Clinical Reference Systems: Pediatric Advisor 10.0
Hay Fever (Allergic Rhinitis)
- Your child has a clear nasal discharge and an itchy nose
and is sneezing and sniffing.
- The symptoms occur during pollen season.
- Similar symptoms occurred during the same month or months
of the previous year.
- Your child may also have itchy, watery eyes (eye
- Your child may also have sinus or ear congestion.
Hay fever is an allergic reaction of the nose (and sinuses)
to an inhaled substance. This allergic sensitivity is often
inherited. During late April and May the most common
offending pollen is from trees. From late May to mid-July,
the offending pollen is usually grass. From late August to
the first frost, the leading cause of hay fever is ragweed
pollen. Although the inhaled substance is usually a pollen,
it can also be animal dander or something else your child is
Hay fever is the most common allergy. More than 15 percent
of people have it.
This is a chronic condition that will probably recur every
year, perhaps for a lifetime. Therefore, it is important to
learn how to control it.
- 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 physician.
Symptoms clear up faster if antihistamines are given at
the first sign of sneezing or sniffing. For children
with occasional symptoms, antihistamines can be taken on
days when symptoms are present or expected. For
children with daily symptoms the best control is
attained if antihistamines are taken continuously
throughout the pollen season.
The main side effect of antihistamines is drowsiness.
If your child becomes drowsy, switch to a combination
product that contains an antihistamine with a
decongestant (such as pseudoephedrine or
phenylpropanolamine). If your child remains drowsy,
continue the drug, but temporarily decrease the dosage.
Your child should become tolerant of the regular dosage
in 1 to 2 weeks. Newer prescription antihistamines
cause much less drowsiness and are FDA approved for use
in children over age 6.
- Prescription nasal sprays
If not helped by antihistamines, severe hay fever can
usually be controlled by new cromolyn or steroid nasal
sprays. Allergy shots are usually not necessary.
These prescription 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.
- 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.
If your child's hay fever is especially bad, consider
taking him to an air-conditioned store or theater for a
Avoid feather pillows, pets, farms, stables, and tobacco
smoke if any of them seem to bring on symptoms of nasal
- Eye allergies associated with hay fever
If your child also has itchy, watery eyes, wash his face
and eyelids to remove pollen. 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 two drops of long-acting
vasoconstrictor eyedrops (a nonprescription item) in the
eyes every 8 to 12 hours for a few days. Ask your
pharmacist to recommend a reliable product.
- Common mistakes
Vasoconstrictor nosedrops or nasal sprays usually do not
help hay fever because they are washed out by nasal
secretions as soon as they have been put into the nose.
Also, if they are used for more than 5 days, they can
irritate the nose and make it more congested.
CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:
- Your child's symptoms are not controlled in 2 days with
- Your child develops sinus pain or pressure.
- You have other concerns or questions.