Tea-Time Talk: Spring Allergies (What I’m Seeing This Week)
This week, I put up a question box about allergies—and noticed something interesting.
Most of the questions were actually the same.
That’s usually a sign that something feels confusing or unclear, especially this time of year when symptoms overlap and linger. So I wanted to sit down and walk through the most common patterns I’m seeing right now, and how I think through them in clinic.
1. “I’m not sure if this is allergies or a cold”
This is one of the most common questions I get. And the truth is—they can look very similar at first. But when you slow down and look at the pattern, they usually separate pretty clearly.
Allergies tend to look like:
clear runny nose
sneezing
itchy eyes
no fever
symptoms that linger for weeks
Whereas viral illnesses tend to look like:
thicker mucus
fatigue or low energy
sometimes fever
and they improve over time (usually within 7–10 days)
From a physiology standpoint, this makes sense. Allergies are driven by histamine release—so symptoms feel itchy and reactive.
Viruses trigger an inflammatory immune response—so kids feel sick and run down. It’s a subtle distinction, but once you see it, it becomes much easier to recognize.
2. “Can babies or toddlers have seasonal allergies?”
Usually not in the first year of life.
Seasonal allergies require repeated exposure over time for the immune system to recognize and respond to an allergen. That’s why they’re more commonly seen after age 2.
So when I see a 6–12 month old with a runny nose, I’m much more likely to think about:
viral illness
environmental irritation - essential oils, candles, dust, etc.
or just normal variation
rather than true seasonal allergies.
3. “What should I be doing at home first?”
Most of the time, I start here.
Before medications, there are a few simple shifts that can make a meaningful difference—especially during peak pollen seasons.
At home, this looks like:
washing hands and face after being outside
changing clothes when coming in
keeping windows closed during high pollen days
Nothing complicated—but done consistently, these small steps reduce ongoing exposure.
On the farm, this has been especially important for us lately. The boys are outside constantly this time of year, which I love—but it also means we’re a little more intentional about how we transition back inside.
4. “When do I start medication—and what actually works?”
If symptoms are persistent or affecting sleep, comfort, or daily life, that’s when I start to layer in medication.
One thing I wish more parents knew:
Nasal steroid sprays are first-line for persistent allergic rhinitis symptoms (not oral antihistamines.) This is because they treat inflammation directly at the level of the nasal passages—where allergic reactions are happening. We typically start with Flonase for kids over 2 years old.
Eye drops like ketotifen can be very helpful for eye symptoms.
Oral antihistamines (like children’s cetirizine) can absolutely help in addition to the nasal spray and eye drops, especially with itching and sneezing.
And consistency matters. These medications work best when used regularly during a season —not just intermittently.
5. “We’ve tried everything—nothing is working”
This is usually the moment where I pause and reassess.
A few things I think through:
Are we using the right medication for these symptoms?
Are we using it consistently?
Is this definitely allergies—or could this be something else?
Sometimes it’s not about adding more—it’s about stepping back and refining the plan. If we’ve examined other possibilities, we will often seek help from a pediatric allergist to give more input, do more testing, or offer different options.
6. “What about eyes, dark circles, dryness, or nosebleeds?”
These come up all the time. Allergies don’t just affect the nose—they affect the entire upper airway system.
Inflammation in the nasal passages can lead to:
congestion
impaired drainage around the eyes
puffiness or “allergic shiners”
Frequent wiping, dryness, and irritation can also lead to:
small nosebleeds
dry or bloody mucus
In these cases, simple supportive care can help:
a saline spray like Ayr Saline Gel is great — it offers moisture as well as gentle saline
gentle moisture - you can use a little moisturizer like Vaseline around the nostrils
minimizing irritation - using wipes like Boogie Wipes instead of tissues can be gentler on the skin
And Just Remember…
Most of the time, caring for kids with allergies isn’t about doing everything.
It’s about:
understanding what you’re seeing
knowing what actually helps
and doing a few simple things consistently
If you’re in the thick of this right now, you’re not alone. This has come up so many times this week—and it’s something I think through often, both in clinic and at home. You’ll get through it, one step at a time. Send me a message on Instagram. I read them, and they often shape what I write next.
Sending you a big hug,
Anjuli
Disclaimer: This blog post is for informational purposes only and should not replace the specific instructions provided by your child's surgeon or healthcare provider. Always follow the post-operative care instructions given by your medical team.