Is Your Baby Experiencing Itchy Eyes and A Runny Nose?

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Dr. Cecile Winnie Joy Brion

Paediatrician, Raffles Hospital Beijing

It’s that time of the year again, the once barren trees are showing signs of life again, new buds starting to pop, flowers starting to bloom. Spring has arrived. Time to prepare that picnic basket and take advantage of the nice weather and great scenery.

But while everything seems nice and sounds exciting, some parents can’t help but worry about the possible respiratory issues due to allergy flare-ups caused by the blooming trees, plants, and flowers. In this article, we will discuss Seasonal Allergies and the simple strategies to keep it under control. It will guide you on how to identify the common springtime allergic conditions, how to treat them, how to prevent them, and when to see your doctor. In addition, we will also discuss other common conditions associated with the Spring, like Allergic Conjunctivitis and Asthma.

Seasonal Allergies & Pollens

Seasonal Allergies—also known as Allergic Rhinitis or Hay Fever can be worrisome. It means sneezing, congestion,  runny nose and other bothersome symptoms.

So what about those pollens?

Mainly due to the wind, pollens from flowers gets carried around and ends up in our nose, eyes and lungs. In the process, our bodies react and releases histamines. In the nose, it causes irritation, swelling and subsequent mucus production. In the eyes, this causes redness, tearing, burning and itchiness. In the lungs, this triggers swelling in the airways, wheezing and mucus production.

Is it the common colds or is it allergies?

Achoo! Sneezing, then comes the sniffles, then nasal congestion... and so on...

So how to differentiate if a child has allergies or just a simple cold??

The key is observation. The symptoms are usually hard to tell apart at the start but it is worth noting that most viral infections lasts 3-5 days, and gets better without intervention. The body will produce their own armor of antibodies to fight off the invading organism. On the other hand, nasal allergies will persist for a few weeks, resulting in persistent coughing, sneezing, and sometimes dark circles under the eyes due to exhaustion of incomplete sleep.

You know it’s seasonal if there are repeated or chronic cold-like symptoms that lasts more than a week or two or that develop at about the same time every year. That’s how you know which season gives you the most troubles.

So what happens?

The initial step for allergies to occur is when the body encounters the allergen for the first time and creates antibodies which attach to specific types of cells. This process, called sensitization, primes the body for an allergy attack the next time it experiences the allergen. The body’s cells release histamines — a chemical  substances that cause the myriad of symptoms such as sneezing, coughing, and rashes on the skin. The most common causes of spring allergies includes: tree and grass pollen, mold spores, and insects.

What can we do?

Minimize your exposure to allergens:
Check the pollen count before planning your activities for the day. On windy days, it is better to stay indoors. Sometimes, the best time to go outside is after a good rain, which helps clear pollen from the air.

Don’t allow your child to play on flower beds and tall grasses

Keep the pollen out by keeping window and doors closed

Wash clothes that were exposed to pollens frequently. This includes hats and scarves.

Take a shower to clean off any allergens that the child may have picked up while playing outdoors

Wear a mask which can reduce the allergens that the child can inhale

Use tight fitting sunglasses to protect the eyes from pollens

Drink extra fluids to help prevent mucus production in the airways

Use a special filter that circulates the air indoors

How do we treat it?

No treatment

Usually, if symptoms are not that bad, symptoms do resolve on their own. It is important to keep the child hydrated, comfortable, and away from the potential source of the allergens.

Avoidance of known allergens
Check pollen counts from your local TV or radio stations
Close doors and windows when pollen counts are high
Use HEPA (high-efficiency particulate air) filters

Nasal Sprays
Saline nasal spray
These are over the counter medications that are so easy to use. It only entails squirting up the spray in the nostrils to wash the nasal cavity. Most kids don’t like it because of the pressure, so do try to be gentle.

Steroid nasal spray
Corticosteroids prevent the symptoms of hay fever developing by stopping the release of histamine (the substance released during an allergic reaction). Some steroid sprays are available over-the-counter whilst others may only be available on prescription.

