What should you know about allergic rhinitis in children?

The lining of the nose reacts to an otherwise harmless substance, becoming swollen and producing watery mucus. A child may sneeze repeatedly, have an itchy or blocked nose, or breathe through the mouth. Itchy, watery eyes and an itchy throat can occur too. Symptoms may come and go with seasons or continue indoors when dust or pets are triggers. Poor sleep, mouth breathing and constant congestion can affect daytime concentration. Allergic rhinitis is different from a short-lived viral cold, although the symptoms can overlap.

Notice when symptoms appear and reduce the relevant exposure where practical: keep windows closed during high-pollen periods, wash the child’s face and hair after outdoor play, and keep bedrooms free of smoke. Wash bedding regularly and follow local advice about dust-mite control. Saline nasal rinses or sprays may loosen mucus; use products suitable for the child’s age and follow the instructions. A clinician or pharmacist can advise whether an antihistamine or steroid nasal spray is appropriate. Nasal sprays work best with correct direction toward the outer wall of the nostril, not the middle partition. Do not share medicines or use decongestant sprays for longer than advised.

Arrange a medical review if symptoms disturb sleep, school, eating or exercise, persist despite sensible trigger reduction, or keep returning without a clear pattern. Seek urgent help if the child has severe breathing difficulty, blue or grey lips, marked swelling of the face or throat, faintness, or cannot speak normally because of breathlessness. A wheeze or cough that accompanies nasal allergies deserves assessment because asthma can coexist with allergic rhinitis.

Ask which trigger is most likely, whether testing would change management, which treatment suits the child’s age, and how long to try it. Ask for a demonstration of nasal-spray technique and what symptoms should prompt an urgent call.