Allergic rhinitis control in infants

Overview

Allergic rhinitis in infants is a condition where the inside of the nose becomes inflamed (swollen and irritated) because of an allergy. It is often called hay fever, but it can happen at any time of year. In babies, it can make them stuffy, sneezy, and uncomfortable.

Yes, allergic rhinitis is common, though it is less common in very young infants. It often appears after the first year of life as babies are exposed to more allergens.

It can affect any infant, but it is more likely if the baby has a family history of allergies, asthma, or eczema.

Symptoms

Common symptoms

• Frequent sneezing, especially in the morning
• Runny or stuffy nose with clear mucus
• Itchy nose, eyes, or throat (baby may rub their face or eyes)
• Watery eyes
• Coughing, especially at night

Symptoms in children

• Same as common symptoms, but older children may also have dark circles under their eyes (allergic shiners) and snore.
• Children might also push the tip of their nose up with their hand (called an allergic salute).

Symptoms in older adults

• Not applicable to this article (focus is infants).

Causes

Main causes

• Pollen from trees, grasses, and weeds (seasonal)
• House dust mites (tiny bugs that live in dust)
• Pet dander (dead skin flakes from furry animals like cats and dogs)
• Mold spores (from damp places)
• Cockroach droppings

Risk factors

• Family history of allergies, asthma, or eczema
• Being born by caesarean section (may slightly increase risk)
• Exposure to tobacco smoke or pollution at home

When to see a doctor

See a doctor urgently if:

• If your baby has trouble breathing or feeding because of nasal congestion
• If symptoms do not improve with simple measures like saline drops

Book a routine appointment if:

• If your baby has persistent sneezing, runny nose, or itchy eyes that last more than a few weeks
• If you suspect allergies are interfering with sleep or growth

Diagnosis

A doctor will ask about your baby’s symptoms, check their nose and eyes, and ask about your family’s allergy history. In infants, diagnosis is usually based on symptoms and physical exam. Allergy testing (like skin prick tests or blood tests) is sometimes done, but it is not always needed in the first year.

Tests that may be done

• Skin prick test – a tiny amount of an allergen is placed on the skin, and the doctor looks for a small raised spot
• Blood test (specific IgE) – measures the level of allergy antibodies to specific allergens

What to expect at your appointment

The doctor may ask you to keep a diary of when symptoms happen and what your baby is exposed to. They might recommend trying to avoid possible triggers first. If tests are needed, they are safe and quick, but results may take a few days. Your doctor will explain everything and answer any questions.

Treatment

Treatment for allergic rhinitis in infants focuses on avoiding triggers and using safe, non-medication methods first. If those are not enough, a doctor may suggest certain medications that are appropriate for infants. Never give any allergy medicine to a baby without a doctor’s advice.

Self-care at home

• Keep windows closed during high pollen seasons and use a saline spray or drops to keep the nose moist
• Wash your baby’s face and hands after being outdoors to remove pollen
• Use a vacuum with a HEPA filter and wash bedding in hot water weekly to reduce dust mites
• Keep pets out of the baby’s bedroom
• Use a cool-mist humidifier in the nursery to soothe dry nasal passages

Medical treatments

If self-care is not enough, a doctor may prescribe a non-sedating antihistamine in liquid form for infants over a certain age, or a nasal corticosteroid spray (an anti-inflammatory spray) to reduce swelling inside the nose. These are used only under medical supervision. Allergy shots (immunotherapy) are usually not given to very young children.

When is surgery considered?

Surgery is not used for allergic rhinitis in infants. It is only considered for older children with severe, uncontrolled symptoms, and even then it is rare.

Living with this condition

Living with allergic rhinitis in an infant means paying attention to their environment. You may need to adjust your daily routines, like checking pollen counts before going out. With careful management, most babies can be comfortable and happy.

Lifestyle tips

• Keep the home as dust-free as possible – use allergen-proof covers for mattresses and pillows
• Avoid smoking near the baby or in the house
• Wash soft toys and bedding in hot water (at least 60°C) to kill dust mites
• Use air conditioning or an air purifier with a HEPA filter if possible

Diet and exercise

Breastfeeding may help lower the risk of allergies. For babies who are on solid foods, there is no evidence that avoiding specific foods helps with allergic rhinitis unless there is a separate food allergy. Gentle exercise like tummy time is fine – it does not worsen symptoms.

Mental health and emotional wellbeing

Caring for a baby with allergies can be stressful and tiring. You may worry about your baby’s discomfort or lack of sleep. It is important to take care of your own mental health too – ask for help from family or friends, and talk to your healthcare provider if you feel overwhelmed.

Prevention

It is not always possible to prevent allergic rhinitis, especially if there is a strong family history. However, reducing exposure to known allergens early on may help delay or lessen symptoms. Breastfeeding for at least 4–6 months may lower the risk of allergies.

Vaccines

There are no vaccines to prevent allergic rhinitis. Flu jabs are recommended for infants from 6 months old to protect against influenza, but that is a different illness.

Complications

If left untreated

• Chronic nasal congestion can lead to sinus infections (sinusitis)
• Middle ear infections (otitis media) – because swelling can block the tubes that drain the ears
• Poor sleep and feeding difficulties can affect growth and development
• Increased risk of developing asthma or eczema

Long-term outlook

With proper management, most infants with allergic rhinitis do very well. Symptoms often become milder as the child grows older. You can help your baby feel comfortable by working with your healthcare provider to find the best approach. There is every reason to be hopeful.

Find support

International organisations

• Allergy UK ↗

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