Pediatric - Hay Fever (Nasal Allergies)
Hay fever (nasal allergies)
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Does this describe your child's symptoms?
- An allergic reaction of the nose (allergic rhinitis)
- An itchy nose and clear discharge is common
- Clear nasal discharge with sneezing, sniffing, and nasal itching
- Eye allergies (itchy, red, watery and puffy) are commonly associated
- Ear and sinus congestion may also be associated
- A tickling, scratchy sensation in the back of the throat can be associated
- Itchy ear canals, itchy skin, and hoarse voice are also seen
- Symptoms occur during pollen season
- Similar symptoms during the same month of the previous year
- No fever
- Hay fever is an allergic reaction of the nose and sinuses to an inhaled substance, usually a pollen.
- Grass, tree and ragweed are the most common pollens
- Allergens from cats, dogs, horses, rabbits and other animals
If not, see these topics
- Doesn't look like hay fever, see COLDS
|Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If|
- You think your child needs to be seen
- Lots of coughing
- Sinus pain around cheekbone or eyes (not just congestion) and not relieved by antihistamines
|Call Your Doctor During Weekday Office Hours If|
- You have other questions or concerns
- Hay fever symptoms interfere with school or normal activities after taking antihistamines for 2 days
- Diagnosis of hay fever has never been confirmed by your doctor
- Year-round symptoms of nasal allergies
|Parent Care at Home If|
- Hay fever and you don't think your child needs to be seen
HOME CARE ADVICE FOR HAY FEVER
And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
- Hay fever is very common, occurring in 15% of children.
- Nose and eye symptoms can be brought under control by giving antihistamines.
- Because pollens are in the air every day during pollen season, antihistamines must be given daily for 2 months or longer.
- Give antihistamines continuously during pollen season (continuously is the key to control).
- Chlorpheniramine (e.g., chlortrimeton) products are effective and don't need a prescription. Any antihistamine you have will do, but some may cause more drowsiness.
- See dosage charts for chlorpheniramine or benadryl.
- The bedtime dosage is especially important for healing the lining of the nose. (Benadryl is a good choice for bedtime)
- Benadryl: If the runny nose and itchy eyes are out of control and your child is taking long-acting antihistamines, it's safe to give an occasional dose of Benadryl (see dosage table) to stabilize your child.
- Loratadine (Claritin) or Cetrizine (Zyrtec):
- Loratadine became OTC in 2003 and Cetirizine become OTC in 2008.
- Advantage: causes less sedation than older antihistamines (Benadryl and chlorpheniramine) AND is long-acting ( lasts up to 24 hours).
- Dosage: For 6-12 year old, give 5 mg chewable tablet once daily in morning
- For over 12 years old, give 10 mg tablet once daily in morning
- Indication: Age 6 (FDA approved) AND drowsiness from older antihistamines interferes with function
- Limitation: doesn't control hay fever symptoms as well as older antihistamines. Also, occasionally will have breakthrough symptoms before 24 hours.
- Cost: ask pharmacist for store brand (Reason: costs less than Claritin or Zyrtec brand)
- 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.
- To make saline nosedrops: 1/2 teaspoon salt to 1 cup (8 oz) of warm water.
- Do nasal washes at least 4 times/day or whenever your child's nose is blocked is blocked or itch.
- Eye Allergies:
- For eye symptoms, wash the pollen or other allergic substance off the face and eyelids.
- Then apply cold compresses.
- Antihistamine-vasoconstrictor eye drops (no prescription needed) are sometimes needed, but oral antihistamines usually control eye symptoms.
- Dosage: 1 drop every 8 hours as necessary.
- Ask your pharmacist to recommend a brand. (e.g. Naphcon A, Opcon A, Visine A)
- Wash Pollen Off Body:
- Remove pollen from the hair and skin with hair washing and a shower, especially before bedtime.
- Expected Course: Since pollen allergies recur each year, learn to control the symptoms.
- Pollen Avoidance:
- Pollen is carried in the air
- Keep windows closed in the home, at least in child's bedroom
- Keep windows closed in car, turn AC on recirculate
- Avoid window fans or attic fans
- Try to stay indoors on windy days (Reason: the pollen count is much higher when it's dry and windy)
- Avoid playing with outdoor dog (Reason: pollen collects in the fur)
- Call Your Doctor If:
- Symptoms aren't controlled in 2 days with continuous antihistamines
- Your child becomes worse
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 1/19/2009
Last Revised: 6/18/2008
Content Set: Pediatric HouseCalls Online
Copyright 1994-2009 Barton D. Schmitt, M.D.