I just came in from walking my dog and found myself sneezing and rubbing my nose….funny I didn’t think I had allergies!! But, all of the pollen blowing around right now not only coats your car and yard, but is coating your nasal passages, eyes and being inhaled into your upper respiratory tract as well causing all sorts of issues with seasonal allergies.
This year is proving to be a big allergy season as most of the U.S. had a mild wet winter which is a perfect “storm” for spring allergies. Tree pollen is the biggest culprit right now, and depending where you live it may be oak, elm, mulberry, maple, pecan, aspen….. but all are producing pollen that are blowing in the spring wind.
At this time of the year many people think they have a cold rather than allergies, but there are several distinguishing features. With a cold, which is due to a virus, not only do you have a runny nose and cough, you often feel achey and may have a low grade fever and sore throat and the symptoms usually last for 7-10 days and then improve. With allergies you may have itchy or watery eyes, and a clear runny nose which may sometimes trigger a cough, especially in children who have underlying asthma. You may also find that your child has 2 bad days, then several good days rather than continuous symptoms like a cold. Even though seasonal allergies are often called “hayfever” there is no fever associated with allergies. Many a parent with a 2 year old comes into the office with their child complaining of a fever of 102, runny nose and cough, and they think their child may have allergies and can go to school…..not so.
Seasonal allergies in children typically present between the ages of 2 - 6 years and occur in up to 10 - 15% of children. Parents may start to notice that their child always has red rimmed eyes and runny nose in March, April as tree pollens emerge, or are worse in June as grass pollen becomes an issue…. all pointing towards allergies.
Fortunately, many of the best products to help prevent and control seasonal allergies are available over the counter. Anti-histamines are the mainstay for allergies for those who have occasional problems. There are both older sedating anti-histamines like diphenhydramine (Benadryl) and newer non-sedating medications such as loratadine (Claritin), cetirizine (Zyrtec), fexofenadine (Allegra). All come in both liquid and pill form and some have orally disintegrating tablets which are wonderful for a young child who cannot yet swallow a pill but balks at liquid medications. (Good time to also discuss how to swallow a pill!).
For children who have known seasonal allergies or ongoing issues I encourage daily steroid nasal spray use - which is a preventative measure to help block the allergic cascade from occurring. You can now buy fluticasone ( Flonase), Mometasone (Nasonex), budesonide (Rhinocort) and triamcinolone (Nascort) all over the counter. Even a young child over the age of 4 years (they are often used in even younger children when prescribed by your pediatrician) may use a steroid nasal spray daily during allergy seaon. Using these nose sprays for extended periods of time has been associated with a slight decrease in growth velocity while being used, so discuss this with your pediatrician.
I typically also recommend a nasal saline solution like Little Remedies to irrigate the nose before using the steroid spray. Not only does this help to wash out any pollen that has adhered inside the nostril, it clears the airway so that the steroid nasal spray may be more effective. Teaching your child to blow their nose after irrigating it is a huge milestone as well, and helps prevent ear infections and sinus infections….keep practicing blowing.
Playing outside at this time of year is always encouraged, but if your child seems to be developing allergies make sure to bathe them and wash their hair (and eyelashes) when they come in at the end of the day. Irrigate their nose, use a daily OTC steroid nasal spray, add OTC antihistamines and see how they do. If they have continued problems time for a visit to your pediatrician to look at other options.