How to manage seasonal allergies in children?

Have children shower and change clothes after recess, outdoor sports, or play during allergy season. At minimum, wash hands and face and change shirts when coming indoors.

Cover your child's pillow, mattress, and box spring with allergen-proof encasements (pore size under 6 microns). Wash the encasement covers monthly in hot water.

Do not give OTC cough and cold combination products to children under 4 (some guidelines say under 6). These products contain decongestants, cough suppressants, and first-generation antihistamines at doses that have caused serious adverse events and deaths.

Watch for asthma warning signs in allergic children: increased coughing (especially at night or with exercise), wheezing, difficulty keeping up with peers during physical activity, and increased rescue inhaler use during allergy season.

Ask your pediatrician or ENT about adenoid enlargement if your child has chronic mouth breathing, snoring, nasal voice quality, sleep-disordered breathing, or recurrent ear infections alongside allergy symptoms.

Provide your child's school with a written allergy management plan that includes medications, triggers, and emergency contacts. Many schools require a physician authorization form for medications to be kept on-site.

Discuss immunotherapy with a pediatric allergist for children with moderate-to-severe allergies. Allergy shots are typically started at age 5+; SLIT tablets are FDA-approved for ages 5-17.

Use Flonase Sensimist (fluticasone furoate, approved ages 2+) or Nasonex (mometasone, approved ages 2+) at 1 spray per nostril once daily for children ages 2-11. Ages 12+ can use 2 sprays per nostril.

Use only second-generation antihistamines at the correct pediatric dose:

Learn to spot allergy signs that children often cannot describe: the allergic salute (upward nose rubbing with the palm), allergic shiners (dark circles under eyes), mouth breathing, snoring, frequent throat clearing, and nose wrinkling.