Spring Is in Full Bloom: A Pediatrician’s Guide to Managing Seasonal Allergies

As the trees turn green and flowers blossom, spring brings longer days, warmer weather, and unfortunately for many children, seasonal allergies. If your child starts sneezing more than usual or rubbing their eyes constantly, they may be experiencing springtime allergies. As a pediatrician, I want to help parents recognize allergy symptoms, understand treatment options, and know when to seek medical care.

Recognizing Allergy Symptoms in Children

Spring allergies, also known as allergic rhinitis or hay fever, are caused by pollen from trees, grass, and flowers. Symptoms can begin as early as 2 to 3 years old, though they are more commonly diagnosed in children over the age of 4 or 5. Typical allergy symptoms include:

• Frequent sneezing
• Runny or stuffy nose
• Itchy, watery eyes
• Postnasal drip (leading to throat clearing)
• Coughing (especially at night)
• Dark circles under the eyes (allergic shiners)

Over-the-Counter Medications for Seasonal Allergies

If your child is struggling with allergy symptoms, several over-the-counter (OTC) medications can provide relief. Below are recommended doses based on age for antihistamines, nasal steroids, and antihistamine eye drops. Always consult your pediatrician before starting a new medication.

1. Antihistamines (Relieves sneezing, itching, and runny nose)

Medication	Age	Dosage
Cetirizine (Zyrtec)	2-5 years	2.5 mg once daily
	6+ years	5-10 mg once daily
Loratadine (Claritin)	2-5 years	5 mg once daily
	6+ years	10 mg once daily
Fexofenadine (Allegra)	2-5 years	30 mg twice daily
	6-11 years	30 mg twice daily
	12+ years	60 mg twice daily or 180 mg once daily

Note: Avoid older antihistamines like diphenhydramine (Benadryl) for daily allergy relief, as they can cause drowsiness and wear off quickly.

2. Nasal Steroids (Helps with congestion and inflammation)

Medication	Age	Dosage
Fluticasone (Flonase Sensimist)	2-11 years	1 spray per nostril daily
	12+ years	2 sprays per nostril daily
Mometasone (Nasonex)	2-11 years	1 spray per nostril daily
	12+ years	2 sprays per nostril daily

Tip: Nasal sprays work best when used consistently and should be aimed slightly outwards (toward the ear) when spraying.

3. Antihistamine Eye Drops (Relieves itchy, watery eyes)

Medication	Age	Dosage
Ketotifen (Zaditor, Alaway)	3+ years	1 drop in each eye twice daily
Olopatadine (Pataday, Patanol)	2+ years	1 drop in each eye once or twice daily, depending on formulation

Preventing Allergies at Home

While medications help relieve symptoms, preventing exposure to allergens is key. Here are some strategies to minimize pollen exposure:

• Keep windows closed in the home and car during high pollen seasons.
• Use air purifiers and ensure your HVAC system has a high-efficiency particulate air (HEPA) filter.
• Bathe children and change their clothes after playing outside.
• Wash bedding frequently in hot water to remove pollen.
• Avoid outdoor activities in the morning and evening when pollen counts are highest.
• Wipe pets down after they’ve been outside to prevent them from carrying pollen indoors.

When to Visit the Pediatrician

While most allergy symptoms can be managed at home, some cases require medical attention. Schedule an appointment if:

• Your child’s symptoms persist despite OTC medication use.
• They experience trouble breathing or wheezing (this could indicate asthma, which often coexists with allergies).
• They develop a persistent cough or nasal congestion that lasts more than 10 days.
• Their symptoms significantly affect their sleep or daily activities.
• You suspect your child may need allergy testing or prescription treatments.

Final Thoughts

Spring should be a time for outdoor fun, not constant sneezing and congestion. By recognizing allergy symptoms, using the right OTC medications, and taking preventative steps at home, you can help your child enjoy the season with fewer allergy struggles. If your child is struggling with spring allergies, don’t hesitate to schedule an appointment. We can help create a personalized plan to keep them comfortable and enjoying spring.

Providers at North Fulton Pediatrics