Integrative Treatment for Children’s Hay Fever

It is springtime and many of your children will be sneezing, itching their eyes and you may be wondering what you can do to help them.

As an integrative paediatrician, I believe in using a combination of conventional treatments, exposure prevention, and natural supplements to manage symptoms effectively. In this post, I’ll guide you through how to help your child get through hay fever season as smoothly as possible.

While medications can provide much-needed relief, they can cause side effects more commonly in children than adults – for example nightmares, irritability, nervousness, agitation, blurred vision, hallucinations, and tummy issues (both diarrhoea and constipation), and many parents are interested in natural options that may prevent or reduce the severity of hay fever with no side effects. I will give you my list of favourite supplements for allergies and tell you how they work. In addition to quercetin, probiotics, and vitamin D, research has shown that supplements like vitamin C, omega-3 fatty acids, and pycnogenol, support immune health and help reduce allergic responses.
 
1. Reducing Allergen Exposure is key in managing hay fever

• Pollen Counts change throughout the day: Check daily pollen counts in your area, and plan outdoor activities when levels are lower, typically in the middle of the day. When the air cools down slowly in the evening, pollen settle to the ground in a phenomenon known as a pollen shower. That is why keeping the windows to your child’s bedroom closed may help prevent a hayfever attack in the evening or the night.

• Minimize Outdoor Exposure: On high pollen days, keep windows closed, use air conditioning rather than fans, and avoid outdoor activities early in the morning when pollen is most prevalent. Do not let your child play in high/flowering grass or freshly cut grass.

• Shower and Change Clothes: Pollen can stick to skin, hair, and clothing, so having your child shower and change after playing outside can help reduce symptoms. Dry bedsheets inside or in a dryer as pollen will stick to them if you hang them outside.

• Air Filters: Using HEPA filters at home can help reduce pollen and other airborne allergens, making the indoor environment more comfortable for children with allergies.

2. Medications: The Conventional Approach and alternatives
 
For children with moderate to severe hay fever, medications may be necessary. Here is a list of commonly used medications and tips on safe alternatives:

•  Antihistamines: Non-drowsy antihistamines such as cetirizine or loratadine can alleviate symptoms like sneezing, itching, and a runny nose. These are generally safe for children, but it’s important to follow the dosage instructions based on their age and weight and to stop them if there are any side effects.

• Nasal sprays: A natural nasal spray like Fess (saline) can be helpful to flush pollen out of the nose;  Xlear nasal spray with xylitol reduces sinus swelling and pressure, nasal congestion, and post-nasal drip.  If these are not sufficient to clear your child’s nose you can use nasal sprays containing steroids – they are usually quite safe and effective, however they can sometimes cause side effects, so stop using them if your child gets nosebleeds, stinging in the nose, nausea, headaches, or a dry and irritated throat.

• Eye Drops and Decongestants: For itchy, watery eyes, antihistamine eye drops can provide quick relief. Stop the eye drops if they cause burning or stinging, or increased sensitivity to light. Weleda Soothing Eye drops are a nice natural alternative. Decongestants are not recommended for children under six.

3. Natural Supplements and treatments for Hay Fever
 
Healthy diet

Of course I cannot write a blog without mentioning healthy food! Research has shown that high consumption of meat, poultry and even seafood, increases the risk of hay fever and on the other hand people with a high intake of fruits and vegetables have a lower risk of hay fever (Rosenkranz).
Your child should avoid processed foods (they are not good for their brain, mood, behaviour and learning either) and eat 5 handfuls of vegetables per day, and at least 2 of fruit – this will build a healthy gut flora and reduce inflammation in the body. A Mediterranean-style diet is best.
 
Many parents seek natural remedies to help manage their children’s hay fever. Research on certain natural supplements suggests they may reduce symptoms or support the immune system to better handle allergens. They work by stopping mast cells from releasing histamine, tryptase and other mediators when triggered by allgerens. Below are my favourite options:

• Quercetin: Quercetin is a natural plant flavonoid found in foods like apples and onions, and it has anti-inflammatory and antihistamine properties. It may help reduce the body’s histamine response to allergens. It has an immediate effect (not as strong as an antihistamine medication, but still often very effective) and it also works over time to reduce inflammation and histamine release, so give it daily. You can get Quercetin in 250mg capsules. For children under 10 one capsule a day is sufficient, for older children you can give it twice daily if needed.

