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Allergy Tips

Allergy Season Is Back!

“Seasonal allergies”, “hay fever”, and “allergic rhinitis” are all names describing the same springtime phenomenon. With the return of warmer temperatures, beautiful trees, and flowers, come the rising tree pollen levels and the return of allergy symptoms.

These symptoms can include:

-           Clear, watery nasal discharge

-           Itchy, runny, or stuffy nose

-           Nasal congestion

-           Itchy, red, or watery eyes

-           Sneezing or coughing

-           Clearing the throat, sore throat, or post nasal drip

-           Worsening eczema (dry skin) or asthma (cough/wheeze/shortness of breath)

-           Headache or sinus pressure

Allergy symptoms occur in response to a particular allergen (for example, tree pollen). Cold symptoms may be similar but usually are shorter in duration (1-2 weeks) and may be accompanied by fever. In contrast, allergy symptoms can last weeks to months depending on the length of the allergen exposure. Other causes of allergy symptoms include:

-           Grass pollen (summer)

-           Weed pollen (fall)

-           Molds (variable seasons)

-           Dust mites (year round – indoor)

-           Animal dander (variable)

 How can I help my child feel better?

If your child is experiencing seasonal allergies, there are steps to take to decrease his/her symptoms. The first step is to try to decrease exposure to the allergen – for example, tree pollen in the spring.

Some possible environmental control strategies include:

-           Keep the windows up in the car.

-           Use air conditioning and keep windows closed at home during high pollen days. There are many websites and apps that are available to follow pollen counts in your area. For example:

http://www.aaaai.org/global/nab-pollen-counts/northeast-region

-           After being outside, wash your child’s hands and face, change clothes, or bathe to decrease the pollen on your skin/hair.  If your child does not wash his/her hair every night, consider covering the hair at night.

-           If you have pets that go outside, wipe their fur with a damp cloth when they return inside to minimize pollen.

-           Check air conditioning filters regularly and consider filters designed to remove allergens.

If environmental control measures alone do not work then there are many over the counter medications that are available for children. These medications are used on an as needed basis. If your child has symptoms every spring, then the medications should be started BEFORE the onset of spring allergy season (generally March) and continued until after the end of the allergy season (generally June).

If your child is under 2 years of age, please consult with your primary care provider for specific recommendations for medication. Oral decongestants and nasal decongestants are not recommended on a regular basis for young children but sometimes are indicated for older children. Please consult with your primary care provider.

-           Nasal irrigation: There are commercially available saline washes for older children that can tolerate a nasal rinse.

-           Oral antihistamines:  These are all available over the counter in in liquid and tablet form.  Some may cause drowsiness. These are helpful for multiple allergy symptoms.  Some of the more commonly used include:

Medication

Products Available

    Age

                     Dosage

Loratadine

(Claritin and other brand names)

- Liquid: 5mg/5ml

- Chewable tablet: 5mg

- Tablet: 10mg

2-5 years

5mg once per day

(5ml liquid OR 1 chewable tablet)

6 years +

10mg once per day

(10ml liquid OR 2 chewable tablets OR 1 tablet)

Cetirizine

(Zyrtec and other brand names)

- Liquid: 1mg/1ml

- Chewable tablet: 5mg

- Tablet: 10mg

6mo - 2 years

2.5mg once per day

(2.5ml liquid)

2-5 years

5mg once per day

(5ml liquid OR 1 chewable tablet)

6 years +

10mg once per day

(10ml liquid OR 2 chewable tablets OR 1 tablet)

Fexofenadine

(Allegra and other brand names)

- Liquid: 30mg/5ml

- ODT Tablet: 30mg or 60mg

6mo - 2 years

15mg twice per day

(2.5ml liquid twice per day)

2-11 years

30mg twice per day

(5ml liquid OR 1 30mg ODT tablet twice per day)

11 years +

60mg twice per day

(10 ml liquid OR 1 60mg ODT tablet twice per day)

Diphenhydramine

(Benadryl and other brand names)

- Liquid: 12.5mg/5ml

- Tablet: 25mg

- Chewable tablet: 12.5mg

2-6 years

6.25mg every 4-6 hours (2.5ml liquid every 4-6 hours)

6-12 years

12.5mg-25mg every 4-6 hours

(5-10ml liquid OR 1-2 chewable tablets OR 1 tablet every 4-6 hours)

12 years +

25mg-50mg every 4-6 hours

(10-20ml liquid OR 2-4 chewable tablets OR 2 tablets every 4-6 hours)

-           Steroid nasal sprays: These medications are especially helpful for itchy, stuffy, runny nose or post nasal drip.

Medication

    Age

                     Dosage

Fluticasone Proprionate (Flonase)

4-11 years

1 spray to each nostril once per day

12 years +

1-2 sprays to each nostril once per day

Fluticasone Furoate (Veramyst)

2-11 years

1 spray to each nostril once per day

12 years +

2 sprays to each nostril once per day

Mometasone (Nasonex)

2-11 years

1 spray to each nostril once per day

12 years +

2 sprays to each nostril once per day

  -           Eye drops : These medications are specifically helpful for itchy, red or runny eyes.

Medication

    Age

                     Dosage

Ketotifen 0.025% (Alaway, Zaditor, and other generics)

3 years +

1 drop to each eye every 8-12 hours

Olopatadine 0.1% (Patanol)

PRESCRIPTION REQUIRED

2 years +

1 drop to each eye twice per day

Olopatadine 0.2% (Pataday)

PRESCRIPTION REQUIRED

2 years +

1 drop to each eye once per day

Next steps?

Please feel free to schedule a visit with your primary care provider if you have any questions about your child’s allergies. Allergy testing and referral to an allergist are not usually necessary, but may be indicated for more severe, chronic allergies.

Here are some additional links for allergy information:

https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/pages/allergy-tips.aspx

https://www.healthychildren.org/English/health-issues/conditions/allergies-asthma/Pages/Seasonal-Allergies-in-Children.aspx

https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Allergic-Rhinitis.aspx

https://www.healthychildren.org/English/health-issues/conditions/allergies-asthma/Pages/Allergy-Medicines.aspx

http://www.aaaai.org/global/nab-pollen-counts/northeast-region