What are seasonal allergies?
Seasonal allergies, commonly referred to as hay fever, are the body's reaction to airborne particles such as pollen or mold. This type of allergy kicks up at the times of year when certain trees, grasses, or weeds are in flower, or when mold releases its spores into the air.
A combination of genetics and interaction with environmental allergens causes some people to develop seasonal allergies. People with hay fever seem to have a hyper-alert immune system that's always on the lookout for substances foreign to the body.
Pollen and mold aren't actually harmful in any way, but when an allergic child or adult breathes in pollen or mold spores, his body perceives it as a dangerous invader and reacts by releasing histamine and other chemicals. Histamine inflames the nose and airways, and the other chemicals cause the well-known symptoms of hay fever: congestion, runny or itchy nose, scratchy throat, watery or itchy eyes, and itchiness in the ears.
Are seasonal allergies a serious problem or just a nuisance?
You should definitely seek help if you suspect that your child may be developing hay fever. "Children suffering from seasonal allergies often can't concentrate, and chronic nasal stuffiness may interfere with the quality of their sleep, making them tired throughout the day and prone to dozing off," says Pung.
Seasonal allergies not only make life miserable for your child, but if left untreated they can lead to some greater long-term health problems, such as sinusitis, chronic ear infections, and even asthma.
In addition, chronic nasal allergies, nasal congestion, or mouth breathing can result in a malformed jaw and teeth (an overbite), which can affect your child's appearance, says Bahna.
What kinds of pollen trigger hay fever?
The most allergenic pollen comes from non-flowering trees, grasses, and low-growing weeds. (Pollen from flowering plants is spread by insects — rather than becoming airborne — so it doesn't tend to cause allergies.)
In the spring, trees such as oak, elm, and birch cause all the fuss, whereas in summertime, grasses such as timothy, Bermuda, and orchard are problematic. From the late summer through fall, the main culprits tend to be weeds such as ragweed (the most common allergen), sagebrush, and Russian thistle.
Weed pollen is small, light, dry, and abundant — and therefore easily disseminated through the air. About half of people with hay fever are sensitive to grass pollens.
How does mold relate to hay fever?
Molds are microscopic fungi related to mushrooms. Outdoor molds grow on soil, grass, fallen leaves, and rotting logs — any damp area with high humidity where air can't circulate well. Molds can also be found indoors in attics, basements, bathrooms, refrigerators and other food storage areas, garbage containers, carpets, and upholstery.
During the warm months, there are actually more mold spores in the air than pollen. In fact, mold spore counts are usually in the thousands per cubic meter (they can reach over 15,000 per cubic meter), while tree pollen counts reach 3,000 to 4,000 per cubic meter and grass counts only climb to the hundreds per cubic meter. Fortunately, most mold spores are not allergenic.
At what age do people develop hay fever?
Seasonal allergies rarely develop before age 3. That's because very young children spend most of their time indoors, says Sami Bahna, professor of pediatrics and medicine and chief of the allergy and immunology section at Louisiana State University Health Sciences Center in Shreveport.
Though a person's tendency to be allergic stays consistent through her lifetime, allergic symptoms can wax and wane, says Y. Howard Pung, director of the pediatric allergy and immunology clinic at Georgetown University Hospital in Washington, D.C. "The hormonal changes during pregnancy could bring relief from allergies for one person and intensify those symptoms for someone else, for example. It's very individual," Pung says.
What time of year do most children have hay fever symptoms?
In general, pollen is in the air in the United States from March through October, though in the South, the pollen season can start as early as January. But that doesn't mean your child will have allergy symptoms for the whole season. It varies from child to child.
"For example, the tree pollinating season may go from mid-March to mid-May, but a child with a low sensitivity to pollen would feel symptoms only during the weeks when pollen levels are highest, whereas a child with high sensitivity may feel it for the entire two months," says Pung. "Second, a child may have more than one type of allergy, in which case, he may have symptoms for the whole year or may have symptoms in the spring and in the fall."
Once you know what type of pollen your child is allergic to, you can estimate when he's most likely to have symptoms. The pollination season for each plant doesn't vary much from year to year.
What role does weather play in hay fever?
The weather can be a big influence on how much pollen is in the air. Hot, dry, and windy weather, for example, helps blow the pollen around, increasing allergy symptoms.
Conversely, people tend to have few allergy symptoms on days that are rainy, cloudy, or still, because pollen doesn't move around much then. Finally, a wet, cold winter followed by an early heat wave can trigger plants to produce more pollen than normal.
When the pollen count reaches high levels, even children who don't normally show allergy symptoms may start sneezing. This is due to the irritating effects of the pollen particles on the nose rather than an actual allergy, says Pung.
Outdoor mold spores begin to appear after a spring thaw and reach their peak in July in warmer states and October in the colder states. Outdoor mold can be found all year long in the South and on the West Coast. In colder climates, mold goes dormant over the winter, springing back to life (and into the air) in the summer and fall.
How can I tell if my child has hay fever?
The symptoms of hay fever can look a lot like those of the common cold or other types of allergies. Your child may have a runny nose with clear mucus, congestion, itchy or watery eyes, itching in his ears, and a scratchy throat. He won't run a fever, though, as he might with a respiratory illness.
Other clues are that your child might seem better indoors and in the car with the air conditioner on. (The air conditioner filters most pollen out of the air coming into the car.)
