Pollen allergies in children

Allergies may be seasonal or they can strike year-round. Plant pollens are often the cause of seasonal allergic rhinitis, more commonly called hay fever.  

 

What is pollen?

The word pollen is derived from the Greek word meaning 'fine flour'. The role of the pollen grain is to fertilise the female flower to reproduce plant species.

Pollen allergy causes allergic rhinitis (hay fever)

The correct name for hay fever is seasonal allergic rhinitis. Even though it was known that pollen rather than hay was the cause as far back as the early 1800's, the term hay fever is still frequently used. Allergic rhinitis symptoms are caused by the body's immune response to inhaled pollen, resulting in chronic inflammation of the eyes and nasal passages. Symptoms include runny nose, itching, nasal congestion, irritable and watery red eyes, and itchy ears, throat and palate. Extreme fatigue may also occur and result in considerable impairment of the quality of life. Children are more likely to develop allergies if one or both parents have allergies.

Immune system reaction

An allergy is a reaction of the immune system to a specific substance, or allergen. The immune system responds to the invading allergen by releasing histamine and other chemicals that typically trigger symptoms in the nose, lungs, throat, sinuses, ears, eyes, skin, or stomach lining. In some children, allergies can also trigger symptoms of asthma—a disease that causes wheezing or difficulty breathing.

Avoiding the culprit

1. If your child has seasonal allergies, you may want to pay attention to pollen counts and try to keep your child inside when the levels are high.
2. In the late spring and early summer, during ragweed pollen season, pollen levels are highest in the morning.
3. In the spring and summer, during the grass pollen season, pollen levels are highest in the evening.
4. Sunny, windy days can be especially troublesome for pollen allergy sufferers.
5. It may also help to keep windows closed in your house and car and run the air conditioner when pollen counts are high.

Pollen can also trigger asthma

Some people with severe allergic rhinitis (hay fever) think that their allergic rhinitis turns into asthma or will make them tight in the chest or wheeze. However, pollen can directly trigger asthma as well as allergic rhinitis (hay fever). Small particles containing allergen can penetrate deep into the airways of the lung. Thunderstorms can also contribute to this - when pollen granules come into contact with water, starch granules are released that are small enough to be breathed into the airways, causing hay fever and asthma in some people. So if you wheeze mostly during spring, see your doctor for appropriate advice.

Tips for reducing pollen exposure

 

-     Stay indoors until after midday (if possible), this will reduce your exposure. 

-     Try to avoid going out on windy days or after thunderstorm.

-     Wear sun glasses to protect your eyes.

-     Do not mow the grass, and stay inside when it is being mown. If mowing is unavoidable, wear a mask. 

-     Keep windows closed both at home and particularly when in your car (and where possible use recirculating air conditioning in your car).

-     Do not picnic in parks or in the country during the pollen season.

-     Try to plan your holidays out of the pollen season or holiday at the seaside.

-     If you are sensitive to particular weeds or trees that are outside your bedroom window, have them removed.

-     Shower when you arrive home and bathe your eyes frequently with a wet washer.

-     Carry a supply of tissues.

Allergy medicine

Pollen seasons can last for several months and exposure is difficult to avoid. However, there are simple ways to prevent or reduce symptoms. For most children, symptoms may be controlled by avoiding the allergen. However, if a child’s symptoms are persistent and not relieved by medicines, it is wise to see a health care professional to assess your child’s symptoms and see if other treatments, including prescription medicines, may be appropriate. Always read the label to make sure the product is appropriate for your child’s age. Just because a product’s box says that it is intended for children does not mean it is intended for children of all ages. Seek advice from your pharmacist or doctor about medications or treatments that will relieve your symptoms. Although drugs do not cure allergies, the medicines available for treatment are much more effective with fewer side effects than those available 20 years ago.

-   Antihistamine tablets or syrups (non-sedating) help sneeze, itch and irritating eyes, but they are not as effective in controlling severe nasal blockage and dribble. The advantage of antihistamines is their flexibility; you can take them when you have problems, and avoid them when you are well. Antihistamine eye drops can also be helpful in controlling watery eyes due to allergies.
Combination drugs containing both an antihistamine and decongestant are also available, but these need to be used with caution as the decongestants can cause many side effects. 

-   Intranasal corticosteroid nasal sprays have a potent action on inflammation when used regularly. These need to be used regularly and with careful attention to the way in which they are used.

-   Decongestant sprays unblock and dry the nose, but should not be used for more than a few days as they can cause long term problems.

-   Decongestant tablets unblock and dry the nose, but should be used with caution as they can have 'stimulant' side effects like trouble sleeping, anxiety or an increase in blood pressure.

-   Natural products such as salt water nasal sprays or douches can help relieve symptoms.

Imunotherapy

 

Medicines only reduce the severity of symptoms. They do not cure it. Children who don't respond to prescription medications, or who suffer from frequent complications of allergic rhinitis, may be candidates for allergen immunotherapy.  After allergy testing, typically by skin testing to detect what allergens your child may react to, a health care professional injects the child with “extracts”—small amounts of the allergens that trigger a reaction. So, immunotherapy (also known as 'desensitation') is  when one tries to switch off the allergic reaction by repeatedly injecting small doses of allergen extracts, by injection or sublingual drops. Both are long term treatments, which are often given over a few years. Immunotherapy should only be initiated by a medical specialist allergist or clinical immunologist.

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