Loratadine 5mg is NOT Appropriate for a 17-Month-Old
You should NOT give Claritin (loratadine) 5mg to a 17-month-old baby because the FDA explicitly states that loratadine requires physician consultation for children under 2 years of age, and the standard 5mg dose is only approved for children 2 years and older. 1
Age-Specific Dosing Requirements
The FDA-approved loratadine dosing is 5mg once daily for children aged 2 to under 6 years; for children under 2 years, the label specifically instructs to "ask a doctor." 1
For a 17-month-old infant, loratadine dosing must be individualized by a physician and would typically be weight-based (approximately 2.5mg for children weighing less than 20kg), NOT the standard 5mg tablet dose. 2
Liquid formulations are strongly preferred for infants because they allow precise weight-based dosing and provide better absorption than tablets. 3, 4
Safer Alternatives for This Age Group
First-Line Option: Cetirizine
Cetirizine at 0.25 mg/kg twice daily (approximately 2.5mg twice daily for a typical 10kg infant) is the recommended oral antihistamine for children 6 months to 2 years, as it is one of only two antihistamines with documented safety data and FDA approval for this age group. 3, 4
Cetirizine and loratadine are the only antihistamines with FDA approval for children under 5 years, but cetirizine has more robust safety data for infants under 2 years. 2, 3
Critical safety threshold: Cetirizine should not be administered to infants younger than 6 months because safety data are lacking. 3
Most Effective Option: Intranasal Corticosteroids
Intranasal corticosteroids are the most effective medication class for controlling all symptoms of allergic rhinitis in children under 2 years, supported by high-quality evidence. 2, 3, 4
When used at recommended doses, intranasal corticosteroids are not associated with clinically significant systemic side effects. 2, 3, 4
The recommended treatment algorithm starts with intranasal corticosteroids as first-line therapy, with cetirizine added as a second-line or adjunctive agent if needed. 2, 3, 4
Critical Safety Warnings
Medications to Absolutely Avoid
First-generation antihistamines (diphenhydramine, hydroxyzine) should NEVER be prescribed for routine allergic symptoms in children under 6 years due to significant safety concerns. 3, 4
Between 1969 and 2006, there were 69 deaths in children under 6 years linked to antihistamine exposure; 41 occurred in children under 2 years, with diphenhydramine responsible for 33 of those deaths. 3, 4
The FDA and American Academy of Pediatrics explicitly recommend against over-the-counter cough-and-cold products containing first-generation antihistamines in children under 6 years. 3, 4
Common Pitfalls to Avoid
Do not assume that adult or older child dosing can simply be reduced for infants—weight-based dosing with appropriate formulations is essential. 5
Do not use antihistamines "to make a child sleepy"—this is explicitly contraindicated per FDA labeling. 3, 4
Avoid OTC cough-and-cold combination products in children under 6 years because of overdose risk. 3, 4
Do not combine cetirizine with other sedative medications due to additive central nervous system depression. 3
Practical Recommendation
For your 17-month-old, consult your pediatrician for proper weight-based dosing of either cetirizine (preferred for this age) or loratadine liquid formulation, or consider intranasal corticosteroids as the most effective first-line option. 2, 3, 4, 1 The standard 5mg loratadine tablet is not appropriate for this age group.