How often have you heard “my allergies are really bad this year?” Children who suffer with seasonal allergies (or allergic rhinitis) can have a harder time concentrating in school, be more irritable, or be more tired. Symptoms are often more severe in the spring or fall. Children who have allergies to things like dust, mold, or pets which are often indoors, or who are exposed to second hand smoke, can experience allergy symptoms all year round. The symptoms include: sneezing, runny nose, nasal congestion, itchy eyes, or itchy nose. Sometimes symptoms are associated with a cough. In this case, you may want to have your child evaluated for asthma since about 40% of children with allergic rhinitis have asthma as well. It is unlikely that children under age 2 have developed seasonal allergies because it takes multiple exposures to allergens to develop a sensitivity.
The recommended treatment for allergies includes avoiding the things that trigger the symptoms and the use of medications. For more severe symptoms, referral to an allergy specialist for allergen immunotherapy may be needed.
Eliminating things that trigger allergies includes things like:
Staying indoors as much as possible
Keeping windows closed and using air conditioning to filter the air
Using saline nasal spray to wash out allergens in the nose after being outdoors
Keeping pets out of sleeping areas
Cleaning regularly by dusting, vacuuming (with HEPA filter) and cleaning bed sheets and pillow cases weekly
For mild symptoms, over the counter medications can be tried. To get the best effect, it is important to use these medications regularly (daily) during the allergy season which can last 8-12 weeks. The fall allergy season usually ends with the first frost.
Some over the counter medications called antihistamines you can try include: Claritin, Zyrtec, or Allegra which should be given at bedtime if given only once daily. These medications should not make your child sleepy like Benadryl. Benadryl can cause some side effects in young children such as agitation or decrease school performance in school age children because of sleepiness, so is not recommended for long term use.
Decongestants can have a number of side effects and are not usually recommended for use in young children. Decongestant nasal sprays such as Afrin should not be used longer than 3 days because there can be a rebound reaction of nasal congestion if it is stopped after longer use.
For watery, itchy eyes, over the counter eye drops called Zaditor can be used in children age 3 or older.
If your child’s symptoms do not improve with avoiding allergens or the regular use of over the counter medications, be sure to make an appointment to see us for an evaluation of the symptoms and recommendations for treatment that are not available over the counter. Research has shown that steroid nasal sprays can be very effective in controlling the symptoms of allergic rhinitis, but these are not available without a prescription. Any child with persistent or moderate to severe symptoms should also be evaluated by your doctor.
Julie Averbeck, RN, MS, CPNP