Our 4-year-old daughter is sneezing like she has hay fever. Isn't she too young? And isn't this the wrong time of the year?
Children can have hay fever, and despite the name, spring is not an uncommon time for its symptoms to appear. Hay fever got its name because its symptoms, caused by an allergic reaction to fall weeds, appear during hay season. In the spring, the same symptoms can be triggered by tree pollen. Some people are allergic to molds, dust mites, animal dander or cockroaches. They may have "hay fever" all year round.
The medical name for the condition is allergic rhinitis. The word part "rhin" refers to the nose. Typically people with allergic rhinitis have rhinorrhea or runny nose, nasal congestion or stuffy nose and sneezing. They may also feel their eyes, nose or palate itching. A child might not complain of itching, but she might be rubbing her eyes or nose repeatedly.
There are now a number of good medications for treating allergic rhinitis, so your daughter needn't suffer if she has it. Your doctor probably will be able to sort out whether this is indeed the diagnosis by a combination of your daughter's symptoms and findings on physical examination. Sometimes some simple tests are needed. These may include looking at her nasal mucous under a microscope to see whether it contains eosinophils -- a type of cell -- or performing skin tests with possible allergens -- proteins like tree pollen to which she might be allergic.
Among the medications that help to relieve the symptoms of allergic rhinitis are antihistamines and nasal sprays containing corticosteroids or cromolyn sodium, each of which helps to interrupt the complex chain of events that makes up the allergic reaction, though each of these does so in a slightly different way. Decongestants can be helpful, because they reduce the swelling of the lining of the nose, making air passage easier. Your doctor will advise you about which medicines would be safest and most effective for someone your daughter's age.
If your daughter is really miserable from her hay fever, you may want to minimize her exposure to things she is allergic to, for instance, tree pollen at this time of the year. You might keep her room window closed and let her play inside during the early morning hours when the amount of tree pollen in the air may be highest. And next year, you may want to start her medicines earlier in the year. Several work better if they are started before the allergen arrives.
Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.
Pub Date: 5/06/97