Family Health Guide

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Allergies: Medication

Commonly recommended drugs for allergic rhinitis include the following. Never give your child any medications, though, without a call to your doctor first.

  • Antihistamines. These medications block histamine, a protein involved in many allergic reactions, which causes itching and mucus production.  Newer generation antihistamines, such as Zyrtec and Clarinex, are less likely to cause drowsiness than older medicines like Benadryl. “They do not cross the blood-brain barrier as much as the older drugs, so they are do not have as sedating an effect,” says Cox, Chair of the American College of Allergy, Asthma and Immunology’s Immunotherapy and Diagnostic committee.
  • Nasal steroids. Drugs like Nasacort, Nasonex and Rhinocort reduce nasal stuffiness and are safe to use in children over long periods of time. They must be used daily, however.   
  • Leukotriene antagonists, such as Singulair, block the action of leukotrienes, which increase inflammation and trigger asthma attacks in sensitive kids.

Allergy immunotherapy 

Can your child’s allergies be cured?  Symptoms can be drastically reduced and in some cases even eliminated with allergy shots. This type of treatment consists of getting shots on a weekly or bi-weekly basis over a period of months to years. Injections contain a diluted extract of the substance that causes your child to have allergic reactions—from pollen to mold spores. Doctors begin with small doses and gradually increase them until your child reaches a maintenance dose. Once your child has reached this stage, she may only need to get the shots every few months.  Over time, the body builds resistance to the effects of these substances, reducing the intensity of symptoms caused by exposure to them. The benefit may even last for your child’s lifetime.  

Doctors base the decision to begin allergy shots on the length of your child’s allergic season, how well medications and other measures control symptoms, your desire to avoid using medication indefinitely, and the cost and convenience of regular shots. The latest research shows allergy immunotherapy slashes health care costs in children with allergic rhinitis by a third. And it’s the only allergy treatment that has been shown to reduce the risk of allergies turning into asthma.   

Treating Food Allergies  

If your child has a mild reaction to a food, an antihistamine like liquid Benadryl or Zyrtec can help quell the allergic response. Even if the incident quickly passes, make an appointment for the pediatrician. If the doctor determines that you child could potentially have a severe reaction or anaphylaxis, she’ll prescribe injectable epinephrine, or EpiPen, which reverses the effect of the reaction. The EpiPen should accompany your child wherever she goes, and anyone whose care your child is in—relatives, teachers, babysitters—should be shown how and when to use it. 

If your child is having an allergic reaction, follow these steps:

  • If your child is having trouble breathing or otherwise seems to be having a severe reaction, call 911 and give an EpiPen injection if you have one.
  • If the reaction is mild to moderate with symptoms limited to itching and hives, administer a dose of liquid antihistamine like Benadryl. Over the next 15 to 30 minutes, monitor your child’s condition. Watch for signs that airways could become blocked: swelling in the tongue and lips, wheezing, drooling or difficult breathing. Don’t give your child the food that may have caused the reaction again until you can see a doctor.  

Currently the best advice for parents of children with food allergies is to help children avoid coming into contact with foods they are allergic to and keep medication handy in case they accidentally ingest them. But someday doctors may be able to offer a new treatment—oral immunotherapy. Still experimental, the treatment involves eating minute portions of an allergic food and then gradually increasing the amount consumed in order to build up tolerance to it. Preliminary studies in children with peanut and other food allergies look promising. But whatever you do, do not try this at home. Talk to your allergist about his take on how soon he may offer this treatment in his practice and its suitability for your child.