The most obvious sign of a seasonal allergy, as opposed to an indoor or a year-round allergy (to dust mites or animal dander, for example) is that the symptoms show up at the same time every year and disappear in about four to ten weeks.
Talk with your child's doctor if you think your child might have allergies. By examining your child and talking with you about his symptoms and when they occur, she can probably help you control his allergies.
Allergy testing may be necessary to identify the exact cause of your child's symptoms. If your child's doctor can't perform the allergy testing, she may refer you to an allergist.
What does allergy testing involve?
To figure out what your child is allergic to, the allergist will probably perform a skin test. This involves pricking the surface of your child's skin with a drop of liquid allergen.
After 15 to 20 minutes, the allergist looks for bumps or welts, like small mosquito bites, which indicate an allergy. The allergist may test a number of substances at the same time, depending on your child's age.
Sometimes an allergist requests a second level of testing, called intradermal testing, in which a lower concentration of allergen is injected deeper into the skin with a fine needle. This is done when the allergist needs to be sure of certain allergens that tested negative by skin-prick testing.
If your child has a rash, or the number of suspected allergens is small, a blood test can check for antibodies specific to those particular allergens. The blood test is more expensive than the skin test, but not always as reliable. The result may vary from one lab to another, says Bahna.
Can I prevent my child from getting seasonal allergies in the first place?
Not completely. The combination of genetics and environmental factors determines whether your child develops allergies. Although you can't change the genetic tendency, you can reduce or delay your child's reactions by taking steps to minimize his exposure to allergens.
If either of a child's parents has allergies of any kind, the child has a high probability of developing allergies, though not necessarily the same ones. If one parent has allergies, the child has a 30 percent probability, but if both parents have allergies, the probability of his developing allergies jumps to more than 50 percent.
Your first line of defense, if you suspect that your child has a high risk of developing allergies, is to keep the windows closed and minimize indoor allergens. Try to keep his bedroom as free from these irritants as you can.
Dust mites are the most common indoor allergen, and they often kick off allergies to other substances as well. For outdoor allergens, minimizing prolonged exposure to pollens is the key, says Pung.
How can I minimize my child's exposure to pollen and mold?
Although you can't really escape pollen when it's in season, you can minimize the amount of pollen and mold your child comes in contact with. Here are some tips from the American Academy of Allergies, Asthma, and Immunology.
- Keep your home clean. Windows, bookshelves, and air conditioning vents collect dust and mold that can provoke allergies. Wash bedding weekly in hot water.
- Keep him away from chemical irritants. Fumes from tobacco smoke, paint, insect sprays, and even new carpeting can irritate the lungs and worsen your child's allergic response.
- Prevent mold from growing inside your home. Use a dehumidifier, especially in the bathroom, basement, and laundry room. Clean the dehumidifier regularly to keep mold from growing in it.
- Don't hang laundry out to dry if your child is allergic, because allergens will collect on them. Use a vented dryer instead.
- Leave pets outside if the weather permits. If your pets are in the house, keep them out of the bedrooms, as they can track in pollen and mold.
- Schedule outdoor activities after 10 a.m. Pollen levels are highest between the hours of 5 a.m. and 10 a.m.
- Check the local pollen count. When it's high (or the weather is hot, dry, and windy), stay inside with the windows closed as much as possible to keep pollen from entering the house. If your house is air conditioned, that's even better.
- While driving, keep the car windows closed and turn on the air conditioner.
- If your child is sensitive to mold, don't make raking up old leaves one of his chores, and encourage him to stay away from damp, still areas near standing water. Playing near a compost pile in the garden is a definite no.
- Getting rid of offending plants in your own backyard might help, but only a little. Because pollen travels so widely, your toddler could be affected by pollen whose source is miles away. Stay off freshly mown grass.
- After your child comes in from playing outside, change his clothing. (If you can't wash his clothes right then, put them in a hamper so they can be washed before being worn again.) If possible, give him a bath right away — if not, wash his hands and make sure you give him a bath at night and wash his hair before bedtime. You don't want him tracking allergens into the bedroom.
- Escape if you can. Most allergists don't advise moving to a new location, since a toddler who has developed an allergy to pollen or grass will probably just develop a new allergy to something else after a few years. On the other hand, it makes a lot of sense to vacation in a place where pollen levels are low (like the beach), if you can arrange it.
What's the best way to treat my child's hay fever?
It depends on the type of reaction your child has. For a mild respiratory reaction, using a saline nasal rinse may be sufficient. For more constant or bothersome symptoms, several non-drowsy prescription antihistamines have become available over-the-counter in the past few years.
You'll want to talk with your child's doctor about these medicines. She may suggest an over-the-counter drug or prescribe another appropriate allergy medicine to help your child's symptoms. If the symptoms persist, she can refer you to an allergist.
Can allergy shots help?
Since most children have allergies to specific things, allergy shots that target individual allergens may be a good option if your child's symptoms persist even after you've tried medications. Some studies show that allergy shots in children may not only provide relief for the current problem, but also prevent more severe allergy symptoms in the future.
In general, allergy shots are considered for children 5 years of age and older. If you think that your child would benefit from allergy shots, you'll want to take him to an allergist. She can evaluate his condition and decide whether the shots would be helpful.