Use intranasal corticosteroids safely in children

What to Do

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.

Why It Works

Despite parental concerns about "steroids," intranasal corticosteroids have an excellent pediatric safety profile with minimal systemic absorption. The AAP and AAAAI endorse their use for moderate-to-severe allergic rhinitis in children. Flonase Sensimist's gentle mist is particularly well-tolerated.

Tips

• One consideration: a very small (0.5cm) reduction in growth velocity may occur in the first year, but studies show it does not affect final adult height
• Teach proper technique: head slightly forward, aim away from septum
• The benefit-risk ratio strongly favors use for symptomatic children
• Consistent daily use is key — explain to older children why they should not skip days