April 13, 2012
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 bring 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. This causes 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 they 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 unhappy time.
There are ways, however, to help your little allergy sufferer feel better.
As with everything, prevention is first and foremost. Here are some suggestions:
- Keep windows closed as much as possible so pollens and molds don't drift into the house. This is especially important in your child's bedroom. That's where she spends the most time.
- Use an air conditioner. Even if it's not hot out, it helps clean the air.
- Watch the pollen counts. If they're very high, play inside instead.
- Get out the umbrellas and rainboots! Rainy and wet days (and cloudy and windless ones) are better for outdoor play. The pollen is less likely to be in the air.
- Have your child wash and change after coming inside. If that's not practical, at least have him stay out of his bedroom during the day. It's important to wash and change before going to bed so the bedroom stays a pollen-free zone.
- Don't hang laundry outside to dry.
- Keep the car windows closed when you drive.
- Mow the lawn and rake leaves when your child isn't at home.
It's hard to prevent all exposure, though. That's where medication can help. Here are some of the options:
- Diphenhydramine. This tried-and-true medicine 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. So it may be less than perfect for daily use.
- Loratadine, cetirizine and fexofenadine. These antihistamines are available without a prescription in both liquid and pill forms. They are given once a day (again, read dosage directions carefully). They are less likely to make children sleepy (cetirizine may, but less then diphenhydramine). It can take a week or so before you really see the results, so be patient. (You can use diphenhydramine while you wait.) If your child suffers from allergies every year, it may even be a good idea to start these before the season begins. Talk to your doctor.
- Leukotriene modifiers. Chemicals called leukotrienes are released by the body during inflammation. Leukotriene modifiers (such as montelukast) are prescription medicines that block leukotrienes. 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 medicine is used for asthma. But there is a non-prescription nasal spray (NasalCrom) that can help the nasal symptoms of allergies.
- Nasal steroid sprays. These are sprayed into the nose, and can really help nasal congestion and sneezing. There are several different kinds of nasal steroids. They're available only by prescription. 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 eye drops. They range from antihistamines to steroids; the type your doctor prescribes depends on how bad your child's symptoms are. There are allergy eye drops available without a prescription, but you should always check with your doctor before putting anything in your child's eyes.
Some children with very severe allergies may need immunotherapy (allergy shots). But this is only after the above medications didn't help and after consultation with an allergy specialist.
If your child is still suffering from allergies despite your preventive efforts and over-the-counter treatments, call your doctor. You should also absolutely call your doctor if your child has any trouble breathing, a very bad cough, a high fever or thick green mucus from the eyes or nose.
Together, you can find the way to make being outside healthy and fun for your child.
For more information on allergy treatment and prevention, visit the American Academy of Allergy, Asthma & Immunology website. You can download its pollen count app to your mobile phone.
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Claire McCarthy, M.D., a senior medical editor for Harvard Health Publications, is an assistant professor in pediatrics at Harvard Medical School. She is an attending physician and Medical Communications Editor at Children's Hospital Boston.