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Clinical Reference Systems: Pediatric Advisor 10.0
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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 allergies).
  • 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 allergic to.

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.


  1. 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.

  2. 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.

  3. 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.

  4. 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 few hours.

    Avoid feather pillows, pets, farms, stables, and tobacco smoke if any of them seem to bring on symptoms of nasal allergy.

  5. 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.

  6. 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.


  • 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.


Sinus Congestion

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems