Hay Fever

We use a variety of approaches to treat hay fever and conjunctivitis. We first identify which allergies actually exist for an individual. Next we explore ways to avoid those specific allergens. We use a wide repertoire of medications to control allergy symptoms. For those who still have problems despite these measures we offer desensitization. Our immunotherapy (allergy shots) protocol can bring allergies under control in 3 to 4 months.

Hay Fever Havoc for Children

Erica Heilman

High season for hay fever is upon us, and allthough the itching, sneezing and runny nose are sure to pass when the last grain of pollen finally drops, these symptoms can wreak havoc on the lives of many each year.

Children are no exception. While hay fever can lead to misery and loss of productivity for adults at work, children can suffer from decreased learning ability at school, behavioral problems, fatigue and frustration as a result of this condition.

The good news is that hay fever, though highly irritating, is also highly treatable in children as well as adults. Below, Dr. Morris Nejat, director of the Pediatric Allergy and Asthma Clinic at Bellevue Hospital Center in New York City, talks about the particular difficulties that children experience with seasonal allergies, and what can be done to stop them.

How common is hay fever in children?
It's very common. The incidence is probably twice that of adults. About 20 percent of children have some form of allergic rhinitis, which is commonly known as hay fever.

How can allergies impact a child's life?
Children like to play outdoors and most of the sports that school-age children play—such as football, baseball, soccer and tennis—are outdoor sports, which happen in the fall and the springtime, when pollen counts are highest. Children that have symptoms of allergic rhinitis may not perform to the best of their abilities.

Also, children with allergies may experience interrupted sleep, which means they may be more tired than they would ordinarily be. So they may not have as much energy or desire to participate in physical activities.

Allergies can also affect a child's learning. Numerous scientific studies have shown that children with allergies don't learn as well as children who don't have allergies. It's also been shown that children treated with non-sedating medicines do better than children who go untreated, but children treated with sedating medication may have a harder time learning than children who are not treated at all. So one has to be very careful about the medicine chosen to treat children.

A lot of children who have allergies tend to avoid social gatherings because their nose is running. They're stuffy; they always have to carry tissues. And even if they don't complain to their parents, they're still very self-conscious about their symptoms and how they look. So they may avoid certain environments that make their allergies worse.

Are we seeing more children diagnosed with allergies in recent years?
Over the past 20 years, diagnosis of allergies has increased significantly, and there are a number of theories behind this. Some believe that the increasingly sedentary lifestyle of the American child, together with the consumption of more high-fat foods may be causing the increase. Another potential reason is the increase in wall-to-wall carpeting, which promotes dust mites, a significant cause of allergies. It may also be due to an increase in the amount of pollutants in the environment. Also, children are given antibiotics earlier and earlier to treat infections, so antibiotic resistance may play a role. These are all theories.

How do allergies first occur in early childhood?
Allergies go through different phases in children. Most infants with allergies have atopic dermatitis, or dry, itchy skin and allergic skin rashes. They may also have food allergies. As they get older, the food allergies tend to go away, and they start to develop symptoms of allergic rhinitis around four to six years of age. Many of these children with allergic rhinitis will then go on to have allergic asthma in their early teens.

What are some of the treatment strategies for children?
The first step is to do is try and identify what your child is allergic to so you can control the environment and decrease their exposure to the allergens. The next step is to determine the most benign, effective medication to treat your child's allergies. You want to make sure that the treatment is not worse for the child than the disease. Non-sedating allergy medications are a good first option for children.

There are both nasal sprays and oral medications. The two main nasal sprays that are used to treat allergy symptoms are decongestant sprays that prevent the release of proteins called histamines, which cause the symptoms in the first place. If you use nasal decongestants too often, however, your nose can become addicted to it. So I would patients to discuss their use with their physician.

Traditionally, the oral medications have been sedating antihistamines. They're effective, but they can make the child tired and give them a dry mouth. These medications have fallen out of favor with physicians. Non-sedating antihistamine are better alternatives.

How are antihistamines administered to children?
Generally, the younger child will take a syrup, and there are new formulations that are called Reditabs, which dissolve in their mouths.

Do children outgrow allergies?
Children may outgrow their allergies, where they will actually become increasingly less allergic. Additionally, as a child gets older, their environment changes, and the exposure to the allergens may change. For example, a child who is allergic to dust mites and has lots of stuffed animals may have more symptoms. Later on, if they're spending more time outdoors and they have fewer stuffed animals, they may be less congested and less sneezy.

Published on: June 23, 2003