Hay fever in children - specialists and information

What does hay fever mean for children?

Hay fever (seasonal allergic rhinitis) is an allergic reaction of the immune system to harmless environmental substances. The body mistakenly classifies these substances as "enemies" and the immune system fights them.

The smallest amounts of certain plant pollen trigger an inflammation of the airways, especially the mucous membranes. This results in typical symptoms.

The symptoms usually occur seasonally, during the flowering period of trees, shrubs, herbs and grasses. The so-called early bloomers (poplars, birches or alders) are the most common triggers of hay fever.

Around every 11th child in Germany suffers from hay fever. And the trend is rising. Some children also suffer from asthma or inflammatory skin diseases such as neurodermatitis. In most patients, allergic rhinitis develops in childhood. In most cases, at least one of their parents also has an allergy.

What are the symptoms of children suffering from hay fever?

Sneezing, sniffling, a blocked nose, obstructed nasal breathing and red, itchy eyes are among the typical signs of the disease. A thin secretion often comes out of the nose. The nasal secretion can lead to eczema on the skin around the nasal entrance.

The symptoms usually appear during contact or directly after contact with the triggering pollen. The antibodies release inflammatory substances, causing the mucous membranes to swell each time they come into contact with the allergens.

Other symptoms include

• Swollen eyelids
• Watery eyes
• Sleep disturbances
• Headaches
• Increased body temperature
• Tiredness and fatigue
• Diffuse inflammation (including in the paranasal sinuses and middle ear)

A severe pollen allergy has a negative effect on well-being. Those affected suffer from a reduced ability to concentrate and are unable to pay sufficient attention at school.

Patients with hay fever often cannot tolerate certain foods. Cross-allergies develop.

The symptoms usually occur in spring. They usually start when the allergy-causing tree or shrub begins to flower. The peak of the disease is in May and June for most sufferers. This is the time when the pollen count is at its highest.

Hay fever is a widespread allergy in children @ Kzenon /AdobeStock

How does hay fever develop in children? What factors favor the disease?

Both genetic predisposition and environmental influences play a role in the development of the condition.

• Children of allergy-free parents only have a 15 percent risk of developing hay fever. If both parents are allergic, the probability rises to 50 to 60 percent. If both parents suffer from the same allergy, the risk of the child becoming ill can rise to up to 80 percent.
• Certain living conditions contribute to the development of a hay fever allergy. The hygiene hypothesis states that increased hygiene standards in childhood inadequately "train" the immune system. This under-training of the immune system with viruses, bacteria and other pathogens promotes an allergy in childhood. The body therefore classifies certain foods or pollen as dangerous.
• Environmental pollutants also promote the increase in allergies. They have an effect on plant pollen production. Particulate matter and ozone alter pollen, increase the release of allergens and intensify allergic reactions.

However, breastfeeding has a certain protective effect against allergies. Doctors therefore recommend that expectant mothers breastfeed their babies for at least four months. Only then should complementary foods be slowly introduced.

How is hay fever diagnosed in children?

In the case of severe allergic symptoms, it is essential to have the illness diagnosed by a doctor. Doctors with an additional qualification in allergology are the best people to contact. These can be pediatricians as well as dermatologists, ear, nose and throat (ENT) specialists, internists and lung specialists with additional training as allergists.

A diagnosis can be made on the basis of the typical symptoms:

• A blood test for antibodies provides further information. The RAST test can be used to determine whether antibodies against pollen proteins can be found in the blood.
• A skin test (prick test) is used to clarify exactly which type of pollen triggers hay fever. Pollen types dissolved in water are applied to the skin with a small scratch. Usually on the inside of the forearm. If redness/swelling or itching occurs within 10 to 15 minutes, this is an allergic reaction.
• Another diagnostic method is the provocation test. The doctor applies the allergen to the nose or to the bronchial or conjunctival mucosa. If the mucous membranes swell, an allergy is present.

What therapies are available?

Those affected can alleviate their symptoms using various methods. In many cases, medication can help.

Allergy sufferers can treat hay fever locally with nasal sprays or systemically with tablets. Check the dosage for children carefully, as undesirable side effects can occur.

• Antihistamines

If symptoms are severe, they reliably and quickly block the allergy symptom. They are administered in the form of tablets, nasal spray or eye drops. The active ingredient makes you tired, which is why it affects your ability to concentrate.

• Cortisone for topical use as a nasal spray

Only certain active ingredients may be used in children under the age of twelve. Cortisone has a strong anti-inflammatory effect. Undesirable side effects include headaches and nosebleeds.

• Decongestants in the form of nasal sprays or drops

They soothe the swollen nasal mucosa. They are particularly suitable for nasal congestion. Those affected should use nasal sprays for a maximum of one week. Salt water nasal sprays can be used to supplement medication. They cleanse and care for the irritated mucous membranes.

• Hyposensitization can help

Hyposensitization helps to "accustom" the body to the allergen and thus prevent the allergic reaction. Doctors administer the highly diluted allergen to the allergy sufferer over a longer period of time in constantly increasing doses. If the therapy is successful, the body "tolerates" the substance and the symptoms disappear permanently.

Hyposensitization can produce good results. The treatment lasts for three years and is successful in around 70 to 80 percent of children with allergies.

How does the disease usually progress? What is the prognosis?

In general, pollen allergy cannot be completely cured. However, there are ways to alleviate the symptoms.

If your child has already developed an allergy, the most important preventative measure is to avoid pollen.

Children and parents can counteract pollen exposure with the following measures:

• Change street clothes in the house and wash them promptly
• Do not enter the bedroom in street clothes
• Shower and wash your hair after spending time outdoors
• Keep car windows and windows closed during heavy pollen counts
• Only air your home at certain times when the pollen count is low

The pollen season varies from year to year, depending on the weather conditions. When it rains, there are hardly any allergens in the air. Warm and dry weather, on the other hand, encourages the spread of allergens. The regional weather report provides information about the current pollen count.

Depending on the type of pollen allergy, affected children should avoid certain foods:

• Tree pollen allergy sufferers generally cannot tolerate certain types of fruit and nuts.
• They should also avoid spices such as curry, aniseed and garlic. Caraway, parsley, dill, fennel and camomile can also aggravate the allergy.
• If you are allergic to cereal or grass pollen, you should only eat vegetables such as peas, lentils and beans in moderation.
• You should avoid histamine-containing foods such as salami, nuts and cheese completely.

Conclusion

Hay fever in children can significantly reduce the quality of life of young patients.

It can be treated well with medication. However, they have side effects such as tiredness and concentration problems. Hyposensitization can cause the allergy to recede.

Appropriate rules of conduct and avoiding certain foods can help to keep the symptoms in check.