Hayfever in children: what parents need to know

Why hayfever is often underestimated in children

Parents sometimes assume hayfever is a minor inconvenience. But for children with moderate to severe symptoms, hayfever during grass pollen season (May to Aug in the UK) can seriously disrupt sleep, cause daytime fatigue, and impair concentration, with real consequences for learning and wellbeing, especially during exam periods.

How hayfever presents in children

Classic hayfever symptoms include sneezing, itchy and watering eyes, a blocked or runny nose, and itching of the roof of the mouth. Children may also show less obvious signs: constant nose rubbing ("allergic salute"), a horizontal crease across the nose, dark circles under the eyes (known as allergic shiners), and chronic mouth breathing due to nasal blockage.

First-line management

For mild to moderate hayfever, the following measures help:

• Non-sedating antihistamines (cetirizine or loratadine)
• Nasal corticosteroid spray (fluticasone or mometasone)
• Eye drops for ocular symptoms (sodium cromoglicate or antihistamine eye drops)

When to consider immunotherapy

If antihistamines and nasal sprays are not providing adequate relief, or if the family prefers not to rely on daily medication long-term, subcutaneous immunotherapy (SCIT) or sublingual immunotherapy (SLIT) is worth discussing. A 3-year course of grass pollen immunotherapy can substantially reduce symptom severity, and the effect continues after the treatment stops.

Dr Sood offers SCIT / SLIT for grass pollen, tree pollen, and house dust mite. An eligibility assessment is the first step.