How to treat allergies in toddlers

When toddlers start sniffling, sneezing, and coughing, most parents assume they’ve picked up a cold or another respiratory virus. But when these symptoms linger for longer than the average illness, consider an environmental allergy.

“An allergy is an inappropriate or exaggerated response of the immune system when exposed to something,” says Adrianna Bravo, MD, a pediatrician and senior medical adviser for Inspire Diagnostics. “The exposure is not to something dangerous, but your body overreacts to it, almost like a false alarm.”

Interestingly, while food allergies can start before the age of 1—and are more likely to cause severe reactions, like anaphylaxis—other types of allergies typically don’t start until after a child’s first birthday. Why? Because the body needs environmental exposure before it can develop a sensitivity, says Dr. Bravo, so it’s unlikely you’ll notice signs of household and seasonal allergies until your child is a toddler. 

Here’s what to do if you think your toddler is showing signs of hay fever or allergic rhinitis, along with how to reduce their exposure to allergens and help them feel better. 

Toddler allergy symptoms

The signs of environmental allergies in toddlers are often pretty noticeable; in fact, it may even seem like your child has a cold or virus that simply won’t go away. However, while pediatric allergies and colds share many symptoms, there are some differences. 

According to Dr. Bravo, common allergy symptoms in toddlers include:

• Sneezing
• Runny or itchy nose
• Sinus pressure
• Itchy, watery eyes 
• Body itching, especially on the skin and in the ears
• Headaches
• Coughing
• Dark circles under the eyes
• Fatigue and tiredness

Less commonly—in more severe cases, or when exposure is chronic—toddler allergies can cause wheezing or trouble breathing and even lead to asthma, Dr. Bravo adds.

The timing of symptoms can also help you figure out if your toddler has allergies. Many parents of toddlers with allergies notice that symptoms worsen at night, so if your child seems mostly okay during the day but unwell in the evening hours, that could be an important clue. 

There are several reasons for this, says Dr. Bravo; aside from the fact that many people tend to get more congested when they lie down, we are often more exposed to our household allergens at night. “When we’re in our bedrooms, there can be the highest concentration of some of those indoor allergens, like dust mites,” Dr. Bravo explains, adding that toddlers are in their bedrooms for about 10 to 12 hours each night (which results in a lot of exposure). Similarly, kids who sleep in rooms near bathrooms, where mold and mildew are highly concentrated, may have more symptoms at night if they have mold allergies. 

Toddler allergies vs. cold

It can be hard for parents to differentiate between allergies and respiratory viruses in their toddlers since many of the symptoms are the same. In general, though, Dr. Bravo says you can look for three clues:

• Duration: If symptoms remain consistent for longer than 10 days, it’s more likely to be allergies than an illness.
• Fever: If your toddler has a fever with respiratory symptoms, it’s unlikely to be allergies and is probably infectious.
• Itching: Itchy eyes, ears, and skin issues—such as hives—are common signs of allergies, not an illness.

When toddler allergies start and how long they last

Most children younger than one won’t display environmental allergy symptoms, but after that, some allergens may begin to trigger an allergic reaction in your child. “By the time your child turns one, they have had enough exposure to things to have an immune system that could overreact,” Dr. Bravo says.

Still, indoor and outdoor allergies usually occur on a different timeline. Indoor allergens can be triggered at any point around your child’s first birthday; because you get a lot of exposure to these allergens by living in your home, the threshold for becoming sensitive to them happens much earlier than it does for outdoor allergens. Meanwhile, a child has to “live through a couple of seasons to become sensitized” to outdoor allergens, Dr. Bravo notes, so providers don’t usually see seasonal or pollen allergies until at least age 3.

Many parents wonder if their child will always have indoor or outdoor allergies once these reactions begin. Unfortunately, Dr. Bravo says environmental and seasonal allergies are likely to persist through childhood and possibly into adulthood, though the symptoms can decrease over time and become easier to treat and control. In fact, kids are actually less likely to outgrow these types of allergies than they are food allergies.

Common toddler allergies

While children may be allergic to many household or environmental allergens, the four most common categories of toddler allergies are pet dander, mold, dust mites, and seasonal or pollen allergies.

1. Pet dander

Kids can be allergic to many different pets, from dogs and cats to birds and hamsters. Basically, any animal that carries dander, or skin flakes, can be a trigger. In general, pet dander allergies are mild to moderate, though kids with asthma may have more severe reactions—and so might kids with atopic dermatitis (eczema), says Michelle Yasharpour, MD, an allergist and immunologist in Beverly Hills, California. 

Some kids will be able to cohabitate with a pet that triggers their allergies if they receive the right combination of treatments, but this isn’t always the case, unfortunately. The good news is that there’s some evidence suggesting exposure to pet dander as a baby can reduce the chance of developing an allergy later in childhood, so it might make sense to expose your child sooner rather than later if you’re planning to have a pet.

2. Mold

Mold can be found in rooms that tend to stay dark and damp: think bathrooms and basements, or rooms without adequate ventilation. When mold spores are released into the air, they are breathed in, which can cause an allergic reaction in some children. 

