Hay Fever (Allergic Rhinitis)

What is hay fever?

Hay fever is an allergic reaction of the nose (and sinuses) to pollen in the air.

Symptoms include:

• a clear nasal discharge
• an itchy nose with sneezing and sniffing
• itchy, watery, pink eyes (eye allergies)
• sometimes, sinus or ear congestion.

Hay fever is the most common allergy. More than 15% of people have it.

What is the cause?

Although pollen is usually the cause of hay fever, similar symptoms can also be caused by pets, farm animals, or something else your child is allergic to. This allergic sensitivity is often inherited.

During April and May the most common pollen causing hay fever is from trees. In June and July, the pollen is usually from grass. From August until the first frost, the leading cause of hay fever is ragweed pollen.

How long will it last?

This is a chronic condition that will probably come back every year during pollen season, perhaps for a lifetime. Therefore, it is important to learn how to control it.

How can I take care of my child?

• Oral antihistamine medicine

  The best drug for hay fever is an antihistamine. It will relieve nose and eye symptoms. Your child needs the antihistamine recommended by your healthcare provider.

  Symptoms clear up faster if antihistamines are given at the first sign of sneezing or sniffing. For children with daily symptoms, the best control also is attained if antihistamines are taken continuously throughout the pollen season. For children with occasional symptoms, antihistamines can be taken on days when symptoms are present or expected.

  The older antihistamines such as Benadryl or Chlor-Trimeton are more powerful than the newer long acting ones. However, they cause drowsiness in some people. If your child becomes drowsy, continue the drug, but decrease the dosage. If drowsiness continues, switch to long-acting antihistamines such as Zyrtec and Claritin, that can be given once per day. They are FDA approved for use in children over age 2 and you can buy them without a prescription. All of these antihistamines are available without a prescription (OTC). Please read and follow label directions.

• Nasal sprays for prevention

If not helped by antihistamines, severe hay fever can usually be controlled by prescription steroid nasal sprays. Allergy shots are occasionally needed.

Nasal sprays must be used when the nose is not dripping. Give your child an antihistamine to stop the dripping before you use the spray. Use the antihistamine recommended by your doctor.

• Nasal washes

  Use warm water or saline nosedrops to wash pollen or other allergic substances out of the nose. Instill 2 or 3 drops in each nostril, followed by blowing the nose. Repeat until open. Teens can just splash warm water in the nose and then blow.

• Pollen removal to decrease symptoms of hay fever

  Pollen tends to collect on the exposed body surfaces and especially in the hair. Shower your child and wash his hair every night before he goes to bed. Your child should avoid handling pets that have been outside and are probably covered with pollen.

• Prevention of hay fever symptoms

  Your child's exposure to pollen can be reduced by not going on drives in the country and by not sitting by an open car window on necessary drives. He should stay away from someone cutting the grass during pollen season. When it is windy or the pollen count is especially high, he should stay indoors. Close the windows that face the prevailing winds. Use an air conditioner rather than an attic or window fan. Fans can pull in pollen.

  If your child's hay fever is especially bad, you could also take him to an air-conditioned store or theater for a few hours.

  Symptoms depend on how high the pollen count is that day. You can get your daily pollen count from http://www.pollen.com. Just type in your zip code.

• Eye allergies associated with hay fever

  If your child also has itchy, watery eyes, wash his face and eyelids to remove pollen or other allergic substances. Then apply a cold wet cloth to the eyelids for 10 minutes. An oral antihistamine will usually bring the eye symptoms under control. If not, put 1 drop of antihistamine eyedrops (a nonprescription item) in the eyes every 12 hours for a few days. Currently the most effective eyedrops are Zaditor and Alaway.

• Common mistakes

  Decongestant nosedrops or nasal sprays usually do not help hay fever because they are washed out by nasal secretions as soon as they are put into the nose. Also, if decongestant nosedrops or nasal sprays are used for more than 5 days, they can irritate the nose and make it more congested.

When should I call my child's healthcare provider?

Call during office hours if:

• Your child's symptoms are not controlled in 2 days with antihistamines.
• Your child develops sinus pain or pressure.
• You have other concerns or questions.