There are many over-the-counter antihistamines and decongestants for sale in formulations designed for children with mild allergy symptoms. However, these may have side effects for the child, such as hyperactivity or sedation. Parent should consult with a physician or healthcare provider before giving children any allergy medication, even over-the-counter (OTC) varieties. It is also important never to give children medications designed for adult use without specific instructions from a physician.

Prescription medications may be necessary for children with moderate to severe allergies. Those approved for limited use in children include:

• Antihistamines. Medications used to treat allergy symptoms such as sneezing, runny nose and itchy and watery eyes. Cetirizine and desloratadine have been approved for children over 6 months of age, and loratadine for children over 2. Fexofenadine hydrochloride has been approved for ages 6 and up. Antihistamines work by neutralizing the histamines that are released in the bloodstream during an allergic reaction. Antihistamines can reduce symptoms when taken after the allergic reaction begins. However, they are most effective when taken 3 to 5 hours before coming into contact with an allergen.
  
  
• Leukotriene modifiers. Medications used to prevent both nasal allergy symptoms and asthma-related symptoms. Montelukast has been approved for children over the age of 1. Leukotriene modifiers are effective when used prior to an allergic reaction because they work to disrupt a specific chemical process in the allergic cascade, preventing some types of leukotriene from forming in the body. These medications are primarily used in the prevention of asthma-related symptoms, but are finding increased use for allergies.
  
  
• Steroid nasal sprays. Medications used to reduce the inflammation associated with symptoms such as nasal stuffiness, sneezing and runny nose. Mometasone furoate monohydrate has been approved for ages 2 and up and fluticasone propionate for ages 4 and up. These medications are most effective when taken daily and often require one to two weeks of use before reaching their full effect.
  
  
• Mast cell stabilizers. Medications effective at treating mild or moderate inflammation in the bronchial tubes as well as sneezing, watery eyes and congestion. Cromolyn sodium may be prescribed in nasal spray form for some children. Mast cell stabilizers prevent mast cells from releasing histamine and other chemicals that can cause allergy symptoms.
  
  
• Epinephrine. Epinephrine (allergy kit) is used to immediately treat the most severe allergic reactions involving the potentially life-threatening condition known as anaphylaxis. Epinephrine is a synthetic form of adrenaline that, when injected, works as a powerful bronchodilator, opening breathing tubes and restoring normal respiration quickly. Most physicians recommend that children who are susceptible to severe reactions carry an injection of epinephrine with them at all times and understand how to self-administer the drug. In the case of infants or young children, anyone watching or supervising the child should have immediate access to an epinephrine shot, as well as know how to properly administer the drug.

The above medications address the symptoms associated with allergies in children. The only treatment currently available for addressing the underlying allergic condition is immunotherapy (allergy shots). By using this method, a child can gradually become more tolerant to a specific allergen (e.g., a specific pollen, latex) over a period of years.

During immunotherapy, tiny amounts of an allergen are injected under the patient’s skin over a period of years. With each shot, the amount of allergen is increased. Over time, the patient’s tolerance level to the allergen rises dramatically, causing a significant reduction in symptoms such as runny nose, itchy eyes and scratchy throat. 

Allergy shots are not always effective and they may not be recommended for children with certain allergies (e.g., food allergies). Administering this therapy safely in children is also more challenging, because young children are not always able to communicate signs of a potential reaction to a physician. Younger children also have smaller respiratory reserves, which also puts them at greater risk of respiratory side effects. Therefore, most health professionals will not prescribe immunotherapy for children under 5.