A Parent's Guide to Allergies in Children

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Allergies are common in children and adults. In fact, studies show that between 36% and 44% of children may have at least one allergy. A variety of triggers, such as foods, pollen, pet dander, mold, or insects, can cause allergy symptoms. Luckily, in addition to avoiding specific triggers, there are a number of effective remedies that can alleviate allergy symptoms.

Understanding more about allergies can help parents get their kids some much-needed relief. And the first step in treating allergies is confirming that your child really has allergies as allergy symptoms are often confused with cold symptoms. Learn more about common childhood allergies, causes, symptoms, getting the correct diagnosis, and effective treatments.

Allergy Causes

Allergies are caused when the body's immune system recognizes a foreign substance (such as a food, bee venom, or pollen) as a pathogen that it needs to fight. While these allergy triggers are not actually harmful, the body reacts to them as if they are with a swift histamine response, which varies in severity from person to person and results in the symptoms that are intended to rid the body of this perceived threat.

It's unclear why people develop allergies, however, occurrence in the overall population is high and prevalence is steady across the country, even if the specific allergens that cause allergy reactions vary.

There are a number of risk factors including family history, race (Black children have higher rates), sex (boys are at increased risk), and exposure to allergens. Interestingly, delayed introduction to some potential allergens (such as peanuts) is associated with a higher risk of developing the allergy.

According to the American Academy of Pediatrics (AAP), the most common type of allergy in children is allergic rhinitis, which is also known as hay fever. This type of allergy is triggered by breathing in tiny particles, such as dust mites or seasonal blooms of pollen. It typically results in symptoms like sneezing, a stuffy nose, itchy eyes.

Allergy Symptoms

Many parents think of a runny nose or itchy, watery eyes when they think of allergies, but there are many other symptoms that can be triggered by allergies. Your child's symptoms will also depend on the type of allergy and the severity of the immune response they have.

Some of the most common allergy symptoms include the following:

  • Allergic crease (crease near the bottom of the child's nose)
  • Allergic shiners (dark circles under the eyes)
  • Contact dermatitis (itchy red skin rash)
  • Fatigue
  • Hacking cough
  • Headache
  • Hives (an itchy red rash that comes and goes, common with food allergies)
  • Intestinal discomfort, including cramps, nausea, or diarrhea
  • Itchy eyes
  • Itchy nose, mouth, or throat
  • Postnasal drip
  • Red, puffy eyes, with tearing and itching
  • Rubbing the nose a lot (allergic salute)
  • Runny nose with clear discharge
  • Sneezing
  • Stuffy nose (congestion)
  • Wheezing or shortness of breath

Allergies vs. Colds

If your child displays common allergy symptoms, it's important to note that they may actually have a cold. It can be tricky to distinguish between the two, particularly if your child hasn't previously been diagnosed with allergies. Suspect a cold if they have body aches, fever, or a runny nose with green or yellow mucous. It's also worth considering a cold if they've been around anyone else with a cold. Likewise, an allergy may be more likely if they have been exposed to any potential allergens.

If you're ever unsure about whether your child has a cold or allergies, consult a pediatrician for diagnosis and appropriate treatment options.

Diagnosis

Sometimes, it's very clear that a child has an allergy; other times, their symptoms may be more subtle. Either way, if you suspect your child has allergies, it's wise to have them evaluated by a doctor to ensure you are treating the appropriate issue. A pediatrician can review your child's symptoms to determine whether allergies are likely and offer guidance for treatment.

The doctor may also refer your child to see an allergy specialist, who can conduct allergy testing to determine exactly what is triggering your child's allergies. You may also be asked to keep a symptom diary to help figure out what is triggering your child's allergies.

Additionally, other conditions like asthma and eczema often coexist with allergies and may be aggravated if allergy symptoms are not well-controlled. So, it's very important to ensure that an effective care plan is developed.

Common Types of Allergies

Children can develop allergies to a wide range of triggers. How their allergy is treated will depend on the type of allergy they have. Generally, the first line of defense is avoiding contact with the allergen in question. However, particularly in the case of airborne triggers like pollen, it can be difficult to completely prevent exposure.

Food Allergies

According to the National Institute of Allergy and Infectious Diseases (NIAID), approximately 5% of children have food allergies. Although a person can be allergic to almost any food, the vast majority of children with a food allergy are allergic to one of these foods:

  • Cow's milk
  • Eggs
  • Fish and shellfish
  • Peanuts
  • Sesame
  • Soy
  • Tree nuts
  • Wheat

If your child eats a food that they are allergic to, they will quickly (usually within minutes) develop any number of food allergy symptoms. These reactions can range from hives, upset stomach, and vomiting to, in rare cases, a life-threatening anaphylactic reaction, which requires immediate medical treatment.

UPDATE: January 2023

As of January 1, 2023, labels on food products must list sesame as an allergen. This is a new requirement from the Food and Drug Administration (FDA). But if you are allergic to sesame, you should still be cautious of the foods you are buying. The law doesn't require products on their way to stores or already on shelves by January 1st to list sesame on the label. Those foods also don't need to be removed or relabeled. Sesame joins eight other food allergens that already must be listed on labels: milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soybeans.

