Allergy symptoms in children can range from mildly inconvenient to potentially life threatening. There are treatment options available both over the counter and through a prescription. Factors like the child’s response to the substance causing the allergic reaction, or allergen, can have an impact on the treatment course.

Allergy medicine for kids can help treat symptoms of an allergy. However, it is important to use this medication correctly since not all drugs labeled for kids are safe for them.

Allergy rates among children have increased over the last several decades. Currently, 10–30% of people in the United States have allergic rhinitis, the most common type of allergy. Allergic rhinitis can cause congestion, cough, and other cold-like symptoms in response to inhaled allergens, such as pollen or dander.

Food allergies, such as ones to peanuts and shellfish, can be more serious. It can cause anaphylaxis, which is a life threatening allergic reaction. About 1 in 25 school-aged children have a food allergy.

The right allergy treatment depends on the type of allergy, the severity of the reaction, the age of the child, and other factors. Parents should talk to a pediatrician or allergist before treating children’s allergies.

Read on to learn more about the allergy medicine that can be given to children, including the best time to take them and some alternatives.

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Examples of different allergy medicines that are suitable for children can include:

Antihistamines

An allergy is a type of immune system overreaction to a harmless compound. During an allergic reaction, the immune system releases a group of chemicals called histamines.

Antihistamines reduce the activity of histamines, and in doing so, reduce allergy symptoms. However, they do not cure the underlying allergy.

Some examples of antihistamines include:

Many antihistamines are available over the counter (OTC). One example is azelastine (nasal spray), which recently received approval from the Food and Drug Administration (FDA) for OTC use. Other antihistamines may require a prescription.

Some people experience fatigue and dizziness with certain antihistamines, so monitor a child closely for these symptoms. The child should avoid potentially dangerous activities while taking antihistamines, such as cycling or swimming.

The right antihistamine dose that a child can take depends on the antihistamine. In the U.S., for medicines containing antihistamines or decongestants, manufacturers must label containers to say they are not suitable for children under 4 years of age.

Caregivers should talk with a pediatrician before giving sedating antihistamines, such as diphenhydramine, or decongestants (see below) to children.

Decongestants

Decongestants, unlike antihistamines, do not target or affect the allergic response. They may only help with nasal congestion symptoms. Decongestants work by narrowing the blood vessels in the nose, which can help reduce swelling and inflammation. In doing so, people with allergies find it easier to breathe.

People should note that decongestants do not treat non-nasal allergy symptoms, such as, rashes or anaphylaxis.

The dosage depends on the decongestant. Check the label, ensure the drug is safe for children, and talk with a pediatrician before trying new medication.

Some examples of decongestants include:

  • xylometazoline (nasal spray)
  • pseudoephedrine
  • phenylephrine

The FDA advises that decongestants are dangerous and potentially life threatening, in children under 2 years of age.

Cromolyn (nasal spray and eye drops)

Oral cromolyn is not an allergy treatment. However, people may use nasal cromolyn or eye drops containing cromolyn to treat some allergic symptoms.

The nasal form of the drug is available over the counter. People can use it to treat allergic rhinitis. The drug works by reducing the levels of histamine in the body and inflammation associated with an allergic response.

Nasal cromolyn seems to have minimal side effects and works effectively when a person uses it before symptoms become severe. There is not enough data to support its use in children under the age of 2, so caregivers of babies and toddlers should contact a doctor.

Eye drops containing cromolyn can be an effective treatment for allergic conjunctivitis.

Corticosteroids

Corticosteroids are a group of drugs that prevent the immune system from overreacting to harmless chemicals.

Nasal corticosteroids can be an effective treatment option for allergic rhinitis.

Most corticosteroids, such as prednisone, require a prescription. However, hydrocortisone cream is safe to use short-term on allergic reactions on the skin if a doctor says doing so is safe.

Because prescription corticosteroids may suppress the immune system, they can cause side effects, such as infections. Before corticosteroid therapy can commence, a doctor may complete a thorough history and physical examination to ensure that using the drug will not worsen any preexisting conditions.

Epinephrine

The body naturally releases the hormone epinephrine during times of sudden, intense stress. It can increase a person’s blood pressure and heart rate, and makes glucose more available for the body to use as energy.

Epinephrine comes in an auto-injection form called an EpiPen. An EpiPen device can help reverse the life threatening symptoms of anaphylaxis. Anaphylaxis can occur when a person has a severe allergy to certain foods.

A person needs a prescription to get an EpiPen. A doctor will usually train the child and caregiver on how to use the auto-injector. Emergency responders may also use an EpiPen without a prescription.

Epinephrine cannot prevent allergic reactions, and it is not a medication for daily or long-term use.

Immunotherapy

Immunotherapy does not treat allergic reactions. Instead, it aims to prevent them by gradually giving a person progressively larger doses of the substance to which they are allergic. A doctor guides the process. This is not something parents should do at home.

Allergy shots are one of the most common types of immunotherapy. Immunotherapy can also come in pill form, or as drops, depending on the allergen.

Learn more about how immunotherapy works here.

The time to take allergy medications depends on the allergen and the medication. In general, follow these guidelines:

  • Symptomatic medications: These are drugs that treat the symptoms of allergies, but do not prevent allergic reactions. They include antihistamines and decongestants. Take these when symptoms appear, or immediately before exposure to an allergen.
  • Allergy suppression: These are drugs that prevent the immune system from triggering an allergic reaction. They include corticosteroids, immunotherapy, and cromolyn. Take them according to a doctor’s recommendation.
  • Emergency medication: Epinephrine is an emergency treatment for severe allergies. Only use it in an emergency. It is important to avoid allergens even when a person has access to epinephrine because anaphylaxis is unpredictable and potentially deadly.

Except for life threatening allergies, a person is not obliged to take allergy medicine. Some alternatives to allergy medications include:

  • Avoiding allergens: This is a safe strategy for many different types of allergies. For example, people who are allergic to pollen may choose to stay indoors during days when the pollen count is exceptionally high. People with severe allergies to things, such as peanuts or bee stings, need to develop a plan to avoid exposure to the allergen.
  • Air filtration: Air filter products may help reduce levels of airborne allergens indoors. They can provide some relief to people with certain allergies.
  • Masks: Masks may help people avoid airborne allergens when other avoidance strategies do not work. For example, a person might wear a mask outside during hay fever season.

Certain allergies can be life threatening, so it is important to have an emergency treatment plan. Alternative and holistic treatments are not viable options for preventing severe reactions and death.

Parents or guardians should contact a doctor if they think their child has an allergy. The right diagnosis and treatment plan can help alleviate symptoms. Also, call a doctor if:

  • a child’s allergies get worse or their treatment stops working
  • a child develops new allergy symptoms
  • a child experiences any side effects to their allergy medicine

If a child has trouble breathing or is exposed to an allergen that previously triggered anaphylaxis, treat with an EpiPen, if the child has one, and call 911 immediately.

Allergy symptoms in children can range from mildly inconvenient to potentially life threatening.

It is important for parents to understand their child’s allergies, the specific symptoms they cause, and whether the child is at risk of anaphylaxis.

Medication for treating one type of allergic reaction, such as rhinitis, may not be useful in treating others, such as, rashes. People should consider that while allergy medications can offer significant relief, no medication is without side effects.

Talking with a doctor before treating allergies might be helpful, especially if the symptoms are new or getting worse. A medical provider can advise on choosing the right allergy medication for a person and whether taking alternative treatments is suitable.