Last reviewed by Faculty of Harvard Medical School on February 3, 2011
By Claire McCarthy, M.D.
Boston Children's Hospital
Spring has sprung and so have seasonal allergies.
Spring is especially welcome in my New England town, where winter can seem endless. We're so happy to see the flowers that it's easy to forget they mean pollen until the sniffling and sneezing begin.
Pollens and mold spores cause seasonal allergies. They get into the air and into our noses, our eyes, and our lungs causing the common symptoms of what we often call "hay fever:"
- Stuffy, itchy, and/or runny nose
- Red, teary eyes
- Scratchy throat
- Nagging cough (from post-nasal drip)
Allergy sufferers may also have headaches or facial pain from sinus congestion and may wheeze, especially if they suffer from asthma. All in all, it can make a person miserable. And for children, who are generally outside more than adults, it can be an especially miserable time.
As much as many parents would like to put their child into a bubble until spring is past, that's not possible. Anyway, summer and fall bring their own molds and pollens. But that doesn't mean you can't make life more bearable for your little allergy sufferer by helping him feel better.
As with everything, prevention is first and foremost. Here are some suggestions from the American Academy of Allergy, Asthma & Immunology:
- Keep windows closed as much as possible so pollens and molds won't drift in.
- Pollen is usually emitted between 5 a.m. and 10 a.m. so wait until after that time to play outside.
- If the pollen count is reported to be high, or it's very windy, play inside instead. You can check the pollen and mold counts in your area.
- Keep car windows closed while traveling.
- Do yard work, such as mowing lawns or raking leaves, when your child isn't at home.
- Don't hang laundry out to dry, as it may collect pollen and molds.
You may want to consider making your child's bedroom a pollen-free zone by keeping the windows shut and by not allowing your child to play there during the day, as they can bring pollen in on their clothes. Give your child a shower or bath before bed so he can have a few hours without allergy triggers. If your child has particularly bad seasonal allergies, you may want to have him change clothes and wash his hands and face when he comes inside.
It's hard to prevent all exposure, though, and that's where medication can help. There are many options, including:
- Diphenhydramine. This tried-and-true medication can be very effective for allergy symptoms. It's available without a prescription in both liquid and pill forms. It is an antihistamine, and works by blocking the effects of histamine, a chemical the body releases during allergic reactions. Make sure you read the dosage directions carefully. The downside is that it can make some children sleepy and some children hyperactive making it less-than-perfect for daily use.
- Loratadine. This is another antihistamine that is effective and available without a prescription in both liquid and pill forms. It's given once a day (again, read dosage directions carefully), and is less likely to have side effects. It may take a week or two before you really see the results, so be patient. (I suggest that parents also give diphenhydramine for that week or two, if symptoms are bad.)
- Prescription antihistamines. There are many, including cetirizine and fexofenadine. Every child is different when it comes to reacting to medication; some do better with one medication than another. If nonprescription medication isn't doing the trick, talk to your doctor about one of the prescription options. You may want to give your insurance company a call first, as many companies have restrictions or policies when it comes to allergy medications and they can be very expensive!
- Leukotriene modifiers. These prescription medications, such as montelukast, block leukotrienes, chemicals released by the body during inflammation. They are more commonly used to treat asthma. But they can be used to treat allergies as well, because those same chemicals are released in allergic reactions.
- Cromolyn. An inhaled form of this anti-inflammation medication is used for asthma, but there is a non-prescription nasal spray (NasalCrom) that can help the nasal symptoms of allergies.
- Nasal steroids. These are sprayed into the nose, and can really help nasal congestion and sneezing. Be patient, however, as they require time to take effect. There are several different kinds of nasal steroids. They are available only by prescription and your doctor will decide which one is best for your child.
- Topical eye medications. If itchy, runny eyes are making your child crazy and oral medication isn't enough, your doctor may prescribe one of the various eyedrops used to treat allergy symptoms. They range from antihistamines to steroids; the type prescribed depends on how bad the symptoms are. There are eye drops for allergy available without a prescription as well, but you should always check with your doctor before putting anything in your child's eyes.
In rare cases of very severe allergies, immunotherapy (allergy shots) may be given. But this is only after the above medications weren't effective, and after consultation with an allergy specialist.
If your child is still suffering from allergies despite your preventive efforts and over-the-counter medication, call your doctor. Together, you can find the way to make being outside healthy and fun for your child.
Be sure to call your doctor right away if, in addition to allergy symptoms, your child has:
- Any trouble breathing
- Fever, especially a high one (102 or higher)
- Green nasal discharge
- Very red eyes with thick discharge
- A severe headache that doesn't improve with acetaminophen or ibuprofen, or any other severe pain
- A bad cough
Claire McCarthy, M.D. is an assistant professor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and medical director of the Martha Eliot Health Center, a neighborhood health service of Children's Hospital. She is a senior medical editor for Harvard Health Publications.