Seasonal allergies, also called “hay fever,” are a group of conditions that occur during certain times of year and cause sneezing, runny nose, nasal congestion, watery and itchy eyes, and scratchy throat. Seasonal allergies do not generally cause fever. Allergies are caused by a reaction of the immune system to harmless substances as though they are attacking the body. Most of the symptoms are caused by pollen from trees, grasses, and weeds, and mold spores, which grow when weather is humid, wet, or damp. This puts south Louisiana at the top of the list for allergy sufferers!
Allergies usually begin in childhood, and can run in families. If one parent has allergies, there is a 25% chance of a child having allergies as well. If both parents are allergic, the risk is 60 to 70%. Seasonal allergies can be life long, but the symptoms can get better or worse over time.
Some people have allergy symptoms all year long. These symptoms are usually caused by insects (dust mites and cockroaches), animals (dogs and cats), and mold spores. Allergy skin testing can be performed to determine what your child is allergic to, including indoor and outdoor allergens.
Tips for preventing allergen exposure:
- Keep windows closed and run air conditioning in home and car to avoid circulating pollen in the air.
- Avoid going outside during peak pollen levels, which occur during late evening and early morning. Avoid going outside during dry, windy days. Check local forecasts for pollen counts.
- Wash your child’s hair before bedtime to remove any residual pollen from the day’s activities.
- Use HEPA filters in air vents and vacuum cleaner.
- Dust mite covers for bedding and pillows can be helpful for children allergic to dust mites.
Treatment for allergies consists of oral antihistamines, steroid nasal spray, and in some severe or resistant cases allergy shots. Many oral antihistamines are now available over the counter. Benadryl is one of the oldest and most effective antihistamines. However, it has the side effect of making most children drowsy. For school age children, this can be problematic, so trying one of the newer antihistamines available (Claritin, Zyrtec, or Allegra) can be helpful. If you have tried one of the medications for 1-2 weeks without result, then you should give a different medication a trial. Sometimes patients will find that one medicine works well for a few years and then their body seems to build up a “tolerance” and that medicine no longer controls symptoms. In this case, patients often find relief with a different class of antihistamine. Flonase (fluticasone), a steroid nasal spray is now available over the counter. It is safe to use in children 4 years and up with 1 spray in each nostril once a day. Also, for itchy, watery eyes, the eye drop Zaditor is available over the counter and can be given 1 drop in each eye up to twice a day. See below for dosing charts.
Benadryl (diphenhydramine) every 6 hours
| Weight | Liquid (12.5mg/5mL) | Chewable (12.5mg) | Capsule (25mg) |
|---|---|---|---|
| 12 to 17 lbs. | 2.5 ml | N/A | N/A |
| 18 to 23 lbs. | 3.75 ml | N/A | N/A |
| 24 to 35 lbs. | 5 ml | 1 tab | N/A |
| 36 to 47 lbs. | 7.5 ml | 1 ½ tabs | N/A |
| 48 to 59 lbs. | 10 ml | 2 tabs | 1 capsule |
| 60 to 71 lbs. | 12.5 ml | 2 ½ tabs | 1 capsule |
| Over 12 years | 10 to 20 ml | 2 to 4 tabs | 1 to 2 capsules |
Claritin (loratadine)
| Age | Liquid (5mg/5mL) | Chewable (5mg) | Reditab (10mg) |
|---|---|---|---|
| 1-2 years | N/A | N/A | N/A |
| 2-6 years | 1 tsp. daily | 1 tablet daily | N/A |
| 6 and over | 2 tsp. daily | 2 tablets daily | 1 tablet daily |
Zyrtec (cetirizine)
| Age | Liquid (1mg/mL) | Chewable (5mg) | Dissolve tabs (10mg) |
|---|---|---|---|
| 1-2 years | ½ tsp. daily | N/A | N/A |
| 2-6 years | ½ to 1 tsp. daily | ½ to 1 tab daily | N/A |
| 6 and over | 1 to 2 tsp. daily | 1 to 2 tabs daily | 1 tab daily |
Allegra (fexofenadine)
| Age | Liquid (30mg/5mL) | Meltable tab (30mg) |
|---|---|---|
| 1-2 years | N/A | N/A |
| 2-12 years | 1 tsp. every 12 hours | 1 tab every 12 hours |
| 12 and over | 2 tsp. every 12 hours | 2 tabs every 12 hours |