Seasonal Allergies

Classic triggers of seasonal allergies include:

  • Grasses (late spring and early summer)
  • Outdoor molds (season varies depending on where you live and can be year-round in some areas)
  • Ragweed and other weeds (late summer and fall)
  • Trees (early spring)

You can often tell that your child has seasonal allergies if their allergy symptoms start or get worse each year during a specific season, although this is sometimes hard to track. You may also notice that your child's seasonal allergy symptoms are better on days that it rains and are worse when it is dry and windy as seasonal allergens spread more easily in those conditions.

Indoor Allergies

While most things that cause seasonal allergies are outside, children with year-round or perennial allergies may be allergic to things inside your house, such as animal dander (cat and dog allergies), cockroaches, dust mites, and indoor molds.

Learning to control these allergy triggers is important to reduce your child's indoor allergies. Thorough cleaning and dusting, removal of pets, eliminating mold, and pest control are all possible ways to reduce exposure to these triggers.

Other Allergy Triggers

In addition to foods, dust, and pollens, other common allergy triggers can include additives in foods or medications, such as the food dye tartrazine (Yellow No. 5), sulfites, adhesives, and ingredients in topical medications, such as neomycin and bacitracin (antibiotics), PABA (sunscreens), and lidocaine (topical anti-itch creams).

Insect bites and stings, such as from bees, are another common allergy trigger. Some children are also allergic to latex, certain medications, such as antibiotics like penicillin and sulfa drugs, and plants like poison ivy.

Allergy Relief

One of the most effective treatment measures is to avoid allergy triggers as much as possible. This may include putting a special allergy-proof cloth mattress cover on your child's mattress if they are allergic to dust mites or keeping windows closed in your car and home when pollen counts are high if they have seasonal allergies. Nasal washes to clear allergens, irritants, and mucus from your child's nose may also be helpful.

There are also a variety of medications, such as antihistamines and nasal steroids, that can be quite effective at controlling symptoms. Discuss medication options with a pediatrician to determine which ones may be most helpful for your child's particular symptoms. They may also suggest allergy shots if your child has moderate to severe allergy symptoms that are hard to control.

When allergy medication is called for, it is often recommended that it is taken daily, especially during their allergy season. This is because it tends to be easier to prevent and control symptoms than it is to alleviate symptoms down once the body's immune response is activated.

Allergy Medicines

Since avoiding allergy triggers can be tough, especially if your child has seasonal allergies, many children with allergies require medicines for relief. Fortunately, a variety of allergy medicines are available that are safe for younger children. Allergy medicines for kids include:

  • Allergy eye drops: Acular (ketorolac), Optivar (azelastine), Pataday (olopatadine), Patanol (olopatadine), Zaditor (ketotifen)
  • Antihistamine nasal sprays: Astelin (azelastine), Patanase (olopatadine)
  • Leukotriene antagonists: Singulair (montelukast)
  • Older sedating antihistamines: Benadryl (diphenhydramine), Extendryl (chlorpheniramine)
  • OTC antihistamine nasal sprays: Astepro (azelastine hydrochloride), a steroid-free option that was approved for nonprescription use for treating seasonal allergies and allergic rhinitis for people ages 6 and up in June 2021
  • OTC antihistamines: Allegra (fexofenadine), Claritin (loratadine), Zyrtec (cetirizine), Xyzal (levocetirizine)
  • Prescription antihistamines: Clarinex (desloratadine)
  • Steroid nasal sprays: Flonase (fluticasone), Nasonex (mometasone), Omnaris (ciclesonide), Rhinocort Aqua (budesonide), Veramyst (fluticasone)

A Word From Verywell

Allergies are a common condition in both children and adults. Once you know what type of allergy your child has, you can more effectively help them find relief. Contact a pediatrician if you have any questions or concerns about your child's allergies. Additionally, a pediatric allergist can be helpful to diagnose and manage your child's allergies.

11 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Salo PM, Arbes SJ, Jaramillo R, Calatroni A, Weir CH, Sever ML, et al. Prevalence of allergic sensitization in the United States: Results from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. J Allergy Clin Immunol. 2014;134(2):350-9. doi:10.1016/j.jaci.2013.12.1071

  2. American Academy of Pediatrics. Seasonal allergies.

  3. National Institutes of Health. Children, males, and Blacks are at increased risk of food allergies.

  4. Chan ES, Abrams EM, Hildebrand KJ, Watson W. Early introduction of foods to prevent food allergyAllergy Asthma Clin Immunol. 2018;14(Suppl 2):57. doi:10.1186/s13223-018-0286-1

  5. American Academy of Pediatrics. Allergies.

  6. American Academy of Pediatrics. Allergy medicine for children.

  7. American Academy of Pediatrics. AAP allergy tips.

  8. National Institute of Allergy and Infectious Diseases. Food allergy.

  9. Lee S. IgE-mediated food allergies in children: prevalence, triggers, and managementKorean J Pediatr. 2017;60(4):99-105. doi:10.3345/kjp.2017.60.4.99

  10. Food and Drug Administration (FDA). Allergic to Sesame? Food Labels Now Must List Sesame as an Allergen.

  11. U.S. Food and Drug Administration. FDA approves a nasal antihistamine for nonprescription use.

Additional Reading
  • Adkinson: Middleton's Allergy: Principles and Practice, 6th ed.
  • Kliegman: Nelson Textbook of Pediatrics, 18th ed.

By Vincent Iannelli, MD
Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years.