Hay fever — known medically as allergic rhinitis — is one of the most common allergic conditions in children in the UK. It affects approximately one in five children and can have a significant impact on quality of life, sleep, concentration and school performance. Despite being widely regarded as a minor inconvenience, poorly controlled hay fever can be genuinely debilitating for children, particularly during exam season when pollen counts are at their highest.

This article explains what hay fever is, what causes it, how to recognise it in your child, and what treatment options are available — including when to seek specialist assessment at Belfast Children's Allergy Clinic.

What Is Hay Fever?

Hay fever is an allergic reaction to airborne allergens — most commonly pollen from grasses, trees and weeds. When a child with hay fever breathes in pollen, their immune system mistakenly identifies it as a threat and releases histamine and other chemicals. This triggers the familiar symptoms of sneezing, itchy eyes, a runny nose and nasal congestion.

Hay fever is a form of allergic rhinitis. When symptoms occur only during the pollen season (typically spring and summer), it is called seasonal allergic rhinitis. When symptoms persist year-round — triggered by house dust mite, pet dander or mould rather than pollen — it is called perennial allergic rhinitis. Many children have both.

Pollen Seasons in Northern Ireland

In Northern Ireland, the main pollen seasons are:

  • Tree pollen: February to May (birch, alder, hazel, oak)
  • Grass pollen: May to August (the most common hay fever trigger)
  • Weed pollen: June to September (nettle, dock, plantain)

Grass pollen is by far the most common cause of hay fever in children in Northern Ireland. Pollen counts tend to be highest on warm, dry, windy days and lowest after rain. The Met Office provides daily pollen forecasts which can help families plan outdoor activities.

Symptoms of Hay Fever in Children

The classic symptoms of hay fever in children include:

  • Frequent sneezing, particularly in the morning
  • Runny nose (clear, watery discharge)
  • Nasal congestion and blocked nose
  • Itchy, red, watery eyes (allergic conjunctivitis)
  • Itchy throat, palate or ears
  • Reduced sense of smell
  • Fatigue and poor sleep due to nasal congestion
  • Worsening of eczema or asthma symptoms during pollen season

In younger children, hay fever can be difficult to distinguish from recurrent colds. A useful clue is that hay fever symptoms are seasonal and consistent — they occur at the same time each year — whereas viral colds are accompanied by fever and resolve within 7–10 days.

How Is Hay Fever Diagnosed?

Hay fever is usually diagnosed on the basis of a detailed clinical history. Dr Anandarajan will ask about the pattern of symptoms, the time of year they occur, whether they are worse outdoors, and whether there is a family history of allergy. Allergy testing — skin prick testing or specific IgE blood tests — can confirm which pollens are responsible and help guide treatment decisions, particularly if symptoms are severe or not responding to standard treatment.

Skin prick testing for hay fever takes around 15–20 minutes and results are available at the same appointment. Testing can identify sensitivity to grass pollen, tree pollens (birch, alder, hazel, oak), weed pollens, house dust mite, cat and dog dander, and mould spores.

Treatment Options for Hay Fever in Children

Most children with hay fever can be managed effectively with a combination of allergen avoidance measures and medication. Treatment should be started two to four weeks before the pollen season begins for best effect.

Non-Sedating Antihistamines

Non-sedating antihistamines (cetirizine, loratadine, fexofenadine) are the first-line treatment for hay fever in children. They are effective for sneezing, runny nose and itchy eyes. They are available over the counter and are generally well tolerated. Cetirizine is licensed from age 2 and loratadine from age 2. Fexofenadine is licensed from age 6.

Intranasal Corticosteroid Sprays

For children with moderate to severe nasal symptoms, an intranasal corticosteroid spray (such as fluticasone or mometasone) is the most effective treatment. These sprays reduce nasal inflammation and are most effective when used regularly throughout the pollen season. They are safe for long-term use and do not cause the drowsiness associated with older antihistamines.

Eye Drops

Antihistamine eye drops (such as sodium cromoglicate or olopatadine) are effective for allergic conjunctivitis. They can be used alongside oral antihistamines and nasal sprays.

Allergen Immunotherapy

For children with severe hay fever that does not respond adequately to medication, allergen immunotherapy (desensitisation) may be appropriate. This involves gradually exposing the immune system to increasing doses of the allergen — either as injections (subcutaneous immunotherapy, SCIT) or as drops or tablets under the tongue (sublingual immunotherapy, SLIT). Immunotherapy can produce long-lasting improvement in symptoms and reduce the risk of developing asthma. Dr Anandarajan can advise on eligibility and arrange referral for immunotherapy where appropriate.

Allergen Avoidance Tips for Hay Fever

  • Check the pollen forecast and keep children indoors on high-pollen days
  • Keep windows and doors closed during peak pollen times (morning and evening)
  • Shower and change clothes after outdoor activities
  • Apply a thin layer of petroleum jelly (Vaseline) around the nostrils to trap pollen
  • Wear wraparound sunglasses outdoors
  • Avoid drying clothes outside during the pollen season
  • Vacuum regularly with a HEPA-filter vacuum cleaner

When Should I See a Specialist for My Child's Hay Fever?

You should consider seeking specialist assessment at Belfast Children's Allergy Clinic if:

  • Your child's hay fever is not adequately controlled by over-the-counter antihistamines and nasal sprays
  • Symptoms are significantly affecting sleep, school performance or quality of life
  • You are unsure which allergens are responsible
  • Your child also has eczema or asthma that worsens during pollen season
  • You want to discuss allergen immunotherapy
  • Your child has year-round nasal symptoms (perennial rhinitis)

No GP referral is required. Dr Anandarajan sees children aged 0–16 at Kingsbridge Private Hospital and Ulster Independent Clinic in Belfast. Same-week appointments are typically available.

Book an Appointment

To book a hay fever assessment for your child, call 028 9066 7878 or book online at kph.fyi/Book-MAnandarajan. Video and telephone consultations are also available via Top Doctors.

Read more about hay fever and allergic rhinitis in children on our conditions page.