Treatment for a Child's Allergy to Pollen or Animals

Your child's healthcare provider will consider your child's age, overall health, how severe the allergic reaction was, and other factors when advising treatment. The most effective ways to treat allergies are avoidance of the allergen, medicine, and immunotherapy.

What is avoidance?

Avoidance simply means staying away from a substance that causes an allergic reaction.

Suggestions for avoiding (some) allergens:

• Remain indoors with the windows closed when the pollen count is high and on windy days.

• Dustproof the home, particularly your child's bedroom.

  • Eliminate, when possible, wall-to-wall carpet, venetian blinds, and down-filled blankets or pillows.

  • Wash bedding, curtains, and clothing often and in hot water to eliminate dust mites.

  • When possible, keep bedding in dust covers.

• Use air conditioning instead of opening the windows.

• Consider putting a dehumidifier in damp areas of the home, but remember to clean it often.

• When playing outside on days when the pollen count is high, have your child wear a facemask. When your child comes inside, he or she should take a shower, wash his or her hair, and change clothes.

• Take vacations in areas where pollen is not as prevalent, such as locations near the ocean.

Your child's doctor will also have suggestions for avoiding the allergens that cause reactions.

Medicine as treatment for allergy

For children who have allergies, there are many effective medicines. These are the most commonly used types. The American Academy of Pediatrics (AAP) recommends against some over-the-counter medicines for infants and young children. Always consult your child's healthcare provider before giving your child any over-the-counter medicines.

What are antihistamines?

Antihistamines are used to relieve or prevent the symptoms of allergic rhinitis (hay fever) and other allergies. They prevent the effects of histamine, a substance produced by the body during an allergic reaction. Newer antihistamines cause less drowsiness than older ones. Ask your healthcare provider which antihistamine you should give your child. Antihistamines come in tablet, capsule, liquid, or injection form and are available both over-the-counter and by prescription.

What are decongestants?

Decongestants are used to treat nasal congestion and other symptoms of colds and allergies. Decongestants cause the blood vessels to narrow, leading to the clearing of nasal congestion. Decongestants are available both over-the-counter and by prescription. The most commonly used forms are liquid, tablet, nasal sprays, or nose drops. The American Academy of Pediatricians does not recommend oral decongestants for children. They can cause a faster heart rate, hyperactivity, anxiousness, and problems sleeping. Spray or nose drops should be used for only a short time. Regular use of decongestants in any form can cause the symptoms to worsen as the body becomes dependent on the medicine. This is called a "rebound effect."

What are nasal steroids?

Nasal steroids are not the same as steroids used in bodybuilding. These medicines control inflammation in the nose caused by allergies. They take a few days to work and are used daily on a regular schedule, not on an as-needed schedule.

What is immunotherapy (allergy shots)?

When avoidance of allergens and daily medicine don't work, immunotherapy may be a treatment option. It is also called desensitization, hyposensitization, and allergy shots. A mixture of the various pollens, mold spores, animal danders, and dust mites to which the child is allergic is formulated. This mixture is called an allergy extract. There is no medicine in the mixture. The mixture is injected under the skin, usually in the fatty tissue in the back of the arm. It is not painful like an injection into the muscle. Over many months, the child's immune system builds up an immunity to the allergen. The injections are usually given weekly or twice a week for a few months. Then once a month for 3 to 5 years.

About 80% to 90% of children improve with immunotherapy. It usually takes 12 to 18 months before definite reduction in allergy symptoms is noticed. In some children, a reduction in symptoms is seen in as soon as 6 to 8 months.

A tablet that dissolves under the tongue might be another way for your child to receive immunotherapy.

Immunotherapy is only part of the treatment plan for allergic children. Since it takes time for immunotherapy to become effective, your child will need to continue the allergy medicines, as prescribed by his or her healthcare provider. It is also important to continue eliminating allergens, such as dust mites, from your child's environment.

Are there side effects to immunotherapy?

There are two types of reactions to immunotherapy: local and systemic. The local reaction is redness and swelling at the injection site. If this condition occurs repeatedly, then the extract strength or schedule is changed.

A systemic reaction is one that may involve the whole body. The symptoms may include nasal congestion, sneezing, hives, swelling, wheezing, and low blood pressure. Such reactions can be serious and even life-threatening. However, deaths related to immunotherapy are extremely rare. If a systemic reaction occurs, your child may continue taking shots, but of a lower dosage.

If you have any questions about immunotherapy, always talk to your child's healthcare provider.

Online Medical Reviewers:

• Blaivas, Allen, J., DO
• Godsey, Cynthia, MSN, APRN, MSHE, FNP-BC
• Kirsi Järvinen-Seppo, M.D., Ph.D.