Nasal decongestants
They usually help a lot especially at night time when kids can’t sleep because of blocked nose. These are available as nasal spray or pills, so you have a choice which one works better for your kids. Oral decongestants such as pseudoephedrine (Sudafed, Afrinol, others) can provide temporary relief from nasal stuffiness. Decongestants also come in nasal sprays, such as oxymetazoline (Afrin) and phenylephrine (Neo-Synephrine)

Anti-histamine medications
Some are available as over the counter medications, and some are prescription medications. It is better to consult your doctor before starting them on medications because frequency and timing are some important factors to ensure the success of the treatment of symptoms. Examples of oral antihistamines include loratadine (Claritin, Alavert), cetirizine (Zyrtec Allergy) and fexofenadine (Allegra Allergy).

Natural remedies
This includes quercetin which is a naturally occurring chemical found in tea, onions and apples. Evidence exists that this can block the release of histamine.

Blood tests work-ups to identify the allergens called Allergy Testing Panel works fairly well in kids 3yrs and older, but are not very reliable in children younger than that.

If symptoms of allergies are getting worst, the doctor may recommend skin tests and blood tests to determine what allergens trigger your symptoms. Testing can help determine what steps you need to take to avoid your specific triggers and identify which treatments are likely to work best for you. The Allergy Panel includes a list of food or inhalation particles that are mostly the common allergens that causes symptoms. It would require a small amount of blood to be sent to the laboratory.

Once the allergen is identified, we can proceed to plan a treatment that is suitable for the child. This may be an anti-histamine to be taken for a certain number of days, or a maintenance medication that needs to be completed for a few weeks. Your doctor may also recommend Allergen Immunotherapy. Also known as desensitization, this treatment involves regular injections containing tiny amounts of substances that cause your allergies. Over time, these injections reduce the immune system reaction that causes symptoms.

Sublingual Allergy Therapy is also a new intervention with promising results. Small amounts of allergens are placed under the tongue, using the same concept as the allergy shots but with a different and more convenient delivery system.

Allergic Conjunctivitis

As mothers, we have all received that one phone call from the school nurse telling you to pick up your kid from school because of red eyes. So is it pink eye? Or simply allergies? How to know the difference?

Bacteria—eyes are red with yellowish or greenish discharge throughout day and night. Eyelids are also swollen.

Virus—eyes red but no drainage or very small amount of drainage or crusting upon waking up

Allergy—usually seasonal, mostly in the spring, eyes usually red with increased tears and unusually itchy

Most common causes:

Pollens
Molds
Dust mites
Animal dander

Treatment:

Cold compress
Minimize contact with the allergen
Avoid rubbing the eyes
Saline eye drops
Allergy eye drops

When to see a doctor:
Intense pain in the eye
Extreme redness in the eye
Inability to open the eyes
Severe sensitivity to light
Difficulty seeing, blurring of vision
Spots or blisters developing near the eye or on the eyelid

Asthma

Asthma deserves a dedicated full article to discuss everything in full, from symptoms, to treatment, and prevention. In this article, we will just have a quick overview.

Asthma is also an important illness to be aware of during the spring time because different allergens can trigger an Asthma attack in which airways are inflamed or swollen, resulting to chest tightness and subsequent difficulty of breathing.

There are some kids whose asthma has more of an allergic trigger and may suffer flare-ups during springtime.

Common triggers include:

Pollens
Temperature changes
Fertilizers’
Insect repellants
Dust and cleaning chemicals

Symptoms of asthma:

Wheezing
Night time coughing
Chest tightness
Shortness of breathing

Treatment:

Nebulization
Inhalers
Anti-histamines

Now that we have enumerated and discussed the most common conditions affecting kids during the springtime, then you can be more confident to schedule those picnic in the parks without worrying too much.

Here at Raffles Hospital, the health of your child is of utmost importance. Our team of Pediatricians will be here to guide you on the appropriate tests necessary for your child. Our in situ laboratory is well equipped to do Allergy Testing which includes food and inhalation categories. We also have a comprehensive food intolerance test. Please feel free to reach us anytime via our 24Hour Hotline [phone] or by simply scanning our QR code.

Images: Raffles Medical Clinic

This post was sponsored by Raffles Hospital Beijing

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