By: Professor Alf Nicholson FRCPI, FRCPCH
If your child has asthma, he is quite likely to get hay fever too because the nose and lungs are all part of the same breathing system. Hay fever (allergic rhinitis) is an allergic reaction around the nose and eyelids. He will have two or more of these symptoms:
- He is always sniffling and blowing his But the mucus is clear and watery.
- His nose itches a He may rub the tip of it with his palm, pushing upwards in the ‘allergic salute’.
- He has regular sneezing fits that go on and
- His eyes are watery and
- He may breathe through his
He will be clear for months, and then it comes back. This is because the allergy is usually to tree pollens in early spring, and grass pollens in late spring and early summer. It will be an inhaled problem and in some cases it can be a reaction to house dust mites or animal dander. The timing is very relevant. When he is exposed to the allergen, symptoms will start quickly – in minutes – and last for hours.
Home Treatment: Hay Fever
Reactions to treatment will vary, depending on the child, but most can find some relief.
When pollen counts are high, keep windows closed and limit his time outdoors if he has hay fever. Avoid contact with pollen if you can. That means avoiding compost piles, hay, mowed grass, raked leaves or any pollinating plants. Daily baths can help.
If dander or house dust mites are the trigger, try to minimise exposure
Try antihistamines first. They are good at tackling all the sneezing and itching and will help the eye problems too. (The newer ones will not make the child feel drowsy.) But they will not do a lot for a blocked nose.
If his nose is blocked, a nasal decongestant will help (it reduces blood supply to the nose). It can be used with antihistamines.
Salt water sprays and saline drops may help to relieve symptoms with some children.
Butterbur is sometimes used as a natural alternative to antihistamines, but children should only use it under medical supervision. Nasal steroids work best, but are expensive, slow to act and the effects are short lived (nose drops are kinder to his nose than sprays). They do not help itching, so he may also need antihistamines.
If nothing works, you could consider immunotherapy, which has had some success. But you must start treatment before the pollen season begins and ideally continue it for three years.
Professor Alf Nicholson FRCPI, FRCPCH is a consultant paediatrician who returned to Ireland in 1996 from Melbourne where he worked in the second largest paediatric hospital in the world. He is Professor of Paediatrics at Temple Street Children’s University Hospital since 2008, Head of the HSE Paediatric Clinical Programme and co-director of the basic specialist programme in paediatrics.