Itchy eyes and chain sneezes are already in full force on the west coast, where temperatures and pollen counts are skyrocketing. It won’t be long before the entire country is bloodshot. Ugh. So we asked our pediatric expert, Dr. JJ Levenstein of MD Moms, for some helpful tips on how to provide seasonal allergy relief for the littlest sufferers among us.

Q. How young can seasonal allergies start?
A. Allergies can present very early—even in infancy. What we usually see are babies who start going out for walks, hitting their first spring, and after a few days or weeks demonstrating typical allergy symptoms—runny nose, sneezing and eye-rubbing. As babies become tots and start to walk, kick, and run in the grass, smell flowers, and basically rub nature into their eyes, nose and skin, allergy symptoms become obvious.

Q. How can you tell if it’s allergies or a cold?
A. Allergy symptoms include clear non-stop faucet nose, allergic shiners (dark circles beneath the eyes), nose rubbing, and cough. Typically one or both of their parents will be allergy or asthma sufferers—an obvious genetic link is a red flag.

Q. Is there anything like Claritin for babies?
A. Non-sedating antihistamines like Claritin (loratidine), Zyrtec (cetirizine) and recently Allegra (fexofenadine) are now over-the-counter and come in liquid forms. None are officially sanctioned for under 2 years, but all are approved for young children. Anecdotally, your pediatrician may be comfortable recommending a non-sedating antihistamine for your baby if he/she is especially miserable; check with your health care provider for recommendations and dosing. Benadryl (diphenhydramine) also works, but can be sedating, and only lasts 4-6 hours, as opposed to the non-sedating types that last 12-24 hours.

Q. At what point should a parent consider giving a child an antihistamine?
A. A child whose nose is constantly running and/or so stuffy that sleep and napping are impossible is a potential candidate for medication. Some tots happily sneeze and blow their way through pollen season; others are puffy-eyed, sleep-deprived and miserable . . . so each child’s case has to be considered individually.

Q. Do certain children respond better to Claritin vs. Allegra vs. Zyrtec? Anything to consider when selecting a brand?  
A. It’s trial and error. One kid’s nirvana is another’s failure; often a parent may need to try 2 or 3 allergy relievers before finding one that makes a difference.  If none do, make sure you contact your health care provider for further guidance.

Q. What about eye drops?
A. Often, applying washcloths dipped in ice water and wrung out can help itchy eyes; alternatives are cucumber slices or wrung-out tea bags. But when children develop very puffy lids, extremely itchy eyes or chemosis (actual swelling of the transparent covering of the eyeball called the conjunctivae) then direct application of an ocular anti-histamine or anti-inflammatory may be indicated. Common names for eye drops are Visine A, Opcon, Napthcon, Alomide, Patanol, Pataday, Zaditor and Optivar. Not all are over-the-counter or approved for use in young children, so your pediatrician, allergist or ophthalmologist can guide you.

Q. Are there any preventative measures that can fend off the need for antihistamines? 
A. When you anticipate being outdoors, especially if it’s windy, wearing sunglasses can reduce the amount of pollen contact with eyes—a common portal of entry, and thus blocked with a bit of eye protection. If your child is extremely sensitive to grasses and pollen, avoidance is the best strategy. That said, staying indoors is generally not in a child’s nature, so pre-medicating (with your doctor’s blessing) on days when outdoor play is expected is probably a good idea.