From the Guidelines
For a 13-month-old with suspected seasonal allergies, the best initial treatment is a non-sedating antihistamine such as cetirizine (Zyrtec) at a dose of 2.5 mg once daily, as it is approved for children as young as 6 months and effectively relieves symptoms like runny nose, sneezing, and itchy eyes without causing significant drowsiness 1. When considering treatment options, it's essential to weigh the benefits and risks of each medication. According to the study published in the Journal of Allergy and Clinical Immunology 1, oral antihistamines are generally effective in reducing rhinorrhea, sneezing, and itching associated with allergic rhinitis. However, they may have little objective effect on nasal congestion. Some key points to consider when treating a 13-month-old with suspected seasonal allergies include:
- Environmental modifications, such as keeping windows closed during high pollen days, changing clothes after outdoor play, bathing the child before bedtime to remove allergens, and using air purifiers with HEPA filters in the home, particularly in the child's bedroom 1.
- Consulting with a pediatrician before starting any medication to confirm the diagnosis, as symptoms of seasonal allergies can mimic those of viral infections in young children 1.
- The pediatrician may recommend starting with environmental changes alone before trying medication, or they might suggest a different antihistamine based on the child's specific symptoms and medical history 1.
- Antihistamines work by blocking histamine receptors, preventing the chemical mediator from causing allergy symptoms 1.
- For severe cases or if symptoms don't improve, the pediatrician might consider referral to an allergist for further evaluation 1. It's also important to note that intranasal corticosteroids are typically the most effective medication class for controlling sneezing, itching, rhinorrhea, and nasal congestion, the 4 major symptoms of allergic rhinitis, but they may not be suitable for a 13-month-old child as a first-line treatment 1. In contrast, a more recent study published in 2015 1 provides information on intranasal antihistamines, which may be considered as an alternative treatment option. However, the study published in the Journal of Allergy and Clinical Immunology 1 provides more comprehensive guidance on the treatment of allergic rhinitis in children. Therefore, based on the available evidence, a non-sedating antihistamine such as cetirizine (Zyrtec) at a dose of 2.5 mg once daily is the best initial treatment for a 13-month-old with suspected seasonal allergies.
From the Research
Initial Treatment for Seasonal Allergies in a 13-Month-Old
- The best initial treatment for a 13-month-old with query seasonal allergies is not directly stated in the provided studies, but based on the information given, the following options can be considered:
- For mild intermittent or mild persistent allergic rhinitis, a second-generation H1 antihistamine (eg, cetirizine, fexofenadine, desloratadine, loratadine) or an intranasal antihistamine (eg, azelastine, olopatadine) may be used as first-line treatment 2.
- For persistent moderate to severe allergic rhinitis, an intranasal corticosteroid (eg, fluticasone, triamcinolone, budesonide, mometasone) either alone or in combination with an intranasal antihistamine may be used as initial treatment 2.
- A systematic review and meta-analysis found that most intranasal medications, including corticosteroids and antihistamines, are effective in improving rhinitis symptoms and quality of life in patients with seasonal allergic rhinitis 3.
- However, it is essential to note that the studies provided do not specifically address the treatment of seasonal allergies in 13-month-old children, and the safety and efficacy of these medications in this age group may vary 2, 3.
- One study is not relevant to the topic of seasonal allergies or their treatment 4.