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Baby and childhood respiratory disorders: hay fever (allergic rhinitis) BABY AND CHILDHOOD RESPIRATORY DISORDERS: HAY FEVER (ALLERGIC RHINITIS)
Hay fever may occur in the first year of life but is more common after one or two years. It commonly occurs at certain seasons when the child breathes in certain particles (usually pollens from grasses and trees) to which he or she is sensitive. At other times the child may be constantly allergic to other material regularly present in the air (such as house dust).
The common symptoms are an itch of the eyes, nose, throat and ear lobes. There may be coughing, sneezing, probably wheezing. This may be accompanied by heat of the affected parts. Attacks may come on suddenly, in certain seasons, or at certain times of the day. Headaches, nosebleed, recurrent sore ears may occur. Often there is a nasal discharge, and frequently the eyes smart and water.
Treatment
It is another form of allergic reaction, and avoiding as much as possible the known troublemakers is the best idea. Keep away from house dust (if known to cause symptoms); avoid venturing outdoors as much as possible on dusty windy days, particularly when pollens to which the child is sensitive are in the air. Spring and summer, and maybe autumn, are often trouble times—it depends largely when the offending pollens are in the atmosphere in the greatest quantities. Frequently pollens may come from grassing areas many hundreds of kilometres away; these may be carried to city areas by prevailing winds and upper air currents in an amazing manner.
Give the child plenty of fluids to drink. They tend to dilute or wash away histamine from the system, the chemical that is liberated by the allergens and the basic cause of the adverse reactions.
Cold packs to affected areas can often give relief. Icy cold packs to the eyes, ears, skin and itchy irritating areas may assist. Applying anti-itch creams and lotions can also bring relief—for example, Eurax cream, Calistaflex, or Liniment calamine containing benzocaine 3 per cent (be sure to keep it away from eyes).
Antihistamine tablets or liquids for younger children often neutralize the histamine and reduce symptoms. But this often makes the child drowsy, so care in avoiding accidents is essential afterwards. Often a good long sleep will follow, which in itself may be beneficial.
In recent years, excellent preventive measures have become available. As with asthma, sodium cromoglycate capsules placed in an insufflator (a rubber bulb) enable the powder to be inhaled into the nose. Long-term use (at the critical times when symptoms most commonly appear) may often reduce their frequency and severity.
More recently, beclomethasone dipropionate (Beconase inhaler) may similarly reduce the severity when inhaled. It takes up to 14 days for these preventive measures to exert their full benefit. They will not give immediate relief from an attack, and they are not designed to. They are to be used as a preventive measure.
Ephedrine was often used in the past, and may still be used by some doctors for mild cases. Various synthetic derivatives are now often used instead of ephedrine itself.
Some doctors find that discovering the allergen by performing allergy tests and then desensitizing the patient is a successful way in which to increase the body's inbuilt immunity to future attacks. In the main, however, this system is not popular, for it involves regular weekly or bi-weekly visits to the doctor for injections—not a popular pastime for children of any age, as most parents would agree.
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