• Probiotics: Studies show that a healthy gut microbiome plays a role in modulating the immune system. They can reduce Th2 lymphocytes involved in allergic reactions. Probiotics, especially strains like Lactobacillus rhamnosus LGG and Lactobacillus plantarum and Bifidobacterium longum, breve, and infantis, may help reduce the severity of allergic reactions. Incorporating a high-quality, child-safe probiotic into your child’s daily routine could be beneficial for overall immune support (Vijayan). The best long-term way to improve your child’s microbiome is to provide your child with lots of different plant foods, like vegetables, fruits, whole grains, and nuts, as these are the food for the beneficial gut bacteria. Each plant feeds a different kind of bacteria, so the more variety of foods your child eats, the more diverse (and healthy) their microbiome will be. And microbiome diversity is one of the best predictors of long-term health!

Vitamin D
Adequate levels of vitamin D are essential for immune function. Low vitamin D increases the risk of infections – that is why people get more colds and flus in the winter. Vitamin D also binds to receptors on mast cells and stops them from releasing histamine. The lower someone’s vitamin D level is, the more severe their allergic reactions become. Ensure your child gets enough sunlight or consider vitamin D supplements if blood levels are below 80nmol/L.  Most children have insufficient vitamin in the winter (unless they take a supplement) and it is lowest at the start of spring – just in time for allergy season. You can use the free D Minder App to monitor healthy and safe sun exposure.
 
Vitamin C
Vitamin C is a powerful antioxidant that may help to reduce the severity of allergic reactions, including hay fever by stabilising mast cells and stopping them from releasing histamine when triggered by allergens. This may help alleviate symptoms like sneezing, runny nose, and watery eyes.
Studies have shown that taking vitamin C supplements can lower histamine levels and reduce allergy symptoms. One study found that 2,000 mg of vitamin C per day reduced histamine levels in adults with hay fever, though dosing for children would be lower based on their age and needs. They may need 250-500mg per day. If you take too much of a vitamin C supplement it can cause diarrhoea – so in that case reduce the dose.

Ideally your child should get Vitamin C from food: oranges, strawberries, tomatoes and bell peppers are great options for children. You will not overdose on vitamin C from fruits and vegetables!
 
Omega-3 Fatty Acids
Omega-3 fatty acids, commonly found in fish, algae oil, and flaxseeds have potent anti-inflammatory properties and may help reduce inflammation associated with allergic reactions. Since hay fever involves inflammation of the nasal passages, omega-3s may help reduce symptoms over time.

With respect to allergies, the best time to supplement with omega 3 is during pregnancy, as prevention.
A study published in The American Journal of Clinical Nutrition found that higher intake of omega-3 fatty acids during pregnancy was associated with lower levels of allergic sensitization in children. Omega-3s may also help balance the immune response and reduce the severity of symptoms (Miles).
Foods high in omega-3s, such as salmon, algae, flaxseeds, and chia seeds, are good additions to your child’s diet. For children who are picky eaters or have specific dietary needs, omega-3 supplements (such as fish oil or algae oil) may be helpful – make sure the product is “mercury free” (not just mercury tested). If your child gets nosebleeds or easy bruising stop the supplement.  Also stop omega 3 supplements for 2 weeks before any surgery.
 
Pycnogenol
Pycnogenol is a natural plant extract derived from pine bark, and it has been studied for its ability to manage allergy symptoms. Pycnogenol is rich in antioxidants and anti-inflammatory compounds, which may help stabilize immune cells and reduce histamine release. This can potentially decrease the intensity of allergic reactions, including hay fever.

A 2010 study found that participants who took pycnogenol starting 5 weeks before allergy season had significantly fewer symptoms of allergic rhinitis compared to those who took a placebo. Another study showed that pycnogenol reduced the need for rescue medication in individuals with hay fever during pollen season (Wilson).

Pycnogenol is considered safe for children. I often recommend it to improve focus, concentration, and memory as it has been shown to be highly effective for that. My favourite brand is Enzo from NZ. It is clean and potent. 1 capsule a day is safe and sufficient for allergy prevention and treatment.
 
Honey
Honey, particularly local honey, is considered beneficial for managing allergies due to its trace amounts of pollen from local plants. The idea is that consuming small amounts of this pollen might help the body build tolerance, potentially reducing allergy symptoms over time (Aw Yong). One study found that people who consumed local honey daily for four weeks, alongside an allergy tablet, saw significant improvements in hay fever symptoms compared to those who only took the tablet.

Honey may offer relief from allergies due to its unique combination of anti-inflammatory properties and bioactive compounds. It contains flavonoids, phenolic acids, and other compounds that prevent the body's inflammatory response, which may help alleviate symptoms like a runny or stuffy nose. Additionally, honey’s rich antioxidants, such as polyphenols, neutralize harmful free radicals that can cause cell damage and further inflammation. By protecting cells from this damage, honey may reduce allergic inflammation and improve overall symptom control. You could add a teaspoon of local honey to a cup of stinging nettle tea which contains natural antihistamines.
 
