“Could it be allergies?” The parents of a newborn asked, as we gazed at their baby’s tiny nose and the even tinier amount of congestion.
“Well . . .” I began. Could it be? Are all snotty noses probably allergies? During some seasons, it sure feels that way. In this post, we’ll review seasonal allergies, also known as hay fever. I’ll discuss who suffers from allergies (and why). We’ll learn why it’s very unlikely for a newborn to have seasonal allergies. Lastly, we’ll touch on treatment options and whether local honey is helpful.
What are seasonal allergies?
The allergies we’re discussing today include allergies from the environment. Usually, we think of plants like flowers, trees, or weeds outside. Allergies also include indoor mold, dust, and pets. Why does this matter? Allergies can make children miserable. If they have a constantly stuffy nose, itchy eyes, and trouble breathing, it’s hard to focus on anything. Allergies often lead to poor sleep, which, as we all know, affects everything.
How do seasonal allergies start?
So, how does someone become allergic to a plant? There are a few steps. First, someone has to be exposed to an allergen. The allergen refers to the thing that causes allergies. Like pollen. Or ragweed. Or dustmites. (Food allergies are a separate topic).
Then, they have to be exposed again. And again. If we use pollen as an example, exposure means being around the pollen, breathing in air near those plants.
After a certain threshold of exposures, they start to show symptoms. For most kids, it takes a few seasons of exposure before they start to have the classic itchy nose, watery eyes, and cough. This means many kids who have allergies will not show many symptoms until they’re well into toddler or preschool years. It’s unusual for a baby under age 6 months to have seasonal allergies at all.
The “threshold” is different from one kid to the next. Genetics plays a role in who and when allergies develop. If someone’s parents have seasonal allergies, they are much more likely to suffer from seasonal allergies themselves.
(Babies are more likely to be allergic to indoor things like dust or mold because they reach that threshold earlier. The exposure is more constant. That being said, a newborn like the one at the beginning of this piece, has had very limited exposures; we should always look for other causes of a stuffy nose).
How do allergy symptoms happen?
There are two “phases” to allergy symptoms. I think it’s helpful to know about both, so that we know what to expect. It also helps us understand why someone may suffer so much.
The first phase happens almost immediately. Someone steps outside. The allergen touches the lining of the nose or eyes. There’s a reaction right away that leads to runny nose and congestion. Nerves are affected too, leading to an itchy feeling. This can also lead to reflexes like sneezing.
But then. There’s another phase that can last for the next 4-8 hours. The first reactions jumpstart another set of reactions that lead to more and longer-lasting symptoms. Usually, it’s mostly congestion. The point? Even after someone has left the place where they were exposed (gone inside, for example), they may still suffer for the next several hours.
Here’s the kicker. Once someone has reached a threshold for one allergen, their body is sort of “primed” for other allergens. So, it doesn’t take as much exposure or as many seasons to become allergic to other things. It’s miserable.
Although I’m focusing more on seasonal allergies today, I want to note that some people have environmental allergies more than just one or two seasons of the year.
What are treatments for seasonal allergies in kids?
If someone already has allergies, avoiding the trigger is the best treatment. Depending on the person, this may mean sleeping with windows closed and even wearing an N-95 mask and sunglasses outside (to limit allergens touching the eyes). It could mean showering whenever coming in from outdoors. This is not always practical with many seasonal allergies. I think of kids who have outdoor recess at school.
Before treating, it’s a good idea to meet with the child’s physician first to confirm the diagnosis. There’s a lot of overlap with cold viruses, especially in young children who attend school or daycare. Both colds and allergies can cause a clear runny nose. One difference? Kids with allergies are much more likely to be itchy, rubbing their nose or eyes a lot.
Treatment includes more than just avoidance.
If the diagnosis is confirmed, there are several treatment options, aside from just avoiding the trigger. Many are available without a prescription including anti-histamines that can be taken by mouth. Nasal sprays are an option too. There are also prescriptions for another class of allergy medications. Even with those treatments, some kids need even more relief. At this point, meeting with an allergist to discuss specific testing and “immunotherapy” is a great idea. Immunotherapy is a treatment that carefully “desensitizes” someone to an allergen. With specific doses given over time, it builds a tolerance. Eventually, someone can handle being around certain allergens much more than before. It truly changes lives. When we think of immunotherapy, allergy shots come to mind first, but now there are other options too. (One treatment dissolves under the tongue, for example).
Does honey help seasonal allergies?
This brings us to local honey. Many people say they find allergy relief by eating local raw honey. The theory is that the honey has some of the local pollen (allergens) in it already. And, by eating small amounts, this also desensitizes the body. It’s a theory similar to allergy shots. The problem is, in most studies, honey hasn’t been proven more effective than non-local pasteurized honey or a honey-flavored placebo.
In my opinion, it doesn’t mean local honey is useless. It does mean it’s hard to study.
And, taking another step back, local honey “treatment” probably doesn’t apply to many seasonal allergy sufferers. Let’s think about it a bit more.
If honey is to be effective, the following would need to be true:
- The person with allergies would need to be allergic to something found in the honey. (Many people are allergic to trees, weeds, or other plants that bees don’t visit).
- The honey would have to contain the “correct” amount of that allergen. Consistently. Bees don’t intentionally put pollen in their honey. It just happens sometimes. And, depending on where the beehive is, it may or may not be “contaminated” with other nearby plants.
- This means, the person would have to eat the “correct” amount of honey consistently and not be allergic to many other things in the environment. The honey itself would also need to be consistently “contaminated” with the appropriate precise blend.
Is this possible? Sure. Personally, I think this might be why some people say honey feels helpful, despite little research proving it so. (It may also be why one small 2013 study in Malaysia showed that local honey improved allergy symptoms). However, we can see why it’s also hard to study. Controlling the amount of allergen in the honey is difficult. And, even if the research were done well, how practical is it in real life? The average person cannot analyze their honey source the same way. This is all to say that honey is not officially recommended for treatment or prevention of seasonal allergies.
Summary
Seasonal allergy sufferers truly do suffer. In many kids, symptoms start at age 3 or 4. For some people, the symptoms can start later. There are effective treatments, often starting with some lifestyle changes and over-the-counter medications. However, with their precise testing and finely tuned treatments, an allergist can be a life-changer.
Maya Mahmood, D.O., F.A.A.P. is a board-certified pediatrician and mom. She is passionate about parents having evidence-based information to help their families be healthier.
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References
Skoner D. P. (2001). Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. The Journal of allergy and clinical immunology, 108(1 Suppl), S2–S8. https://doi.org/10.1067/mai.2001.115569
Asha’ari, Z. A., Ahmad, M. Z., Jihan, W. S., Che, C. M., & Leman, I. (2013). Ingestion of honey improves the symptoms of allergic rhinitis: evidence from a randomized placebo-controlled trial in the East coast of Peninsular Malaysia. Annals of Saudi medicine, 33(5), 469–475. https://doi.org/10.5144/0256-4947.2013.469
acaai.org American College of Allergy, Asthma, and Immunology
Rajan, T. V., Tennen, H., Lindquist, R. L., Cohen, L., & Clive, J. (2002). Effect of ingestion of honey on symptoms of rhinoconjunctivitis. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 88(2), 198–203. https://doi.org/10.1016/S1081-1206(10)61996-5
