By Denise Del Colle, RN
The Nurse Advice line at COPA has received many calls lately for allergic rhinitis, commonly known as hay fever, which is the body’s immune system reacting to pollen, a foreign object and breathed in through the nose. We enjoy relatively mild and brief pollination periods compared with most of the rest of the country. However, in early spring, we react to juniper which is starting its growth season. The peak of grass pollination comes about a month after the grass starts to grow and may coincide with the yellow ponderosa pine pollen. Sagebrush and tumble weed pollinate until the weather turns cold.
Symptoms of hay fever include an itchy nose and clear nasal discharge with sneezing, sniffing, and scratchy sensation in the back of the throat. Eye symptoms (itchy, watery, and puffy) are associated 70% of the time. There is no fever or colored mucous with hay fever. However, if your child has lots of coughing, fever or sinus pain around the cheekbone or eyes for more than 24 hours, he/she child needs to see a pediatrician.
Antihistamines help control symptoms of the nose and eyes, reducing the runny nose, nasal itching and sneezing. Benadryl or chlorpheniramine products are most effective and are purchased over-the-counter, but can be sedating for some. If sedation occurs, often it is temporary, and can be managed by reducing the dosage or extending the dosing intervals often given every 8 hours. The bedtime dosage is especially important for healing the lining of the nose. Less sedating and longer acting antihistamines are used for school-aged children or teens who find the Benadryl or chlorpheniramine too sedating.
The key to hay fever control is to give the antihistamines every day during pollen season. Cooling the palate is helpful for itching nose and sneezing: offer a popsicle, suck on ice or offer your child a cold drink. Exercise is good as it opens up the nose. Be gentle with the nose. Sudden nose bleeds happen to hay fever sufferers, particularly as they rub, blow or pick the nose. Vaseline, twice daily on the raw or tender spots in the nose, can prevent many bleeds and promote healing.
For eye symptoms, wash the pollen or other allergic substance off the face and eyelids and apply cold compresses. Antihistamine eye drops can be effective. Ketotifen is the first choice. It is safe and effective and can be found under the brand names of Zaditor and Alaway. The dosage is 1 drop each eye every 12 hours on a daily basis during pollen season for severe allergies. Consider sports goggles for running or biking. Instruct your child to not scratch or touch their eyes. Use over-the-counter saline nose drops or spray to wash out pollen or loosen up dried mucus.
It is very helpful to give a complete shampoo and shower before bed each night to remove pollen from the hair and skin. Have the child remove outside clothes before going into the bedroom or bathroom and sleep with the windows and doors closed. When driving in the car, use the recycled air setting and close the windows to cut down on the pollen exposure and try to restrict outdoor activities during windy/high pollen days. As always keep children away from secondhand smoke which irritates the mucous membranes of the nose and eyes. Pollen is worse in the early afternoon. Have the kids play or exercise outside in the morning or early evening. Be aware that playing with the outdoor dog can aggravate hay fever as pollen collects in the fur.
Hay fever and complications associated with hay fever are a major cause of missing school and are among the most common complaints at COPA these past few weeks. We recommend taking your child to the doctor if symptoms interfere with sleep or school, after taking antihistamines for greater than two days, or if a diagnosis has never been confirmed by a physician. And, don’t forget to enjoy the beauty and blossoms of Spring!