Children are magnets for colds. But when the sniffles and sneezing won’t go away for weeks, the culprit may be allergies.
Long-lasting sneezing, with a stuffy or runny nose, may signal the presence of allergic rhinitis—the collection of symptoms that affect the nose when you have an allergic reaction to something you breathe in and that lands on the lining inside the nose.
Allergies may be seasonal or can strike year-round (perennial). In most parts of the United States, plant pollens are often the cause of seasonal allergic rhinitis—more commonly called hay fever. Indoor substances, such as mold, dust mites, and pet dander, may cause the perennial kind.
Up to 40 percent of children suffer from allergic rhinitis. And children are more likely to develop allergies if one or both parents have allergies.
The U.S. Food and Drug Administration (FDA) regulates over-the-counter (OTC) and prescription medicines that offer allergy relief as well as allergen extracts used to diagnose and treat allergies. Take care to read and follow the directions provided when giving any medicine to children, including these products.
Immune System Reaction
An allergy is the body’s reaction to a specific substance, or allergen. Our immune system responds to the invading allergen by releasing histamine and other chemicals that typically trigger symptoms in the nose, lungs, throat, sinuses, ears, eyes, skin, or stomach lining.
In some children, allergies can also trigger symptoms of asthma—a disease that causes wheezing or difficulty breathing. If a child has allergies and asthma, “not controlling the allergies can make asthma worse,” says Anthony Durmowicz, M.D., a pediatric pulmonary doctor at the FDA.
Avoid Pollen, Mold and Other Allergy Triggers
If your child has seasonal allergies, pay attention to pollen counts and try to keep your child inside when the levels are high.
- In the late summer and early fall, during ragweed pollen season, pollen levels are highest in the morning.
- In the spring and summer, during the grass pollen season, pollen levels are highest in the evening.
- Some molds, another allergy trigger, may also be seasonal. For example, leaf mold is more common in the fall.
- Sunny, windy days can be especially troublesome for pollen allergy sufferers.
It may also help to keep windows closed in your house and car and run the air conditioner.
Allergy Medicines for Children
For most children, symptoms may be controlled by avoiding the allergen, if known, and using OTC medicines. But if a child’s symptoms are persistent and not relieved by OTC medicines, see a health care professional.
Although some allergy medicines are approved for use in children as young as 6 months, the FDA cautions that simply because a product’s box says that it is intended for children does not mean it is intended for children of all ages. Always read the label to make sure the product is right for your child’s age.
When your child is taking more than one medication, read the label to be sure that the active ingredients aren’t the same. Although the big print may say the product is to treat a certain symptom, different products may have the same medicine (active ingredient). It might seem that you are buying different products to treat different symptoms, but in fact the same medicine could be in all the products. The result: You might accidently be giving too much of one type of medicine to your child.
Children are more sensitive than adults to many drugs. For example, some antihistamines can have adverse effects at lower doses on young patients, causing excitability or excessive drowsiness.
Allergy Shots and Children
Jay E. Slater, M.D., a pediatric allergist at the FDA, says that children who don’t respond to either OTC or prescription medications, or who suffer from frequent complications of allergic rhinitis, may be candidates for allergen immunotherapy—commonly known as allergy shots.
After allergy testing, typically by skin testing to detect what allergens your child may react to, a health care professional injects the child with “extracts”—small amounts of the allergens that trigger a reaction. The doses are gradually increased so that the body builds up immunity to these allergens. Allergen extracts are manufactured from natural substances, such as pollens, insect venoms, animal hair, and foods. More than 1,200 extracts are licensed by the FDA.
In 2014, the FDA approved three new immunotherapy products that are taken under the tongue for treatment of hay fever caused by certain pollens, two of them for use in children. All of them are intended for daily use, before and during the pollen season. They are not meant for immediate symptom relief. Although they are intended for at-home use, these are prescription medications, and first doses are taken in the presence of a health care provider. The products are Oralair, Grastek, and Ragwitek (which is approved for use in adults only).
In 2017, the FDA approved Odactra, the first immunotherapy product administered under the tongue for treatment of house dust mite induced allergic rhinitis (nasal inflammation) with or without conjunctivitis (eye inflammation). Odactra is approved for use only in adults.
“Allergy shots are never appropriate for food allergies,” adds Slater, “but it’s common to use extracts to test for food allergies so the child can avoid those foods.”
“In the last 20 years, there has been a remarkable transformation in allergy treatments,” says Slater. “Kids used to be miserable for months out of the year, and drugs made them incredibly sleepy. But today’s products offer proven approaches for relief of seasonal allergy symptoms.”