Happy nose,
happy days!

• Try to stop your child from rubbing their eyes, as this can make symptoms worse
• Gently bathe the eyes with cool water or use a clean, cold compress to soothe itching
• Sunglasses outdoors can help protect eyes from pollen
• Over-the-counter allergy eye drops may help, but check they’re suitable for children

If symptoms are ongoing, severe, or affecting sleep, school, or concentration, you don’t have to manage it alone. Support and effective treatments are available to help your child feel more comfortable and get back to enjoying their day.

Allergic conjunctivitis is a common eye allergy that often appears alongside hay fever. It can make your child’s eyes feel very itchy, sore, red, watery, and puffy. This can be miserable and upsetting for them, and exhausting for parents. It’s caused by allergens such as pollen, dust mites, or pet dander and usually affects both eyes at the same time. Although it can look alarming, it isn’t an infection and won’t damage your child’s eyesight.

How common are hay fever and allergic rhinitis in children?

Approximately one quarter of adults in Europe experience airborne allergies, which include asthma, hay fever and allergic rhinitis. The proportion among children is 30% to 40%. That figure is expected to reach half of Europeans by 2050, according to the World Health Organisation.

Is hay fever getting more common?

Studies show that climate change is affecting when and how plants release pollen and spores. Warmer weather means plants and trees are flowering earlier and for longer, leading to extended pollen seasons. As a result, more people, including children, are developing allergy symptoms, and existing hay fever sufferers are experiencing more severe symptoms.

How can my child be diagnosed with hay fever?

A detailed history is essential; hay fever can often be diagnosed by noting when and where the symptoms arise. If the trigger is not obvious, or if you plan to do immunotherapy and need a more specific diagnosis, skin prick tests or blood tests (specific IgE to the allergen being  tested) can help. The best thing to do is to chat to a doctor, who can tell you the best way to get a diagnosis, and discuss treatment options.

When should I contact a doctor about my child’s hay fever symptoms?

You should contact a doctor about your child’s hay fever if their symptoms are severe, if they impact sleep or daily activities, or aren’t improving with over-the-counter treatments. Seek medical advice if your child’s symptoms worsen, if they develop frequent ear or sinus infections, or if you’re unsure what’s causing the symptoms.

If your child has serious symptoms such as throat swelling or severe difficulty breathing, call emergency services immediately.

How is hay fever treated in children?

As always with allergies, avoiding triggers is an important part of managing hay fever and allergic rhinitis. However, for children especially, the reality isn’t always that easy. Medications such as antihistamines, decongestants, nasal corticosteroids, and immunotherapy can help relieve symptoms and ease discomfort.

Identifying the differences between seasonal and year-round (perennial) allergic rhinitis is a great first step. For seasonal allergies, pollen calendars and forecasts can help with planning, and antihistamines and nasal sprays can provide relief. Perennial allergic rhinitis is likely to be triggered by indoor allergens, so treatments such as cleaning or using air purifiers may help.

Antihistamines are often used to relieve symptoms of allergies, including hay fever, allergic rhinitis, and allergic conjunctivitis. There are many types: drowsy and non-drowsy; tablets, syrups, creams, gels, sprays, and drops. Some are available over the counter; others require a prescription. Some are suitable for children; others are not. The best advice is to speak with a medical professional or allergy specialist to determine the most effective treatment for your child.

Can immunotherapy be used for hay fever and allergic rhinitis?

Yes. In fact, immunotherapy, or desensitisation, was first developed over 100 years ago to treat hay fever. Modern-day immunotherapy works by gradually introducing a small amount of the allergen into the body at increasing doses, helping the immune system build tolerance and reduce the severity of allergic reactions over time.

Are hay fever treatments and antihistamines safe for children?

Yes. When used correctly, inhalers are safe, effective, and an essential part of managing hay fever. They help to ease symptoms and help your child breathe more easily.

How can I help my child manage the symptoms of hay fever?

There are three key aspects to managing hay fever effectively. First, taking a daily antihistamine is essential. Older, sedating antihistamines such as Piriton should be avoided. Their side effects, particularly drowsiness, can impact concentration. Instead, newer, non-sedating options are recommended.

Second, if nasal symptoms are the main problem, evidence supports the use of a nasal steroid spray. Many people use these sprays incorrectly, which reduces their effectiveness (see advice below). Used properly, however, they can make a significant difference.

Third, some children struggle with itchy, watery eyes. In these cases, it’s worth trying over-the-counter sodium cromoglycate eye drops. If eye symptoms continue to be troublesome, a GP can prescribe antihistamine eye drops, which may provide better relief.

Above all, the most important thing with all hay fever treatments is consistency. These medications work best when used continuously throughout the hay fever season, rather than only when symptoms flare up. Daily use gives the best chance of keeping symptoms under control.

It can also help to:

• Monitor pollen forecasts. While it is not always practical or ideal to keep children indoors as a preventative measure, it is worth noting that cooler rainy days tend to have less pollen. So get those wellies on!
• Leave allergens at the door. On high-pollen days, it can help to take off outdoor clothes or have a bath or shower after being outside. This can remove any pollen that is clinging to clothes, skin or hair.

Keep washing indoors: Although line drying is ideal in the summer, wet clothes can collect pollen.

How to use a hay fever nose spray correctly

One of the most important parts of treating hay fever is using a nasal spray. Many people say their spray doesn’t work for them. In most cases, this isn’t because the medication is ineffective, but because it isn’t being used correctly.

A common mistake is spraying straight up into the nose while taking a deep sniff. This causes two problems. First, the spray hits the hard, central part of the nose, which isn’t affected by hay fever. Repeated spraying in this area can lead to nosebleeds. Second, taking a deep sniff pulls the medication straight down into the throat and stomach, where it is swallowed and deactivated. When that happens, the spray can’t do its job.

Using the nasal spray correctly makes a big difference to how well it works. A helpful way to remember the technique is to think of crossing over your hands. Use your right hand to spray your left nostril, and your left hand to spray your right nostril. Gently tilt your head forward, aim the spray slightly outwards, and spray once. Then breathe normally for about ten seconds. Repeat on the other side, again breathing normally. A small amount of spray may run out of the nose. This is normal and can simply be wiped away.

This technique keeps the medication in the nose, exactly where it needs to be, allowing it to have its maximum effect. Commonly recommended nasal sprays for children and young people include Nasonex, Avamys, and Flixonase.

As a children’s allergy specialist, I have spent more than 25 years helping families understand and manage allergic conditions such as hay fever.

I trained in Birmingham, Liverpool and hospitals across the Midlands. As well as holding degrees in medicine, pharmacology, and child health, I am a certified European Paediatric Allergist. This means I have spent many years studying how children’s immune systems and airways work, and how to keep them healthy.

In my NHS role, I lead one of the busiest allergy services in the region, caring for around 3,000 children each year. Many of these children have asthma or allergy-related breathing symptoms. I have helped shape national guidelines, improve allergy services across the UK, and support healthcare professionals who care for children with asthma and allergies. I’ve also recently been awarded the title of honorary professor for my teaching work at The University of Birmingham.

Above all, every child deserves the chance to breathe well, play freely and feel safe. My role is to reassure and empower parents and give children with hay fever and allergies the best possible start.