Seasonal Allergy Guide

Seasonal Allergy Survival Guide

Child and Adolescent Healthcare

This is a general guide to help you manage seasonal allergy symptoms with your children. Seasonal allergies are most commonly caused by pollen and mold spores released as the weather gets warmer. In the fall other spores and pollen are released that can cause the same type of symptoms.

General recommendations would be to wash off the face, hands and even change clothing, if possible, after your child comes indoors. Just as the pollen collects on cars and windows, it will land on your child as well. Whenever your child touches his/her hair, skin, clothing and then rubs his or her eyes or nose, your child can cause continuous exposure to the pollen even when indoors. Wearing a hat to cover hair and removing it when he/she comes indoors can also help. Keep your children off of their beds and furniture in the home after coming in from outdoors until they have changed his/her clothing to keep pollen from those surfaces as well.

Keeping windows closed at night can be helpful as well. Many pollens and mold spores are released into the air in the very early morning hours even before sunrise.

The following may be helpful tips to help manage seasonal allergy symptoms.

Intermittent symptoms (if your child has sporadic symptoms—only has sneezing or runny nose with some exposures like a freshly mowed lawn, etc.) might only need a dose of Benadryl (diphenhydramine) at the times that he or she is having symptoms. This is an antihistamine that works fairly quickly but only lasts about 4 hours. Most children do just fine with this medication but some kids will get a bit tired or sleepy. A small percentage of children can actually get a bit of an energy boost for those hours.

Mainly Eye symptoms: Over the counter antihistamine eye drops work quite well and can be used as needed on days that your child has symptoms. Some examples of these eye drops are:

-Zaditor

-Visine Allergy

-Alaway

-Opcon A

Most major pharmacy chains have their own store brand as well.

Children under 3 may not do as well with an eye drop and some are not formulated for very young children. Children younger than 3 may benefit more from a long-acting oral antihistamine. (see below)

Mainly nasal symptoms (itching, runny nose, congestion) can be controlled with a long-acting oral antihistamine or a nasal spray. Children under 3 may not be able to use or tolerate many nasal sprays. Check with our office for recommendations if the oral antihistamine is not giving your child enough relief.

It should be noted that nasal sprays DO NOT give immediate relief so your child may need to use both a nasal spray and an oral antihistamine for the first 5-7 days while the nasal spray is beginning to work on the nasal passages.

Medicated nasal sprays should always be used in conjunction with a saline nasal spray to rinse the nasal passages anytime your child has been outside or before using the medicated nasal spray to clear out the nose of pollen and mucus. Saline nasal rinses can be used several times a day.

Nasal Sprays available over the counter include:

-Fluticasone proprionate(Flonase)”Children’s Flonase available as well as sensimist)

-Budesonide (Rhinocort) “Children’s Rhinocort” available **Fragrance free option**

-Mometasone (Nasonex)

-Triamcinolone (Nasocort) **AGE 2 and up**

Major pharmacy generic versions are also available and more affordable. They are medically equivalent to these name brands.

 

These should be given as 1 spray to each nostril once daily. Older children and teens may benefit from 2 sprays once a day for the first week and then decrease to 1 spray daily. 

There are other prescription nasal sprays that are similar to the over the counter sprays listed above. These include Qnasl, Veramyst and Beconase among others but they work very similarly to the over the counter medications and are generally not covered by insurance carriers.

Multiple symptoms (itchy eyes, watery eyes, nasal congestion, runny nose, sneezing, itching) will likely require using multiple remedies.

In addition to eye drops and nasal spray, a long acting antihistamine can be used.

Long acting antihistamines include:

Loratadine (Claritin or Alavert) 5mg children under 40lbs, 10mg above 40lbs (liquid and dissolve tabs are available in both dosages)ONCE A DAY

Cetirizine (Zyrtec) 5mg daily for children under 6, 10mg for children over 6 (liquid and tablet available) ONCE A DAY

Fexofenadine (Allegra) liquid for age 2 and up, liquid and dissolve tab for age 6 and up. Follow directions for once or twice a day dosing depending on the type you purchase.

Step-Wise Approach to managing allergies

-Be consistent with all of the prevention measures listed above

-If there is one main symptom, choose the right fit (for eye itching, use eyedrops, for nasal congestion and itching, use nasal spray)

-If there are multiple symptoms (eye, nose, itching, running nose, sneezing, etc)

1. First, start with a long-acting antihistamine.

2. Next, add eye drops or nasal spray or both

3. Next, add in another long acting antihistamine. Generally using loratadine in the morning (less likely to cause sleepiness) and then another in the evening. ***For children under 4 please talk with a physician about using more than one antihistamine.