Mold is one of the more serious types of household allergens on our list: Not only can it exacerbate asthma, it is often associated with triggering new cases of asthma. One study found that babies who grew up in homes with high amounts of mold were three times more likely to develop asthma by age 7 than kids who didn’t. 

3. Dust mites

No one likes to think about it, but there are literally millions upon millions of invisible pests known as dust mites living in your bedroom. In fact, more than 80% of U.S. homes have dust mites—and anywhere from 40% to 85% of kids with asthma are allergic to them. You can’t eliminate dust mites completely, but you can keep them from making a home for themselves in your pillows and mattresses, reducing your exposure to their allergen-triggering existence. 

You’ll know your toddler has a dust mite allergy if their symptoms occur primarily at night; if your child is waking up during the night with a stuffy nose, sore throat, or nagging cough, it might be something in their bedding triggering their allergies. Dust mite allergies can also worsen atopic dermatitis and asthma symptoms in children.

4. Seasonal

Seasonal allergies—which include tree pollen, grass pollen, and weed pollen, among other things—can cause everything from sneezing and runny nose to itchiness of the ears and throat. Dr. Yasharpour says eye symptoms are also prevalent in kids with pollen allergies, so be on the lookout for red, itchy, watery eyes if you suspect your toddler has seasonal allergies. 

While this type of allergy is relatively mild, it can cause some complications in kids with a lot of exposure: Having a chronically stuffy nose can lead to sleep disorders in young children, like sleep apnea. 

Toddler allergy test

The best way to test your toddler for allergies is by taking them to an allergist; not only will they perform a detailed medical history and a physical exam, but they will also ask about any family history of allergies and asthma, according to Dr. Yasharpour.

An allergist may also perform one or more types of allergy testing to confirm whether your child has allergies (and if so, to which allergens), including:

• Skin prick test
• Patch test
• Intradermal skin test
• Blood test for immunoglobulin E (IgE) antibodies

If possible, it’s best to wait until your toddler is at least 2 before taking them for allergy testing, says Dr. Yasharpour: “Testing can be done as early as infancy, but caution must be used in interpreting tests at this age [because] sensitivity is much lower due to lower levels of IgE.”

Still, if your child is younger than 2 and exhibiting clear allergy signs, talk to an allergist about getting them tested ASAP.

How to relieve toddler allergy symptoms 

Helping your toddler manage their allergy symptoms revolves around two goals: reducing their allergen exposure and providing treatment options to relieve your child’s allergy symptoms. 

You can reduce your toddler’s exposure with the following tips:

• Add air filters or purifiers to your home to reduce the number of allergens circulating—including in air conditioning units.
• Use hypoallergenic bedding and sealing mattresses and pillows in dust mite covers. 
• Wash bedding frequently in hot water.
• Keep pets outdoors if your child has a pet dander allergy. If a pet is already part of your family, you can still take steps to reduce exposure to irritants, says Dr. Yasharpour. Keep your pet out of your child’s bedroom, groom and bathe them frequently, and clean or vacuum as often as possible to limit dander. 
• Change clothes after coming indoors to avoid the spread of pollen in the home. Wash items after you’ve spent time outside and keep outdoor clothing items away from bedrooms.
• Remove wall-to-wall carpeting, if possible.
• Clean bathrooms often to reduce the spread of mold and mildew. 
• Add dehumidifiers to damp rooms.
• Take extra protective steps during allergy season, like keeping your child’s bedroom windows closed overnight and car windows closed while traveling or staying inside when pollen counts are high.

Once you’ve taken steps to limit your toddler’s exposure to their allergy triggers, you can treat your toddler’s symptoms with:

• Nasal rinses: Dr. Yasharpour recommends nasal irrigation with saline to flush out allergens.
• Over-the-counter (OTC) allergy medicines: Antihistamine-based pills, liquids, and eye drops can reduce allergy symptoms, as can steroid nasal sprays and prescription inhalers. However, some of these medications may not be safe for your child to take depending on their age and other medical conditions. Always check with your child’s pediatrician before administering any OTC allergy medication—especially combination medications that may contain decongestants. Typically, children’s formulations of Claritin, Zyrtec, and Allegra are considered safe for kids older than 2, as are Flonase and Nasacort (though your toddler might not be a fan of nasal sprays!). 
• Desensitization methods: According to Dr. Yasharpour, desensitization can reprogram the immune system and even be curative in some patients; your child’s allergist may recommend allergy shots, tablets, or drops to lessen their response to their allergens. This is also called immunotherapy and can be very effective for the majority of children. Note: You should never try to desensitize your child on your own, only under the care of a healthcare provider.

Although you might be tempted to run a humidifier while your toddler sleeps to alleviate nasal congestion or coughing, moist air can actually make some allergy symptoms worse; dust mites thrive in humid environments, and mold is more likely to form where the air is warm and wet, too. Many experts advise parents to remove excess moisture from the air with a dehumidifier instead.

Beyond that, don’t stress about choosing the right treatments for your toddler on your own: consult with your child’s allergist for an individualized plan. If your child is afraid of needles or frequent travel to receive allergy shots is a concern, says Dr. Yasharpour, an allergist will take that into consideration when advising you on the best next steps.