Understanding seasonal allergies in children

We may still be seeing some chilly days, but allergies are in full effect. Chances are, if you’re not sneezing and itching, someone in your family is. Despite how common seasonal allergies are, many people still have questions about them. We hope to answer some of those so you and the kids in your life can find some relief from seasonal allergies and related allergy symptoms.

Keep reading to learn more, and listen to our podcast with Dr. Portnoy on seasonal allergies here, or search for "The Parent-ish Podcast" wherever you listen to podcasts! You’ll hear practical tips on managing allergy symptoms, understanding the pollen count and knowing when to consider allergy testing.

What time of year do allergies start?

Typically, allergies start showing up as early as February. To a lot of people, this is confusing, as it is still winter and often still cold. But trees start to pollinate (when they produce pollen to reach other trees and reproduce) in early to mid-February. The reason they start producing pollen in February is so their pollen can flow freely through the air before they produce leaves. Trees are wind-pollinated plants. They have smaller, lighter pollen that travels through the air. In order to make sure they reproduce successfully, trees make a large amount of pollen. Each type of tree produces pollen at a unique time somewhere between February and May, so allergy symptoms may vary or persist for that whole time, especially when the pollen count is high.

Grass pollen is produced after the snow melts and grass has had a chance to photosynthesize. Usually, that is in May and June. Grass allergy season is intense but shorter than tree pollen season. During these months, checking the daily pollen count can help you anticipate when seasonal allergies are likely to flare and when allergy symptoms may be worse.

Weed pollen starts showing up in mid to late August and peaks around Labor Day. The most dominant weed allergen in the Kansas City area is ragweed. This late-season pollen can trigger seasonal allergies well into the fall, leading to sneezing, itching, and other allergy symptoms that sometimes get mistaken for early cold or flu.

Is it allergies or is it a cold?

• Allergies tend to be more persistent over weeks and even months. Colds usually last 7-10 days. Seasonal allergies often come back at the same time each year, especially when the pollen count spikes.
• Allergy symptoms are often more itchy and sneezy than colds. Colds tend to be more stuffy, achy and can come with a fever. With seasonal allergies, you may notice clear drainage, itchy eyes and nose and no fever, even when symptoms are strong.
• Sometimes, colds and allergies can happen at the same time, particularly in the fall when rhinovirus and ragweed are both prevalent. If you’re unsure what’s causing your allergy symptoms, allergy testing can help clarify what’s going on.

How do I treat allergy symptoms?

• Take over-the-counter antihistamines. This includes medications commonly known as Allegra, Claritin or Zyrtec. These can ease many allergy symptoms related to seasonal allergies, such as sneezing, itching and runny nose.
• For nasal congestion, use a nasal spray, commonly known as Flonase, Nasacort or Nasonex. They reduce inflammation and congestion in the nose to make breathing easier.
• If congestion is severe enough to make sleeping difficult, add a decongestant nasal spray, commonly called Afrin, before bed. If you’re going to use a nasal decongestant for more than a few weeks consecutively, use it with Flonase.
• Antihistamine nasal sprays can also be used, such as Astelin or Astepro.
• For itchy, watery eyes, use over-the-counter eye drops like Pataday or Patenol. Refrigerate the eye drops for the most soothing application.
• Over-the-counter oral decongestants are not recommended.
• If over-the-counter medications are not working and symptoms are still severe, it might be time to make an appointment with an allergist. At that visit, you can discuss whether allergy testing is appropriate to better understand triggers and tailor treatment for seasonal allergies.

How does an allergist treat severe allergies?

• An allergist will conduct either a skin or blood test to determine what a patient is allergic to. This type of allergy testing helps identify specific pollens, molds or other allergens that are driving your child's allergy symptoms.
• The patient can use that information to try to reduce exposure to the most reactive allergens. For example, when allergy testing shows sensitivity to tree or grass pollen, you can plan outdoor time for when the pollen count is lower and adjust your routine during peak seasonal allergies.
• An allergist can also offer allergy shots to immunize the patient to the thing they are allergic to. This process can be very effective, but it does require a long-term commitment. It usually takes 5 to 6 months of weekly injections to build up to a maintenance dose and then a maintenance dose for 3 to 5 years. At that point, a patient can go into long-term remission of their symptoms and experience far fewer allergy symptoms during seasonal allergies.

Many effective and inexpensive treatments are now available for seasonal allergies. There is no need to suffer through months of allergy symptoms. See what works for your family, keep an eye on the pollen count, and talk with your provider about allergy testing if needed so you can all enjoy the outdoors as much as possible.