If spring or fall is in the air and your little one is suddenly sneezing up a storm or rubbing their eyes nonstop, there’s a good chance they have seasonal allergies. Allergic rhinitis (the technical term for seasonal allergies) occurs when pollen from plants is released into the air, and, in turn, the eyes, nose and throat, setting off a reaction — and it’s very common in kids. According to the American College of Allergy, Asthma and Immunology (ACAAI), seasonal allergies affect about 40% of children in the U.S.
However, even though seasonal allergies are pervasive, it’s unlikely your child will suffer from them before they hit toddlerhood.
“Children under the age of 2 usually don’t have seasonal allergies because, typically, it takes a couple of seasons to develop allergies to pollens in the first place,” says Dr. Meng Chen, clinical assistant professor of Allergy and Immunology at Stanford University School of Medicine.
If your child breezed through their first spring with nary a sniffle but seems stuffed up every time you return from park now, there’s a good chance they’ve developed seasonal allergies. Here’s expert advice on what to look for, how to tell the difference between allergies and illness and how to treat them.
What are the symptoms of seasonal allergies in babies and toddlers?
According to Chen, allergies can trigger a variety of symptoms. Here are some of the most common tell-tale signs:
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Watery and/or itchy eyes.
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Sneezing.
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Runny or congested nose.
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Frequent eye and nose rubbing. “Toddlers often rub their faces when they have allergies, due to itchiness,” says Chen.
Chen also notes that allergies can trigger asthma symptoms, including a cough, for some. According to the Asthma and Allergy Foundation of America (AAFA), allergic asthma (when allergies affect the lungs and airways, in addition to the common symptoms), is the most common type of asthma, accounting for about 60% of people with asthma.
Is there a way to test babies and toddlers for seasonal allergies?
If your child has been showing signs of seasonal allergies and you want to get to the bottom of things (i.e. know the exact triggers), you can get them tested.
“If you’re concerned that your child has allergies you can have them tested by an allergist in order to get more information,” says Chen. “There are two ways to test for environmental allergies: skin prick testing, which is a quick, 15-minute procedure or a blood test.”
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Skin prick test. During a skin prick test for children, the skin is slightly punctured by a lancet (typically not painful) on the upper back before applying a small drop of allergen extracts, such as pollen, mold or pet dander to the areas. The areas that are red, bumpy or irritated after about 15 minutes indicate an allergy to that particular substance.
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Blood test. In some cases (such as a situation where a child is unable to stop taking their allergy medicine, which would obscure skin prick test results), blood tests can be administered to try to determine triggers. However, according to the ACAAI, these tests are usually more expensive, less sensitive and take longer to find out the results.
Keep in mind, though, for many pediatricians, allergy testing won’t be a first line of defense.
“I rarely refer a kid for allergy testing since we’re all allergic to the same things — grass, trees, dust, etc.” says Dr. Nick DeBlasio, a pediatrician at the Pediatric Primary Care Center at Cincinnati Children’s Hospital Medical Center in Cincinnati. “However, if a patient is not responding to traditional treatment, a pediatrician may refer them for allergy testing to get more information.”
How do you treat allergies in babies and toddlers?
One of the simplest ways to treat toddler and baby seasonal allergies is to avoid the culprits as much as possible.
“For seasonal allergies caused by pollen, we recommend keeping the windows and doors to the home closed to prevent pollen from getting into the house,” says Chen. “Also, changing your child’s clothes after returning from the outdoors and bathing in the evenings to remove allergens from the body and hair can be helpful, as well as using a high efficiency air purifier (HEPA).”
The American Academy of Pediatrics (AAP) also gives the following suggestions:
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For kids whose allergies are triggered by grass pollen, avoid going outside when grass is cut, and steer clear of fields with overgrown grass.
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For kids with mold allergies, avoid playing in dead leaf piles in the fall.
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Be mindful of pets that are tracking pollen and mold in and out of the house. (Bathe them frequently!)
In cases that are more extreme, a doctor may recommend immunotherapy — allergy shots. However, according to American Academy of Allergy, Asthma and Immunology (AAAAI), this treatment usually isn’t recommended for kids before age 5, since they may have a difficult time “cooperating with such a program.”
What can you give babies and toddlers for allergies?
It’s important to speak with your child’s pediatrician before administering any medication, but keep in mind, allergy medication, like Benadryl, generally isn’t recommended before 12 months of age. (And seasonal allergies usually don’t crop up until about age 2, anyway.)
If you have the OK from your pediatrician to give your little one an over-the-counter medication, it will likely be an antihistamine.
“The most common type of over-the-counter allergy medication used on an as-needed basis is an antihistamine,” says Chen. “Common antihistamines include diphenhydramine (Benadryl), loratadine (Claritin), fexofenadine (Allegra), cetirizine (Zyrtec) and levocetirizine (Xyzal).”
According to Chen, diphenhydramine (Benadryl) lasts for approximately six hours and may cause sleepiness, or, in some cases, hyperactivity, so it’s not usually the first choice.
“I usually recommend one of the other antihistamines, which last for 24 hours and are designed to be non-sedating,” Chen says. “Steroid-based nasal sprays can also be an effective over-the-counter treatment, but they need to be used daily in order to be effective.”
How do you know if your child is sick with a cold or flu or has allergies?
While there are some overlapping symptoms between allergies and viruses, the primary distinction between the two is fever.
“Fever is the easiest way to tell if it’s allergies or something else,” says DeBlasio. “Allergies do not give you fevers. Many viral illnesses, including flu and even common colds, will give a child a fever.”
DeBlasio also notes that kids with viral illnesses may have aches and pains, as well, while kids with allergies tend to have more nasal and eye itching.
Other differentiating factors between allergies and cold and flu, according to DeBlasio, include:
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Colds tend to change. “Colds usually get worse and then get better over the course of a few days,” says DeBlasio. “Allergies tend to stick around longer.”
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Allergies are worse during certain times. “Seasonal allergies are usually pretty bad in spring and fall,” says DeBlasio. “The season of the year will also give some clue about whether it is allergies or a cold.”
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Allergies are worse after being outdoors. “Seasonal allergy symptoms are worse when an allergic child spends long periods outside,” says DeBlasio. “Time spent outdoors won’t change the symptoms of a cold.”
Additionally, familiarize yourself with your child’s tell-tale allergy symptoms if they’re ongoing. This may help you distinguish between a stuffy nose from a cold or congestion from allergies.
“I always know when my son’s allergies are acting up by his eyes,” says mom of three Jaclyn Santos, of Hazlet, New Jersey. “When his eyes are red, itchy and appear to have dark circles underneath, I’m almost positive it isn’t a virus.”
Of course, whenever you’re in doubt, it’s best to see your pediatrician. A physical exam will often give insight as to whether your child is suffering from allergies or a viral illness, along with the best course of treatment.
