Hayfever (seasonal allergic rhinitis) is among the most common chronic conditions in school-age children and is significantly undertreated. Beyond the misery of sneezing and itchy eyes, research has shown that children with untreated hayfever perform measurably worse in GCSE exams — which typically fall during the grass pollen peak in June and July.
How Children Experience Hayfever Differently
Children with hayfever often present with classic physical signs that parents and teachers may not recognise: the “allergic salute” (persistent upward nose rub with the back of the hand), “allergic shiners” (dark under-eye circles from venous congestion, not sleep deprivation), and a horizontal nasal crease from repeated rubbing. Children commonly have co-existing allergic conditions — hayfever, asthma and eczema often cluster together (the “atopic march”), with hayfever increasing asthma exacerbation risk through the unified airway effect.
Age-Appropriate Treatment
From 1–2 years
Cetirizine oral solution (check individual product license — some are from 1 year, some from 2) and loratadine syrup from 2 years are the appropriate first-line antihistamines. Saline nasal drops (preservative-free) for symptomatic nasal congestion. Avoid sedating antihistamines (chlorphenamine) in young children — significant sedation and paradoxical excitation risks.
From 2–6 years
Cetirizine syrup 2.5mg (2–6 years) or loratadine syrup 2.5mg (2–5 years). Sodium cromoglicate eye drops from 2 years for ocular symptoms (Opticrom — safe mast cell stabiliser for prevention during the season).
From 6 years
Full adult antihistamine doses apply with age-adjusted dosing. Intranasal corticosteroid sprays are approved from 6 years (Pirinase Junior 27.5mcg fluticasone furoate, Beconase beclometasone 50mcg). These are the most effective treatment for persistent moderate-severe rhinitis — more effective than antihistamines alone for nasal symptoms — and are safe for prolonged seasonal use at standard doses.
Managing Hayfever Through Exam Season
GCSE and A-level exam season coincides with grass pollen peak (June–July). Preparation: ensure prescriptions are current and adequate supply is available. A daily non-sedating antihistamine + ICS nasal spray (started 2 weeks before expected season onset) provides maximum baseline control. Ensure the school is informed so understanding is given during high-pollen days. The headteacher/exams officer should be notified of the condition — some provisions (extra time, alternative arrangements) may apply for severely affected students.
Frequently Asked Questions About Hayfever in Children
At what age can children take antihistamines for hayfever?
Cetirizine oral solution is available from as young as 1 year in some formulations; loratadine syrup typically from 2 years; fexofenadine from 6 years. Always check the specific product label. First-generation (sedating) antihistamines like chlorphenamine should not be used in children under 2 and should be used with caution in young children generally.
Can hayfever cause poor sleep in children?
Yes — nasal congestion from hayfever is a significant cause of disturbed sleep, mouth breathing, snoring and night waking in children. Poor sleep amplifies daytime symptoms, concentration difficulties and behavioural problems. ICS nasal spray is particularly valuable for children with nighttime congestion, as it effectively treats congestion that antihistamines alone often don’t address.
Is allergy immunotherapy available for children?
Yes — sublingual immunotherapy (SLIT) is available from age 5 for grass pollen allergy and is NICE-approved for children with poorly controlled symptoms despite conventional treatment. It involves daily sublingual tablets or drops containing grass pollen extract for 3 years. It is the only disease-modifying treatment for allergic rhinitis, with lasting benefits after treatment ends. Referral via GP to NHS allergy clinic.
When should a child see a GP about hayfever?
See a GP if: symptoms are not adequately controlled by OTC treatment, hayfever is worsening asthma control, symptoms are present year-round (suggesting perennial allergy), or immunotherapy is being considered. A GP can prescribe prescription-strength nasal steroids and arrange allergy testing and referral.
Browse antihistamines and allergy nasal sprays at Huncoat Pharmacy. Related: Allergy Guide, Hayfever Season Preparation.
At Huncoat Pharmacy: Pharmacy First, Browse children’s hay fever remedies.