A physician trying to diagnose allergic rhinitis will conduct a full physical examination of the child as well as compile a medical history and a list of symptoms. Although many of the symptoms associated with allergic rhinitis mimic those of the common cold and upper respiratory infection, the presence of eye-related symptoms and lack of fever often suggest the presence of an allergy. If the physician suspects an allergy, allergy tests may be administered to pinpoint which allergen is triggering symptoms.

Identifying allergens is crucial, because avoidance is the best treatment for allergic rhinitis in children as well as in adults. However, avoidance is not always possible and medications may be used to relieve symptoms or reduce the frequency of allergic reactions. While some allergy medications are available over-the-counter (OTC), parents should never give any medicine to a child without first consulting a physician.

Over-the-counter antihistamines and decongestants are available in child doses, but they may make children drowsy and affect performance in school. Also, over-the-counter decongestants should not be used for more than a few consecutive days. Overuse of these drugs can lead to a “rebound effect” in which symptoms actually get worse. Prescription oral antihistamines and nasal sprays containing cromolyn sodium are often used to treat children because they are effective and offer the lowest risk of side effects.

In cases of more severe allergic rhinitis, children may need to take corticosteroids. These are anti-inflammatory drugs that do an excellent job of preventing the inflammation that leads to allergy symptoms. However, these drugs are suspected to at least temporarily suppress growth rates in some children. For that reason, caution must be exercised.

Corticosteroids also can be used in conjunction with an antihistamine to both improve treatment effectiveness, and reduce the level of the corticosteroid needed.

Finally, if medications fail, a doctor may suggest allergy shots (immunotherapy) to tame symptoms. Allergy shots involve regular injections of a small dose of an allergen over a period of months. The goal is to gradually increase the child’s tolerance of a particular allergen.

Administering this therapy safely in children is 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 puts them at greater risk of respiratory side effects.