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Hay fever in children

Updated: December 2018

What is hay fever in children?

Hay fever in children is nothing more than an allergic reaction to certain allergens, mostly grass pollen, and is referred to medically as allergic rhinitis.

At warm times of year, children prefer to play outside, where they inhale airborne flower, tree and grass pollen. The healthy immune system of a child usually ignores these substances. However, in the case of a pollen allergy, these allergens irritate the mucous membranes.

The child starts to sneeze, their eyes water and their nose runs. These symptoms of hay fever in children occur because antibodies are formed in the organism of the child that release the messenger substance histamine.

This overreaction by the immune system usually starts suddenly and can take place at different times of the year, depending on when particular pollens are airborne.

The spring brings with it tree pollen, followed by grass and cereal pollen in the summer. Later in the year, herb pollen also can cause the typical itchy eyes and sneezing.

Due to climate change and the spread of plants which have been introduced from other continents (e.g. ambrosia from America), hay fever may be triggered at almost any time of year.

Causes and triggers of hay fever?

Hay fever in children is triggered by allergens that the child is allergic to, i.e. pollen. Grass pollen is one of the most common triggers of hay fever. However, tree, herbal and flower pollen also can lead to an allergic reaction.

Hay fever is triggered by contact with a particular allergen – pollen of a particular plant.

Symptoms of hay fever in children

Typical symptoms of hay fever in children are itchy eyes and sneezing, a runny nose and laboured breathing. The respiratory muscles contract and the bronchial mucosa may swell due to inflammation. It also can cause a sore throat or difficulty swallowing.

Some children with pollen allergy hardly notice the symptoms; their lives are hardly affected at all. Others, however, may be severely affected, especially if in addition to the hay fever they also are triggered by food allergies.

Therapy and treatment

Hay fever therapy comprises a three-pillar approach.

The easiest way to reduce discomfort is to avoid the triggering allergens. You can keep the windows closed at the appropriate time of year and be sure to wash the pollen out of long hair and clothing.

It is rather difficult to recommend that children spend as little time outdoors as possible, as this would considerably limit their enjoyment and social contacts.

Administering allergy therapeutics often makes it possible for them to enjoy time outdoors without any issues. Within this context, antihistamines that the child can use as eye drops, tablets or a nasal spray are a popular course of treatment. However, these sometimes cause side effects such as tiredness.

Immunotherapy is used in order to get the pollen allergy under control in the long term. This treatment is also referred to as hypo-sensitisation and often takes place over several years. With this method, allergens are injected under the skin in order to get the immune system used to them. This method of treatment is particularly well-suited if it is known exactly which pollen causes hay fever in the child.

Long-term effects of hay fever in children

If you completely refrain from therapy for hay fever, the constant irritation of the upper respiratory tract will cause the symptoms to shift to the lower respiratory tract (the bronchi). This will lead to an escalation of the condition. About 30% of hay fever patients, who remain untreated, go on to develop allergic asthma. This is why you should not take childhood hay fever lightly and should instead seek targeted treatment options.

Diagnosing hay fever in children

Diagnosis often raises the question of whether the child is actually experiencing a cold, hay fever or any other allergy. It is typical for hay fever in children to start suddenly, whereas a cold often starts with a headache or sore throat. Colds last for about 7–9 days, whereas the symptoms of hay fever can last much longer and usually return at the same time each year.

Ailments associated with a pollen allergy are also dependent on the location and weather. A pollen allergy is much more noticeable outdoors; pollen dust enters the house on clothing or through open windows. Unlike with a cold, the nasal secretion does not change its colour, it remains clear and watery.

A blood test must be carried out to determine with certainty that the child's ailments stem from hay fever or a pollen allergy.

If the suspicion of an allergy is confirmed, a skin test is carried out. For this, allergens are dissolved in water and brought into contact with the skin. This determines which pollen the child is allergic to.

Prevention

Prevention is better than cure. Therefore, the allergens should be avoided as much as possible. You can use a pollen calendar and meteorological service pollen alerts to plan the time you spend outdoors. Only ventilate intermittently. In cities, the pollen concentration in the air is highest in the evening.


References:

Federal Association of Paediatricians (2016). Hay fever (pollen allergy). Retrieved from www.kinderaerzte-im-netz.de/krankheiten/heuschnupfen-pollenallergie/

STRÖER Media Brands GmbH. Hay fever in children. Retrieved from www.familie.de/gesundheit/heuschnupfen-bei-kindern-541345.html

ALK-Abelló Arzneimittel GmbH. Asthma. Retrieved from www.allergiecheck.de/asthma/

German Society for Pulmonology and Respiratory Medicine. What is hay fever? Retrieved from www.lungenaerzte-im-netz.de/krankheiten/heuschnupfen/was-ist-heuschnupfen/