Allergic Rhinitis in Children – Basic Information Every Parent Must Know

I’m stunned! I never knew there were so many types of rhinitis in children. There are acute rhinitis, allergic rhinitis, chronic simple rhinitis, chronic hypertrophic rhinitis, atrophic rhinitis, dry rhinitis, caseous rhinitis and eosinophilic rhinitis. I shall spend more time researching on the other types of rhinitis by for now, let’s discuss the most common form of pediatric rhinitis: allergic rhinitis. So what is allergic rhinitis?

What is Allergic Rhinitis

Allergic rhinitis, also commonly known as hay fever, is a type of inflammation in the nose which occurs when the immune system overreacts to allergens in the air. Signs and symptoms include a runny or stuffy nose, sneezing, red, itchy, and watery eyes, and swelling around the eyes. The fluid from the nose is usually clear.

Causes of Pediatric Allergic Rhinitis

There are generally FOUR main causes of allergic rhinitis, namely, Genetics, Environment, Diet and Disease.

Genetics – A baby with a history of family allergic condition has a much higher possibility of having allergic rhinitis compared with a baby with no family history.

The baby does not inherit allergic rhinitis, but they actually inherit the allergic condition. A baby with inherited allergic condition are more prone to develop diseases such as urticaria and bronchitis, which are associated with allergies. Overtime, allergic rhinitis gradually develops and allergen stimulation can trigger the onset of allergic rhinitis.

Environment – The cause of seasonal allergic rhinitis is due to the presence of allergens in the environment. Allergens such as pollen, indoor dust, fungi, animal dander feathers, house dust mites are causes of allergic rhinitis. As the amount of pollution in the atmosphere worsens, babies who do not have an allergic condition may eventually also become allergic to the pollutants in the environment because their immune system has not yet fully developed.

Diet – Some allergens in our diet stimulate the nasal mucosa which can cause allergic rhinitis in the baby. Dietary allergy differs from baby to baby and mothers or caregivers need to be aware of what individual babies are allergic to. In general, the more common food known to cause allergic reactions in babies and young children are: milk, eggs, fish, shrimp, meat, fruit, and even some vegetables may become allergens.

Illness – Allergic rhinitis is often accompanied by a cold. Sometimes a cold can directly lead to the onset of allergic rhinitis in the baby. In addition, antibiotics and other drugs used by the baby in some diseases can indirectly cause the onset of allergic rhinitis in the baby.

Symptoms of Pediatric Allergic Rhinitis

Typical symptoms are nasal itching, continuous episodes of frequent sneezing, watery nose and stuffy nose.

Nasal Itching and Continuous Sneezing – There are several frequent consecutive sneezing episodes every day, followed by nasal congestion and/or runny nose, especially in the morning and at night. Nasal itch is seen in most patients, sometimes the itch may be occur away from the nose, along the soft palate, face and external auditory canal. Itchy eyes are more commonly associated with seasonal rhinitis.

Clear Nasal Mucus – While sneezing, a large number of snot will be expelled. However, when the acute reaction weakens or disappear, the mucus may be reduced or thickened.

Stuffy Nose – It varies in severity, and can be either intermittent or persistent. The blockage can occur in either one or both the nostrils.

Pediatric Allergic Rhinitis Complications

Parents should be cautious when your child suffers from prolonged allergic rhinitis.

Inducing Other Illnesses

Autumn and winter season is a good season for colds. In Singapore, it would be the cold and rainy season. Allergic rhinitis occurs more during the cold weather, and it’s symptoms are very similar to the common cold/flu. Allergic rhinitis’ symptoms also includes nasal congestion, runny nose, itchy nose, sneezing, and so on. It is easy for doctors to treat allergic rhinitis as a cold, hence missing out on the best time to treat your baby. If not be treated in time, allergic rhinitis can worsen and complications such as sinusitis, otitis media, and bronchial asthma can develop.

Disturbing the Child’s Biological Clock

Whether it is seasonal allergic rhinitis or perennial allergic rhinitis, the condition will affect you and your child or baby’s sleep. Your child’s sleep quality is therefore degraded, disrupting your his biological clock. Your child or baby will end up cranky and crying a lot.

Affecting the Child’s Facial Structure

Frequent pushing up of the nose causes nasal crease

Perennial allergic rhinitis in babies can cause changes to your baby’s facial appearance. Complications caused by pediatric allergic rhinitis such as bronchial asthma, sinusitis, allergic pharyngitis blocks the baby’s nasal cavity. Because the baby’s nasal cavity is blocked and he can’t accurately expresses himself, the baby often makes small movements such as pushing the nose, making faces and deliberately widening eyes, etc.

The baby needs to frequently use his mouth to breathe. Mouth breathing leads minor problems include chronically dry lips, mouth and teeth, or more serious issues such as crooked teeth, an underdeveloped jaw and poor development of the face.

Babies who often push the tip of the nose up can cause the formation of a horizontal wrinkle on the back of the nose, called allergic nasal crease. 

Best Treatment for Allergic Rhinitis

There are two major treatment strategies for allergic rhinitis

1. Avoid Contact with Allergens and Irritating Substances.

The most ideal way to prevent allergic rhinitis is to find out what your child is allergic to which induces allergic rhinitis attacks and avoid contact with them as much as possible. Common allergens are dust, mites, fungi, animal skins, feathers, and so on.

2. Medical Treatment.

• Antihistamines (oral or intranasal) are the drugs of choice, which help to reduce nasal mucosal edema and reduce the symptoms of salivation and sneezing.
• Nasal glucocorticoid (commonly known as nasal sprays) can be used as first-line drugs for patients with mild to moderate allergic rhinitis attacks.
• Nasal decongestant can quickly reduce and relieve nasal congestion, but using in large amount and long-term application can cause drug-induced rhinitis. Hence, nasal decongestant can only be used as a short-term adjuvant, mostly for children over 6 years old.

How to Prevent Allergic Rhinitis

So far, there is no specific drug for eradicating allergic rhinitis, therefore, we should focus more effort on improving the baby/child’s immune system to prevent allergic rhinitis.

Exercise – Strengthen your baby’s immunity through exercises appropriate for their age. Simple exercises like taking a stroll, letting them run freely, cycling or swimming are possible means of strengthening their respiratory functions thereby preventing acute respiratory diseases, and improve your baby’s immunity.

Staying Away from Allergens – The most ideal way to prevent allergic rhinitis is to identify the types of allergens that triggers and allergic reaction and as much as possible avoid contact with these allergens. Whenever there are symptoms such as runny nose and sneezing, visit the doctor promptly.

Massage – Frequent massage at both sides of the nose is also an effective way to help the baby can breathe smoothly.

Cold Water Face Wash – Parents can guide the child to wash his face with cold water from young. Cold water stimulates the skin while increasing local blood circulation and maintaining clear nasal passage.

Diet – Baby should try to avoid food such as seafood, shrimps and crabs which are common causes of allergy. Instead, eat more nutritious foods, fresh vegetables and food rich in Vitamin C. Avoid greasy, sweet food or sweet drinks.

Ventilation – The air in the baby’s room should be circulated to keep the air fresh.

Medication – Your baby can use systemic and topical anti-allergic drugs under the guidance of a doctor to relieve symptoms.

Keeping Warm – During cold or rainy season, due to the change in temperature, pay extra attention to the baby warm. This helps to reduce allergic rhinitis caused by cold.

I hope this article has provided some basic information on allergic rhinitis in children. Please comment below if you have more that you would like to share, particularly in the treatment and prevention of allergic rhinitis.