The Best Allergy Medicines and Treatments for Kids
Seasonal allergies happen when the body perceives certain outside elements as a threat, and the immune system releases antibodies and histamine in response. The main triggers are pollen from trees in the spring, grasses in the summer, and weeds in the fall—although mold can also trigger allergies throughout the year.
Allergy symptoms may include sneezing, runny nose with clear mucus, itchy and watery eyes, nasal congestion, sinus pressure, scratchy throat, and itchy nose and ears. Unlike the common cold, which lasts seven to 10 days, seasonal allergies may stick around for weeks or months at a time, says Fuad Baroody, M.D., director of pediatric otolaryngology at the University of Chicago Medical Center.
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Untreated allergy symptoms can negatively affect a kid's life. For example, congestion might lead to "fatigue, poor concentration in school, and learning problems because kids won't be sleeping well at night," says Todd Mahr, M.D., Director of Pediatric Allergy/Asthma/Immunology at Gunderson Lutheran Hospital in La Crosse, Wisconsin. He adds that constant nose-blowing and congestion may cause social tension, shyness, or teasing.
What's more, "because children's bones and teeth are still developing, chronic mouth breathing (due to allergy-causing congestion) can cause teeth to come in at an improper angle," says Dr. Mahr. "Kids who have allergies are also more likely to have ear infections and sinus infections." Allergies can also worsen asthma in kids who suffer from it.
Want to help your child feel better again? Keep reading to learn more about seasonal allergy treatments and medications, and talk to your child's doctor about trying them out.
Seasonal Allergy Medicines for Kids
To combat symptoms, most allergists recommend starting with the simplest over-the-counter treatment and adding more medications as needed. "We want to keep children on the lowest amount of medication possible to control symptoms so they have the least possible side effects," says Edith Schussler, M.D., a pediatric allergist at Weill Cornell Medicine, in New York City. Check out the best types of allergy medicines on the market today.
Antihistamines remain the most popular and least expensive line of defense against allergies. They don't prevent an allergic reaction, but they counter the effects of histamine (a substance released by the body to fight off the allergen). Most allergy drugs are formulated in doses for children 2 years and older with a doctor's approval. Although antihistamines can provide relief, they're often sedating—a side effect you may not want for your child, especially if they're in school. Conversely, they can cause hyperactivity in some kids.
Consider starting with a daily dose of an over-the-counter, second-generation antihistamine such as Zyrtec (cetirizine), Allegra (fexofenadine), or Claritin (loratadine) in a children's formulation. Unlike first-generation antihistamines such as Benadryl, these drugs were designed not to cross the blood-brain barrier, which means they are less likely to cause drowsiness or hyperactivity. If your child begins taking medication even before their symptoms kick in, their body may not produce the allergy-causing histamines at all.
An antihistamine should provide enough relief for your child to get through the day. For children with severe allergies that don't respond to over-the-counter medications, ask your doctor about prescription-strength antihistamines and sprays.
A number of prescription antihistamines now on the market control the effects of histamine without making kids sleepy or lethargic. They're also convenient: You need to give these formulas to your child only once a day, making them easier to deal with than over-the-counter antihistamines, which must sometimes be administered every four or six hours.
Steroid Nasal Sprays
Examples of steroid nasal sprays include Nasonex (mometasone; prescription only), Flonase (fluticasone), or Nasacort (triamcinolone acetonide). These daily-use sprays diminish swelling in the nasal passages and eyes. Flonase, for example, "reduces the allergic inflammation that contributes to nasal tissue swelling. It also helps reduce the production of watery mucus, which contributes to chronic runny nose and postnasal drip," says Dr. Baroody.
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Nasal sprays take a few days to kick in, and your child may not love the feeling of a spritz up their nose at first. But stick with it. A nasal spray can relieve the same symptoms that antihistamines do and also clear airways.
Cromolyn sodium, a nasal spray that until recently was prescription only but can now be bought over the counter in a children's formula, inhibits the release of histamine from special cells called mast cells. Each dose blocks a reaction for about four hours. Knowing in advance when allergies will strike can help: For NasalCrom to be fully effective, doctors often advise giving it to your child regularly for one to two weeks before allergy season. "It can also be helpful taken just before your child is exposed to an allergen on an as-needed basis," says Laurie Smith, M.D., who chairs the section on allergy and immunology at the American Academy of Pediatrics.
You can also use saline eye drops to wash away pollen. Or ask your child's doctor about antihistamine eye drops such as prescription Pataday or OTC Zaditor. "The drops can sting a little, but if you refrigerate them, it takes a bit of that away," says Jeffrey Demain, M.D., director of the Allergy, Asthma and Immunology Center of Alaska, in Anchorage. Antihistamine nasal sprays often help with eye symptoms as well.
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Why You Should Avoid Decongestant Sprays
Giving your child a decongestant nasal spray to relieve stuffiness is acceptable for short-term relief as long as you don't use it for more than a day or two. "If you use them longer than that, they can cause a rebound effect, in which the congestion becomes even worse," says Dr. Smith. Because seasonal allergies tend to last weeks or months, not days, Dr. Smith is cautious about recommending them at all.
Oral decongestants don't pose a rebound problem, but they also don't address sneezing and itching and can make some children hyperactive. Plus, the American Academy of Pediatrics (AAP) advises against using decongestants for young children.
Treating Symptoms with Allergy Shots
If you've tried pills, sprays, and rinses but your child continues to suffer, talk to their allergist about allergy shots (immunotherapy). This treatment exposes your child to increasing amounts of the allergen though shots. In the long run, it makes the body less reactive to triggers.
"They are still the cornerstone of long-term treatment," says Dr. Demain. "We have shots for almost every common allergen, and they also reduce the risk for developing new allergies and asthma." The only real drawback? Getting your kid on board with a plan involving needles. The treatment starts out with two shots a week for up to two to three months, then tapers down to once a week, then every other week, and finally monthly.
After about three years, the allergy may be gone for good. Dr. Schussler suggests allergy shots after a patient has tried everything else and is at least 7 or 8 years old. "Some kids will be completely cured, and some still need to take an antihistamine when pollen counts are very high, but pretty much all children feel much better," she says.
Although treatments are usually done through a series of shots in an allergist's office, the FDA has approved sublingual immunotherapy, or under-the-tongue drops, for dust mites, ragweed, and pasture grasses like timothy, according to the American College of Asthma, Allergy, and Immunology. (These tablets are kid-friendlier than shots.) "Research suggests that for patients with a limited number of allergic triggers, drops such as these are effective and safe enough to be given by parents at home," says Sakina Bajowala, M.D., an allergist in North Aurora, Illinois, and mom of two sons with seasonal allergies.