Hay Fever (Nasal Allergies)

Pediatric HouseCalls Online

DEFINITION 

Symptoms

  • Clear nasal discharge with sneezing, sniffing, and nasal itching.
  • Eye allergies (itchy, red, watery and puffy) are commonly associated.
  • Ear and sinus congestion may also be associated.
  • A tickling, scratchy sensation in the back of the throat can be associated.
  • Itchy ear canals, itchy skin, and hoarse voice are also seen.
  • Symptoms occur during pollen season.
  • Similar symptoms during the same month of the previous year.
  • No fever.

Causes

See More Appropriate Topic (instead of this one) If

  • Doesn't look like hay fever, see COLDS.

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

  • You think your child needs to be seen.
  • Lots of coughing.
  • Sinus pain (around cheekbone or eyes) and not relieved by antihistamines

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns.
  • Hay fever symptoms interfere with school or normal activities after taking antihistamines for 2 days.
  • Diagnosis of hay fever has never been confirmed by your doctor.
  • Year-round symptoms of nasal allergies.

Parent Care at Home If

  • Hay fever and you don't think your child needs to be seen.

HOME CARE ADVICE FOR HAY FEVER

  1. Antihistamines:  
    • Give antihistamines continuously during pollen season (continuously is the key to control).
    • Chlorpheniramine (e.g. chlortrimeton) products are effective and don't need a prescription (Any antihistamine you have will do, but some may cause more drowsiness).
    • See dosage chart for chlorpheniramine or benadryl
    • The bedtime dosage is especially important for healing the lining of the nose.
    • Long-acting products (less dosages per day) and combination antihistamine-decongestant products (less sedating) may be more helpful.
    • Loratadine: Newer antihistamine that causes less sedation (over-the-counter in 2003).
      • Dosage: 10 mg tablet once daily in morning (orally dissolving tablet also available)
      • Indication: weight over 66 pounds (30 kg) AND drowsiness interferes with school
      • Limitation: doesn't control hay fever as well as older antihistamines.
      • Cost: store brand usually costs half the Claritin brand
  2. Eye Allergies:  
  3. Wash Off Pollen:  
    • Remove pollen from the nose with nasal washes (using warm tap water) whenever needed.  
    • Instill 2 or 3 nose drops in each nostril followed by blowing the nose.  Repeat until open.  
    • Remove pollen from the hair and skin with hair washing and a shower, especially before bedtime.
  4. Expected Course:  Since pollen allergies recur each year, learn to control the symptoms.
  5. Call Your Doctor If:
    • Symptoms aren't controlled in 2 days with continuous antihistamines
    • Your child becomes worse

And remember, contact your doctor is your child develops any of the "Call Your Doctor" symptoms.

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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.

Copyright:Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.

Last Review Date: 9/3/2006

Last Revised: 8/5/2006 2:20:46 PM

Content Set: Pediatric HouseCalls Online

Version Year: 2006

Copyright 1994-2006 Barton D. Schmitt, M.D.

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Is Your Child Sick?

Pediatric HouseCalls Online is a guide for treating your child at home, calling your child's doctor or seeking immediate medical attention. Developed by Dr. Barton Schmitt, MD, FAAP, a board-certified pediatrician on staff at The Children’s Hospital. Dr. Schmitt has developed health tools for parents, including Pediatric HouseCalls Online, the Parent Advice Line and his 3rd edition of Your Child’s Health, which is available in bookstores.

Are You Sick?

David A Thompson, MD is the author of Adult HouseCalls Online. He is a board-certified emergency medicine physician at MacNeal Hospital in Chicago. He has a national reputation in telephone triage, decision support tools, medical information technology and quality improvement. Adult HouseCalls Online is a decision support tool for adults that has been reviewed and approved by adult physicians.

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