How to identify and treat seasonal allergies in children
Recognise early signs of pollen, grass or insect sting allergies, and know when you need to seek medical advice.
Spring and summer are allergy season in South Africa, which runs from around August to March, with the release of pollen and fungal spore levels from blooming flowers, trees, and grasses, and increased insect activity.
Pollen allergy typically starts in childhood, but can occur at any age. Symptoms include a runny or stuffy nose, sneezing, red, itchy and watery eyes, coughing and sometimes a sore throat, says Cape Town allergologist and paediatrician Dr Pieter de Waal. “Other signs include dark circles under the eyes and headache from the pressure of congested sinuses.”
How to tell seasonal allergies from a cold or viral infection
A runny nose and nasal congestion may also signal something other than pollen allergy, such as enlarged adenoids or most commonly, a summer cold – so it’s important to identify an infection, rather than allergy:
• Colds tend to cause a low-grade fever (between 37.5 and 38.5⁰), while seasonal allergies do not typically cause a fever.
• Systemic symptoms, such as body aches and pains, may be present with viral illnesses.
• Colds do not cause itching, while itchiness is a hallmark of seasonal allergies.
• Colds typically last only a few days, and no longer than one or two weeks, but an allergy can persist for weeks and recur during pollen season.
“If your little one has nasal symptoms together with watery, itchy eyes, with dark discolouration below them, allergic rhinitis (hay fever) may be a strong possibility,” says Dr De Waal. See your healthcare provider to assist in differentiating a viral flu from an allergy. General practitioners may refer you to a paediatric allergologist, who can confirm the diagnosis of an allergy and assist in identifying a possible culprit allergen.
Take steps to avoid exposure to pollen by following the pollen counts in your area at www.pollencount.co.za, and schedule outings around them. When counts are high, close the windows of your home and car and make sure anyone allergic takes their anti-allergy medication every day – this will ensure that they stay ahead of their allergy symptoms.
To relieve symptoms, the go-to treatment for seasonal allergies is oral antihistamines such as loratadine, now available in child-friendly, non-drowsy formulations for children, says Dr De Waal. It’s important to check the label for age safety – and to speak to your doctor – however, as antihistamines are generally not recommended for children under the age of two. A simple saline nasal spray can help flush out the nose and clear it of allergens. Nasal and oral decongestants are generally not safe for babies and children younger than six years of age.
Ask your doctor about allergy immunotherapy. This treatment entails introducing a small amount of allergen into your child’s system over several years and has been shown to potentially cure hay fever. It can be given via subcutaneous injections or drops underneath the tongue. “It also protects, if started young enough, against the development of asthma later in life, especially in grass-allergic individuals,” says Dr De Waal.
How to treat allergic allergic reactions to insect bites
Insect stings are a common cause of allergic reactions during spring and summer, mainly because children spend more time outside. The most common culprits of insect sting reactions are the honeybees and less common, yellow jackets and paper wasps.
It’s normal for a sting to cause redness, pain and swelling at the site, which usually goes away in an hour or two, but this can last for up to 24 hours after a sting. Swelling and itching, widespread skin hives, difficulty in breathing or chest wheezing, sweating, stomach pain or cramps, vomiting, or a tight and itchy sensation in the throat, are all signs of possible severe allergic reaction, and should be attended to immediately – these signs may indicate a possible life-threatening reaction, warns Dr De Waal.
For mild reactions, an antihistamine needs to be given as soon as possible and medical treatment sought. Severe reactions require an injection of epinephrine (adrenaline) administered intramuscularly. Parents or caregivers of children diagnosed with insect sting allergy should always carry an epinephrine auto-injector and should know how to use it correctly.
It is also important that they wear an allergy-alert bracelet and have an Anaphylaxis Action Plan – this contains written instructions on how to recognise an allergic reaction and how to treat it effectively in emergency situations, says Dr De Waal. “Teachers and caregivers at schools and daycare centres should also be educated on the administration of emergency medication.”
For more information, and for downloadable information-leaflets and Anaphylaxis Action Plans, contact the Allergy Foundation South Africa, 081 405 8442, email [email protected] or visit www.allergyfoundation.co.za.
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