Hay fever in children can be mistaken for a persistent cold. The distinguishing features:
- It lasts weeks and follows the seasons rather than resolving in a week
- Itching — of the nose, eyes, throat or roof of the mouth — which colds rarely cause
- Clear nasal discharge rather than thick and coloured
- No fever
- Repeated sneezing in runs
- Symptoms that worsen outdoors, on dry windy days, or after grass is cut
Persistent mouth breathing, a horizontal crease across the nose from repeated upward wiping, and dark shadows under the eyes are all common signs in children.
Treatments by Age
Antihistamines
Cetirizine and loratadine syrups are widely used in children, with age and weight-dependent dosing on the label. Fexofenadine has a 30mg tablet used in children aged 6 to 11.
Avoid older sedating antihistamines such as chlorphenamine for daytime use in children — the sedation is real and it affects concentration at school.
Nasal sprays
Steroid nasal sprays are effective and are used in children, but licensing varies by product and age. Some are pharmacy-only for adults but prescribed for children. Check with a pharmacist rather than assuming an adult product is suitable.
Technique is the limiting factor. A child who sniffs hard, aims up the nose or uses it inconsistently will get little benefit — it is worth watching them do it rather than assuming.
Eye drops
Sodium cromoglicate drops are commonly used for allergic eye symptoms in children and are available over the counter. Check the age suitability on the product.
School and Exams
UK exam season sits squarely in grass pollen season, which is genuinely unfortunate. Research has linked hay fever symptoms — and sedating medication — to underperformance in exams.
Practical steps:
- Start preventive treatment two to four weeks before the season, not when symptoms appear
- Use non-sedating antihistamines, and check that the specific product your child takes does not make them drowsy
- Tell the school. Many will allow medication to be taken during the day with appropriate arrangements
- Mention severe hay fever to the exams officer — special consideration exists for medical circumstances
Reducing Exposure
- Shower and change clothes after coming in on high pollen days
- Keep bedroom windows shut in the early morning and evening, when pollen counts peak
- Dry washing indoors during the season
- Wraparound sunglasses genuinely help with eye symptoms
- Apply a barrier balm around the nostrils before going out
When to See a GP
- Symptoms are not controlled by over-the-counter treatment
- There is wheezing, coughing or breathlessness — hay fever and asthma are closely linked, and poorly controlled hay fever worsens asthma
- Sleep is disrupted enough to affect daytime functioning
- Symptoms are present all year round, which suggests a different or additional allergy
- Only one nostril is affected, or there is blood-stained discharge — that needs assessment rather than treatment
Cost
Children's prescriptions are free in the UK, so a GP appointment is worth having if over-the-counter treatment is not working — you may end up paying nothing for a more effective treatment than the one you are buying.