What to do when your child has allergic rhinitis

Is your child constantly sneezing and sniffling? Summer may be a beautiful season, but for many children, warm weather means allergic rhinitis and suffering from a runny nose, red eyes and an itchy throat.

What is allergic rhinitis?

Allergic rhinitis, commonly referred to as hay fever, is caused by an allergic reaction to irritants in the air. 

“Hay fever – which results in the inflammation of the nasal passages and a variety of annoying symptoms, such as the characteristic stuffy or runny nose – is a very common condition affecting approximately one in five adults and one in three children. The condition can commence at any age, even from as young as one month,” says Dr Phillip Coetzee, a paediatrician who practices at Netcare Blaauwberg Hospital in Cape Town.

“While hay fever does not pose a serious threat to a child’s health, in more serious cases it can be debilitating and negatively impact their quality of life – particularly in children who often have more severe symptoms – affecting school performance. It’s therefore, recommend that more serious cases are not left untreated and should be managed in consultation with a family doctor, ENT specialist, or paediatrician.”

What causes hay fever in children?

Hay fever is an allergic reaction in children who react to certain airborne ‘triggers’ or allergens.

Seasonal hay fever

Seasonal hay fever is usually caused by pollens from trees, grasses, and weeds. As pollen counts from plants are much higher in spring and summer, many more children tend to suffer hay fever at this time of the year.

All-year-round hayfever

Those children who suffer all-year-round, or with perennial hay fever, on the other hand, tend to have triggers such as cockroaches, or dust mites, which are tiny creatures that may live in mattresses, pillows, soft toys, carpets and curtains.

Animal dander, fungal spores or moulds

Other common allergens include animal dander, which are tiny flecks of skin shed by animals such as cats, dogs, birds and other animals; and fungal spores or moulds, which may grow in a damp bathroom cupboard, for example.

What are the symptoms of hay fever?

Dr Coetzee says that with perennial hay fever the predominant symptoms in children include postnasal drip, persistent nasal congestion and trouble sleeping.

How to manage your child’s hay fever

It’s important that parents help their children avoid specific allergic triggers. Fortunately, The Allergy and Immunology Research Unit provides accurate national pollen and mould monitoring within various South African cities. This can enable parents to take the necessary proactive precautions, such as limiting their children’s outdoor activities at times of high pollen count and using medications.

Your child’s doctor may suggest allergy testing if your child’s symptoms are not well controlled with medications, or if it is not clear what is causing your child’s symptoms. This may include a skin prick or blood test. The following treatments are available to assist in the management of hay fever in children:

• Steroid (cortisone) nasal sprays are the first line of treatment. They have few side effects and dramatically relieve symptoms in most children. If your child’s nose is crusted or contains mucus, you can first clean it with saline (saltwater) nasal irrigation before using the steroid nasal spray.
• Antihistamines relieve itching, sneezing, and runny nose, but they do not relieve nasal congestion. Bear in mind that the older generation sedating antihistamines should not be used in children.
• Antihistamine eye drops can relieve itching or irritation of the eyes.
• Decongestants in oral or nasal spray form should not be used for more than a few days at a time, because of the risk of rebound nasal congestion, and are discouraged in the treatment of hay fever.

A word on allergen immunotherapy

Allergen immunotherapy, which can be very successfully used to resolve allergic problems such as hay fever, involves trying to alter the way a child’s immune system reacts to allergens. The most common form of immunotherapy is regular injections. Whether your child is a candidate for immunotherapy depends on your child’s age, history as well as what your child is allergic to.