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Allergic rhinitis can be a highly irritating, and sometimes debilitating, condition – so how can you help your child?

According to the Allergy Society of South Africa (ALLSA) allergic rhinitis (the correct term for hay fever) affects almost 2 in 10 South Africans. “The basis of nasal allergic problems is from the interaction of common inhaled allergens with specialised cells in the nasal mucous membrane. This results in the release of powerful chemical agents of which histamine is the best known,” says ALLSA. These substances cause severe swelling of the mucous membrane lining the nasal passages, intense itching of the eyes, throat and palate, sneezing, and the production of copious amounts of watery mucous.

Contributing factors

Dr Sarah Karabus, a Cape Town-based paediatrician, says: “Allergic rhinitis can be seasonal – often due to various pollens present in the air at different times of the year. It can also be persistent, due to year-round allergen triggers such as dogs, cats, birds, dust mites, moulds, fungal spores and cockroaches. Dust-mite triggers are more common in small children, while pollen allergies usually develop in the older child.”

Other factors are cigarette smoke and genetics. If one parent has allergic rhinitis, there is a 30–60% chance of their child developing allergic rhinitis. The chances increase to 50–70% if  both parents suffer.  “Avoid indoor smoking. It not only worsens the allergy, but is also a cause and risk factor for asthma in children,” advises Dr Ahmed Ismail Manjra, of the Paediatric Allergy and Asthma Centre at Westville Hospital in Durban.

Triggers and symptoms

The best advice in treating allergic rhinitis is to avoid the triggers, but it’s not always possible to do this.

Other than those already mentioned above, “symptoms include a permanent stuffy or running nose, constant nose wiggling, wiping or pushing of the nose (called the ‘allergic salute’), red watery eyes, dark rings under the eyes, snoring and mouth breathing”. Karabus adds that if your child suffers from food allergies or eczema he could be more prone to allergic rhinitis.

If you are not sure about the triggers, you can get your child tested by an allergy specialist. This will help you know what to try and avoid. For example, staying indoors on hot windy days when pollen levels peak; or avoiding pets, though Karabus admits this is often difficult to do and impractical. “Getting rid of the family pet, for example, may not help immediately – it can take up to a year for the dander, the microscopic protein that causes the allergy, levels to drop.”

For more about diagnosing and treating allergies in children, read here

Treating hay fever

The treatment for allergic rhinitis differs from that of the common cold, though the symptoms can be very similar. “The common cold is caused by a virus, which can lead to a fever, a sore throat and a runny nose,” says Manjra, “but allergic rhinitis does not cause a fever.” A cold can last up to 10 days, while the allergy symptoms can be present continuously, says Karabus. Both Karabus and Manjra say that not treating allergic rhinitis can be detrimental to your child’s health. It can worsen asthma, cause dental problems, sinusitis and a post-nasal drip. “It can also affect a child’s sleep, reducing ability to concentrate, and thus leading to problems at school,” concludes Karabus.

“In general, treatment for toddlers and babies is the same as for adults. However, certain medication cannot be taken by children,” says Karabus. She suggests using a saline spray to wash pollens out of the eyes and nose. Medical treatment includes antihistamines (oral) or nasal spray. You can also have allergy immunotherapy (vaccination), offered at specialised centres. “Speak to your health-care practitioner about what is best for your child,” advises Karabus.

Marina Zietsman