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  • Hay Fever (Nasal Allergies)

    Definition

    • An allergic reaction of the nose (called allergic rhinitis)
    • An itchy nose, clear discharge and sneezing is common

    Symptoms

    • Clear nasal discharge with sneezing, sniffing, and itching of nose (100%)
    • Eye allergies (itchy, red, watery and puffy) also can occur (70%)
    • Ear and sinus congestion or fullness can occur
    • Throat can also feel scratchy or have a tickly feeling at times
    • Itchy ear canals, itchy skin or hoarse voice sometimes also occur
    • Symptoms happen during pollen season
    • Same symptoms during the same month of the last year
    • Past diagnosis by a doctor is helpful
    • No fever

    Causes

    • Hay fever is an allergic reaction of the nose and sinuses. It is a reaction to an inhaled substance (called an allergen). Most often, this is a pollen.
    • Grass, trees, weeds and molds are the most common pollens.
    • Allergens can also be from cats, dogs, horses, rabbits and other animals.

    When to Call Us for Hay Fever (Nasal Allergies)

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

    • You think your child needs to be seen
    • Lots of coughing
    • Sinus pain (not just congestion) does not go away with allergy medicines. (NOTE: Sinus pain is around the cheekbone or eyes.)

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns
    • Hay fever symptoms make it hard to go to school or do normal activities. (NOTE: Taking allergy medicine for 2 days has not helped.)
    • Diagnosis of hay fever has never been made by a doctor
    • Year-round symptoms of nasal allergies
    • Snoring is a frequent problem

    Parent Care at Home If:

    • Hay fever

    Care Advice for Hay Fever

    What You Should Know:

    • Hay fever is very common. It happens in about 15% of children.
    • Nose and eye symptoms can be controlled by giving allergy medicines.
    • Pollens are in the air every day during pollen season. So, allergy meds must be given daily. They need to used for 2 months or longer during pollen season.
    • Here is some care advice that should help.

    Allergy Medicines:

    • Allergy medicines are called antihistamines. They are the drug of choice for nasal allergies.
    • They will help control the symptoms. These include a runny nose, nasal itching and sneezing.
    • Benadryl or Chlorpheniramine (CTM) products are helpful. No prescription is needed. They need to be given every 6 to 8 hours. See Dose Tables.
    • The bedtime dosage is especially important for healing the lining of the nose.
    • The key to control is to give allergy meds every day during pollen season.

    Cetirizine (Zyrtec) or Loratadine (Claritin):

    • Loratadine and Cetirizine are long-acting allergy medicines. No prescription is needed.
    • Advantage: Causes less sedation than older allergy meds such as Benadryl and chlorpheniramine. They are long-acting and last up to 24 hours.
    • Dose:
      • AGE 2- 6 years old: Discuss with your child’s doctor. If approved, give 2.5 mg (2.5 ml or 1/2 teaspoon) of liquid syrup. Use once daily in the morning.
      • AGE 6-12 years old: Give 5 mg chewable tablet once daily in morning.
      • AGE 12 years and older: Give 10 mg tablet once daily in morning.
    • Downside: Doesn’t control hay fever symptoms as well as older allergy medicines. Also, sometimes will have breakthrough symptoms before 24 hours. If that happens, you can give a single dose of Benadryl or CTM.
    • Cost: Ask the pharmacist for a store brand. Reason: Costs less than Claritin or Zyrtec brand.

    Nasal Washes to Wash Out Pollen:

    • Use saline nose drops or spray. This helps to wash out pollen or to loosen up dried mucus. If you don’t have saline, you can use warm tap water.
      1. Put 3 drops in each nostril.
      2. Blow each nostril out while closing off the other nostril. Then, do the other side.
      3. Repeat nose drops and blowing until the discharge is clear.
    • How often: Do nasal washes when your child can’t breathe through the nose. Also, do them if the nose is very itchy.
    • Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
    • Saline nose drops can also be made at home. Use 1/2 teaspoon (2 ml) of table salt. Stir the salt into 1 cup (8 ounces or 240 ml) of warm water.
    • Other option: Use a warm shower to loosen mucus. Breathe in the moist air, then blow each nostril.

    Eye Allergies:

    • For eye symptoms, wash off the face and eyelids. This will remove pollen or any other allergic substances.
    • Then put a cold wet washcloth on the eyes.
    • Most often, an allergy medicine given by mouth will help the eye symptoms. Sometimes, eye drops are also needed.
    • Antihistamine Eye Drops – Ketotifen (1st Choice):
      • Ketotifen eye drops are a safe and effective product. Examples are Zaditor or Alaway. No prescription is needed.
      • Dose: 1 drop every 12 hours.
      • For severe allergies, use ketotifen eyedrops every day during pollen season. This will give the best control.
    • Antihistamine/Vasoconstrictive Eyedrops (2nd Choice):
      • Dose: 1 drop every 8 hours
      • Ask your pharmacist to suggest a brand. Some brand names are Naphcon A, Opcon A, or Visine A.
      • Do not use for over 5 days. (Reason: Will cause red eyes from rebound effect).
      • Downside: Doesn’t work as well as Ketotifen eye drops.

    Wash Pollen Off Body:

    • Remove pollen from the hair and skin with shampoo and a shower. This is especially important before bedtime.

    What to Expect:

    • Since pollen allergies recur each year, learn to control the symptoms.

    Pollen – How to Reduce the Pollen Your Child Breathes:

    • Pollen is carried in the air.
    • Keep windows closed in the home, at least in your child’s bedroom.
    • Keep windows closed in car. Turn the air conditioner on recirculate.
    • Avoid window fans or attic fans. They pull in pollen.
    • Try to stay indoors on windy days. Reason: The pollen count is much higher when it’s dry and windy.
    • Avoid playing with the outdoor dog. Reason: Pollen collects in the fur.
    • Pollen Count: You can get your daily pollen count from Pollen.Com. Just type in your zip code.

    Call Your Doctor If:

    • Symptoms are not better in 2 days after starting allergy medicine
    • Your child becomes worse

    Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

    Author and Senior Reviewer: Barton D. Schmitt, M.D.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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