From the Guidelines
For a 9-month-old with allergic rhinitis, the most appropriate treatment approach is to use montelukast, as it is approved for perennial allergic rhinitis in children as young as 6 months and has been shown to be safe and effective 1. When considering treatment for allergic rhinitis in a 9-month-old, it's crucial to prioritize the safety and efficacy of the medication.
- Environmental modifications should also be implemented, such as removing allergens and using a HEPA air purifier in the baby's room.
- Saline nasal sprays can be used to gently clear mucus, but medication should only be considered under the guidance of a pediatrician.
- Montelukast, a leukotriene receptor antagonist, has been proven to produce statistically significant improvement in nasal symptoms and quality of life scores compared with placebo 1.
- The combination of montelukast and a second-generation antihistamine may show added benefit for allergic rhinitis, but this should be approached with caution in infants due to the limited data on antihistamine use in this age group 1.
- It's essential to weigh the benefits and risks of any medication in infants and to consult with a pediatrician before initiating treatment.
- Breastfeeding mothers might consider eliminating common allergens from their diet if the baby shows sensitivity, as this can help reduce exposure to allergens.
- Decongestants should be avoided entirely in infants due to the potential risks associated with their use 1.
From the FDA Drug Label
Uses • Temporarily relieves these symptoms due to hay fever or other respiratory allergies: • runny nose • sneezing • itchy, watery eyes • itching of the nose or throat The FDA drug label does not answer the question.
From the Research
Treatment Options for Allergic Rhinitis in 9-Month-Old Infants
- The treatment of allergic rhinitis in infants and children involves a step-wise approach, starting with avoidance of allergens and proceeding to pharmacotherapy if necessary 2, 3, 4.
- For mild intermittent allergic rhinitis, second-generation antihistamines such as cetirizine, fexofenadine, desloratadine, and loratadine may be considered 3, 5.
- However, limited data are available regarding the use of these agents in infants, except for desloratadine, cetirizine, and montelukast 3.
- Intranasal corticosteroids, such as mometasone furoate, beclomethasone dipropionate, and budesonide, are effective for treating allergic rhinitis in children, but their use in infants requires careful consideration due to potential systemic effects 2.
- Azelastine nasal spray is another option for treating allergic rhinitis in children, but its use in infants has not been extensively studied 3, 5.
Considerations for Treatment Selection
- The choice of treatment for allergic rhinitis in infants should be based on the severity and frequency of symptoms, as well as the presence of comorbidities such as asthma or eczema 5, 6, 4.
- The safety and efficacy of treatment options should be carefully evaluated, taking into account potential side effects and interactions with other medications 3, 5.
- A therapeutic ladder approach may be used, starting with mild treatments and progressing to more potent options as needed 4.
Importance of Accurate Diagnosis and Treatment
- Accurate diagnosis and treatment of allergic rhinitis are crucial to reduce the negative impact on the quality of life of the patient and their relatives, as well as to minimize medical costs 6.
- Specific allergen immunotherapy may be considered in selected patients to prevent new sensitizations and reduce bronchial hyperreactivity associated with allergic rhinitis 6.