Allergy medications for pregnancy and children

Choosing the safest allergy relief medication can be overwhelming, especially if you're pregnant or looking for the best allergy medicine for kids.

Here you'll find answers to your questions about allergy pills and common allergy medicines, including if you can take allergy medications during pregnancy and which allergy medications are safe for children.

A stuffy or runny nose (known as rhinitis) is relatively common in pregnancy and is not always caused by allergies. It may be caused by bacteria, viruses or even as a side effect of certain medications. Allergic rhinitis, which is caused by an allergen, is usually pre-existing, although it may develop or be recognized for the first time during pregnancy. There are some natural remedies, such as nasal saline irrigation, that can be helpful for mild symptoms. Exercising, using nasal dilator strips and elevating the head of your bed by 30 to 45 degrees have also been shown to help.

Researchers estimate that up to 40% of children suffer from allergic rhinitis. For some children, symptoms may be relieved by simply avoiding the allergen or any of the following nonmedical treatments:

• Monitor pollen and mold counts, which are usually reported as part of weather reports. When counts are high, keep your children indoors, and keep doors and windows in your house and car closed.
• Try using a humidifier. The moisture from a humidifier can soothe dry sinus passages, but note that humidifiers are prone to collecting dust and mold. If you do use a humidifier or have one in your child's room, make sure to clean it completely and often.

If your child's symptoms are not relieved by these tips, there are several choices of over-the-counter (OTC) medicines you can try.

The best allergy medicine for kids depends on your child's age, symptoms and other health conditions. If your child is diagnosed with allergic rhinitis, treatment can include nasal sprays, such as cromolyn sodium or oral antihistamines, such as loratadine (Claritin), fexofenadine (Allegra) or cetirizine (Zyrtec) for mild or episodic symptoms. Zyrtec has been approved by the U.S. Food and Drug Administration (FDA) for children older than 6 months of age. Claritin and Allegra have been approved for use in children age 2 and older. Zyrtec, Allegra and Claritin are available in a liquid syrup formulation that is specially dosed for children.

For children with severe allergy symptoms that are not relieved by oral medications, a steroidal nasal spray may be considered. Nasacort, Flonase and Nasonex have all been approved by the FDA for children over 2 years of age. The dose is typically one spray per nostril, once daily. Nosebleeds are a common side effect of these nasal sprays but are usually nothing to worry about. Coating the insides of your child's nostrils with a saline gel, like Ayr, may help prevent this side effect.

If you are looking for an allergy medicine for a child of toddler age or older who is experiencing itchy eyes, consider topical allergy eye drops, such as olopatadine (Pataday), for kids age 3 and older, or ketotifen (Zaditor), for children age 2 and older. These are antihistamine medications that can relieve itchy eyes due to allergens for up 12 hours.

If you decide to treat your child's symptoms with OTC medicines, be sure to follow the directions on the package carefully. Do not give your child more medicine than directed on the package without talking to a healthcare provider first.

Although nasal symptoms, such as a runny nose, may exist in babies under age 2, allergic rhinitis is uncommon in this group since they have not yet had repeated exposure to inhaled allergens. Before you look for an allergy medicine for a 1-year-old or a 2-year-old, call your child's healthcare provider. Young children should be evaluated for other causes of allergy-like symptoms before being treated with common allergy medicines.

The last line of defense for all allergy sufferers is allergen immunotherapy. This can be in the form of allergy shots or tablets that dissolve under the tongue. Immunotherapy has been shown to be effective in adults and older children, and particularly in preventing allergic asthma. While women may not start immunotherapy during pregnancy, you may be able to continue the treatment during pregnancy if your provider tells you it's OK to do so. If you've tried other medications and they didn't relieve your allergies, see your healthcare provider. They may refer you to a specialist for allergen immunotherapy.

Reviewed April 2021.