to allergies and asthma.

"Allergies and asthma account for over 14 million missed school days, millions of dollars in medical bills and even lost work days for parents of children who suffer from allergic disease," says Dr. Wanda Phipatanakul, an indoor-allergen expert with the American Academy of Allergy, Asthma & Immunology.

Common triggers

The most common allergens and triggers that may cause an allergic or asthmatic reaction include:

•  Dust mites;

•  Chalk dust;

•  Pollen and molds;

•  Exercise;

•  Insect stings;

•  Animal dander from class pets or pet hair on clothing;

•  Pest allergens.

If your children have food sensitivities, remind them not to share food with their friends. Milk, eggs, peanuts, wheat, soy and tree nuts account for 90 percent of food allergies in children.

Tips to avoid allergies at school

However, you  have less control over the allergens your children may be exposed to at school than at home, so the key to reducing the severity of symptoms is avoiding the triggers. Take a look at this helpful checklist to find out what you can do to help relieve some potential allergens that may affect your child's allergies or asthma during school:

•  Tour the school to identify potential allergy/asthma triggers in the classrooms.

•  Meet with teachers and school nurses to discuss your child's allergic condition.

•  Encourage your children to take their medications as prescribed.

•  Review your children's triggers with them and encourage them to ask their teachers for help when symptoms worsen.

•  Tell teachers and school cafeteria staff to avoid giving your children foods that will trigger an asthma or allergic reation. Have the cafeteria staff suggest safe alternatives.

•  Fix your food-sensitive child a lunch to take to school each day.

•  Ensure a dose of auto-injectable epinephrine is with your child for emergency situations, and make sure that teachers and the school nurse know how to use it properly.

•  Inform physical education teachers and coaches about asthma and warning signs of exacerbation that could trigger exercise-induced asthma.
 
•  See an allergist/immunologist, a medical doctor trained to treat such conditions, before a school year begins or as close to opening day as possible If you believe your child suffers from an allergy or asthma.

Children and adults under the care of allergist/immunologists make fewer visits to hospital emergency rooms and are better able to manage their allergies and asthma, according to the academy.