Environmental allergies are very common and can develop any time during childhood.

Spring allergies (April/May) are caused by tree pollen released this time of year in the Northeast US.  Many children will suffer from annoying allergy symptoms in the spring!

Here are a few tips for managing your children’s allergy symptoms…

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What causes allergies?  Try to explain what causes allergies so your children can better understand their bodies and science!

An allergy is when the body’s immune system – which is supposed to fight infections like viruses and bacteria – mistakenly thinks that something that is not a germ needs to be fought.  In these moments, the body overreacts.  Some people overreact to peanuts and have a peanut allergy.  In the spring time it is tree pollen that causes some people’s immune system to overreact and cause seasonal allergies.

Symptoms of allergies: You can use these “big science words” with even the youngest children because this will expand their vocabulary!

• Rhinitis: sneezing, itchy, clear runny nose, post-nasal drip
• Conjunctivitis: itchy, watery, red eyes. Mucous discharge (yellow boogies) are also possible.
• If a child has eczema – it may cause worsening rash with increasing dryness, itching, and red skin
• If a child has asthma – it may cause increasing wheezing and cough, especially after or while playing outdoors

Managing allergy symptoms:

1.Avoidance and removal!  Help your children take responsibility to keep pollen away from their body or try to remove it as fast as possible!

• Wear hats with brims (baseball caps) and/or sunglasses to protect the eyes and face from pollen.
• Try to avoid too much outdoor time on high pollen days. (You can monitor pollen counts in your region – there are many useful pollen tracking smartphone apps).
• Keep windows at home closed to prevent pollen from blowing into your house.
• Have your children wash their face and hands, change clothes, or shower when they come inside from outdoors.

2. Medications for allergies:

• Many medications for allergies are now over-the-counter.
• You can use nasal sprays, eye drops, and/or oral medications for allergy symptoms.  Some children need all 3 types – nasal spray, eye drops, and oral medications.

Nasal sprays:  Spray the mist once in the air before using on your child so they know what to expect.

• Saline nasal sprays help to remove pollen and decrease symptoms.  Nasal saline rinses are more complex to use than sprays and require a cooperative child.
• Topical steroid nasal sprays (like Flonase, Nasocort, Rhinocort, and Nasonex, etc) help decrease runny nose symptoms, but they may take several days to a week to work.
• Topical antihistamine nasal sprays – prescription only – (like azelastine and olopatadine) reduce runny nose, itching, sneezing and work quickly.
• Combination steroid and antihistamine sprays (like Dymista) – prescription only – are given if other sprays are not effective.
• Do not use of neosynephrine (Afrin) nasal spray for children – this is not recommended for children!

Eye Drops: Have children lie down when using eye drops and place in the corner of the eye near the nose. Tell them to expect a magic raindrop (the magic is it will help with the irritation of the eye!)

• Artificial tear drops  –  can help prevent pollen from getting if used before going out and can help remove pollen if used after being outside. They can be used as often as needed.
• Antihistamine eye drops (like Optivar, Zaditor, and Patanol) – recommended for children over 3 years.  These work quickly and can be given 2 times per day if needed.
• Steroid eye drops – require a prescription – used for severe allergic eye symptoms

Oral medications: There are both liquid and chewable tablets available for children depending on their preference.  Let your child choose whether they prefer to drink or chew their medication – giving choices helps with cooperation in addition to building self confidence!

• Oral antihistamines are very effective for itching, sneezing, and dripping.  These work quickly but may be more effective if taken daily during the allergy season.
• Nonsedating antihistamines (like Claritin, Zyrtec, Allegra, and Xyzal)  last  12-24 hours, and are generally well-tolerated.
• Sedating antihistamines (like Benadryl) last only 6 hrs and make most people sleepy so are not usually recommended for daytime use.
• Oral steroids – require a prescription – and are generally given only on a short term basis for children who have severe allergic eye symptoms or worsening asthma.
• Oral medications may have side effects, and there are appropriate doses for different age children that should be confirmed with your pediatrician.

3. Immunotherapy:

• If your child has severe environmental allergies, they may benefit from allergen immunotherapy (or “allergy shots”). This is type of treatment can take a while to work and involve lots of doctors visits, but it may provide the most relief from allergy symptoms in the long-term, and if effective, may allow your child to reduce or discontinue taking allergy medications.

Call your pediatrician:

1. If your child’s allergy symptoms persist and are still bothersome despite your attempts to manage with over-the-counter medications
2. If you observe worsening asthma and eczema symptoms
3. If you observe other signs of illness – fever, eye pain/blurry vision, etc.

Notify the school nurse/teacher:

It can be helpful to inform the school if your child has allergies so they can help decrease exposure to pollen, give medications for symptoms, and do not mistakenly think your child has an infectious “pink eye.”

How do you know if your child actually has seasonal allergies:

Many people are unsure if their child has environmental allergies. Often it is difficult to distinguish allergic symptoms from viral colds/illnesses.

• In general, children with allergies are often more itchy and sneezy, and the nasal discharge tends to be watery and clear.
• Fever is not associated with allergies.
• Allergies usually happen at particular times of the year:
• Early spring time (April and May): tree pollen
• Late Spring / early summer (June and July): grass pollen
• Summer and Fall: ragweed and other weed pollen
• Fall: Outdoor mold
• Year-round “perennial” allergies: dogs, cats, cockroaches, dust mites, indoor mold

• People may develop new allergies over the course of their childhood and into adulthood.
• If you are unsure about your child’s allergies, pediatricians and/or allergist can do blood tests and/or skin prick tests to detect what specifically a person is allergic to.

Special thanks to pediatric allergist, Dr. Amanda Cox!

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