Acupressure
Acupuncture has been shown to work in adults as well as antihistamines (He), but children generally do not like to be stuck with needles. A similar but painless alternative is acupressure. In a recent study (in adults) pressing certain points for 40 seconds to a minute once a day reduced hayfever symptoms (Israel) significantly and reduced the need for antihistamine medication.

The points are at the bottom of the nose on both sides, between the eyebrows, at the bottom of the skull, on the inside of the elbow and in the web between the thumb and pointer.

Acupressure is easy, painless and has no side effects.  It may be a handy additional tool in the treatment for hay fever.
 
4. Balancing Treatment with Natural Approaches
 
Managing hay fever in children often requires a multifaceted approach. While medications like antihistamines and nasal sprays can provide immediate relief, prevention strategies like minimizing allergen exposure are just as important. Additionally, a healthy diet and natural supplements such as quercetin, probiotics, vitamin D, vitamin C, omega-3s, honey, and pycnogenol offer a holistic way to reduce symptoms and support immune health. Try them out and see what works best for your child. Integrative approaches for allergies not only alleviate symptoms but also support your child’s overall health and immune system function.

Before starting any new supplement, always consult your health care provider to ensure it’s safe for your child, especially in combination with other medications. Every child is different, and a personalized approach is often the best way to manage hay fever effectively.
 
With the right combination of strategies, hay fever doesn’t have to take away the joy of spring and summer for your child!
 
References:
Aw Yong PY, Islam F, Harith HH, Israf DA, Tan JW, Tham CL. The Potential use of Honey as a Remedy for Allergic Diseases: A Mini Review. Front Pharmacol. 2021 Jan 26;11:599080. doi: 10.3389/fphar.2020.599080. PMID: 33574752; PMCID: PMC7870997.
 
He M, Qin W, Qin Z, Zhao C. Acupuncture for allergic rhinitis: a systematic review and meta-analysis. Eur J Med Res. 2022 Apr 25;27(1):58. doi: 10.1186/s40001-022-00682-3. PMID: 35462555; PMCID: PMC9036742.
 
Israel L, Rotter G, Förster-Ruhrmann U, Hummelsberger J, Nögel R, Michalsen A, Tissen-Diabaté T, Binting S, Reinhold T, Ortiz M, Brinkhaus B. Acupressure in patients with seasonal allergic rhinitis: a randomized controlled exploratory trial. Chin Med. 2021 Dec 18;16(1):137. doi: 10.1186/s13020-021-00536-w. PMID: 34922567; PMCID: PMC8684198.
 
Miles EA, Calder PC. Can Early Omega-3 Fatty Acid Exposure Reduce Risk of Childhood Allergic Disease? Nutrients. 2017 Jul 21;9(7):784. doi: 10.3390/nu9070784. PMID: 28754005; PMCID: PMC5537898.
 
Rosenkranz RR, Rosenkranz SK, Neessen KJ. Dietary factors associated with lifetime asthma or hayfever diagnosis in Australian middle-aged and older adults: a cross-sectional study. Nutr J. 2012 Oct 12;11:84. doi: 10.1186/1475-2891-11-84. PMID: 23057785; PMCID: PMC3544658.
 
Vijayan S, Kandi V, Palacholla PS, Rajendran R, Jarugu C, Ca J, Pravallika M, Reddy SC, Sucharitha AS. Probiotics in Allergy and Immunological Diseases: A Comprehensive Review. Cureus. 2024 Mar 8;16(3):e55817. doi: 10.7759/cureus.55817. PMID: 38590477; PMCID: PMC10999892.
 
Wilson D, Evans M, Guthrie N, Sharma P, Baisley J, Schonlau F, Burki C. A randomized, double-blind, placebo-controlled exploratory study to evaluate the potential of pycnogenol for improving allergic rhinitis symptoms. Phytother Res. 2010 Aug;24(8):1115-9. doi: 10.1002/ptr.3232. PMID: 20549654.

Yamada S, Shirai M, Inaba Y, Takara T. Effects of repeated oral intake of a quercetin-containing supplement on allergic reaction: a randomized, placebo-controlled, double-blind parallel-group study. Eur Rev Med Pharmacol Sci. 2022 Jun;26(12):4331-4345. doi: 10.26355/eurrev_202206_29072. PMID: 35776034.