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hello - I suffer with hay fever and thought my daughter had escaped. However, she has various good allergies and seems to be showing the signs of what I think is hay fever. Are there any particular treatments you would recommend I could use for her as I'm keen to avoid dosing her up with all sorts of drowsy stuff and only really familiar with my own treatments.

Many thanks in anticipation of your help.
Sally

Dear Sally,

Children with food allergy often develop allergies to inhalant allergens and may develop allergic rhinitis (hayfever) and asthma. This is called the Allergic March as in an atopic child eczema and food allergy may precede asthma/hay-fever.

I would recommend getting testing for inhalant allergens in your daughter and this could be done at your next food allergy appointment if she is already seen for these. However there are also clues in the history as to what she might be allergic to. Seasonal allergens like tree pollen (Feb/March - April/May) and grass pollen (April/May- July /Aug) usually declare themselves at these times of year. Allergens which are present all year round such as house dust mite and pet animals are more difficult to diagnose as there is often no clear seasonality (although house dust mite allergy can be worse in the winter). House dust mite need high humidity and thus do not survive well at high altitude, thus often the hayfever symptoms may resolve when on holiday in the mountains; this can be a good clue. For pets often the child has symptoms (eyes itching, runny nose) when stroking or in close contact with the pet but this is not always the case.

With regards to treatment in children I would recommend a non-sedating antihistamine such as Cetirizine or Loratadine (both can be bought over the counter) and a steroid nasal spray which has minimal absorption of steroid into the body such as Avamys, Nasonex or Flixonase. Flixonase can be bought over the counter and is licensed from 4 years of age.

Best wishes,