A Guide to Allergies in Children
Key takeaways:
Allergies in kids are more common than many people think. Kids can develop allergies to foods, medicine, pollen, dust, dander, and other things.
Signs of allergies in kids include hives, itching, sneezing, and red, watery eyes. But babies and toddlers with allergies can develop unusual symptoms, like bloody stool and trouble gaining weight.
It may be time to see an allergist for allergy testing if you think your child may have allergies but you can't figure out exactly what's going on.
Table of contents
Allergies are common at every age. Even babies and toddlers can develop allergies. Allergies in children can show up in unexpected ways. Many children develop familiar symptoms like hives or stuffy noses. But others can have symptoms like bloody poop or trouble gaining weight.
Figuring out whether your baby is having an allergic reaction can be challenging. But knowing what to look out for and when to get help can make the process much easier. Here’s what you should know about allergies in kids.
What are signs of allergies in children?
Allergies are symptoms that develop when children are exposed to triggers, like:
Pollen or plants
Cockroaches
Dust, mold, or house mites
Animal dander
Medications
Chemicals
Foods, especially peanuts, tree nuts, soybeans, cow’s milk, fish, wheat, seafood, or sesame
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When they’re exposed to these triggers, kids who have allergies can develop symptoms like:
Rashes and hives
Congestion and runny nose
Sneezing
Itchy, red, watery eyes
Cough
Weight loss or trouble gaining weight
Children with allergies can also develop anaphylaxis — a more serious allergic reaction. Symptoms of anaphylaxis include:
Hives
Face, tongue, or lip swelling
Trouble swallowing
Throat tightness
Cough
Trouble breathing
Chest tightness
Vomiting
Diarrhea
Stomach pain
Dizziness
Confusion
What are the most common allergies in children?
Your child’s age matters when it comes to allergies. Children can develop allergies to many types of triggers, but they’re more likely to develop certain types of allergies at certain ages.
For example, babies and toddlers are more likely to develop food allergies than older children. Food allergies may last throughout childhood or even into adulthood.
But toddlers, young children, and school-age children are more likely to develop seasonal allergies. Babies and infants don’t usually have seasonal allergies.
Let’s go over some of the most common types of childhood allergies.
The most common allergy in young infants is cow's milk protein. Babies aren’t born with allergies, but they can start to develop them very soon after birth. Cow’s milk protein allergy causes inflammation and bleeding inside the baby’s gut, a problem called “allergic colitis.” (Allergic colitis is different from lactose intolerance, which usually happens in older people and is a problem digesting the sugar in milk.)
Sometimes allergic colitis shows up as blood in the diaper. Other times it might cause low iron levels or poor growth. Babies who have an allergy to cow’s milk protein should be switched to a diet that does not contain cow’s milk. If the baby is breastfeeding, the breastfeeding parent will need to remove cow’s milk from their diet, too. Fortunately, many babies outgrow this allergy by the age of 1.
Food allergies might be the scariest kind of allergies for parents. They’re increasing in frequency, although they’re still uncommon. About 6% of children have food allergies.
The most common food allergies in children are:
Peanut
Tree nut
Soy
Cow’s milk
Fish
Wheat
Seafood
Sesame
Most food allergies do not cause life-threatening reactions. Many children with food allergies only develop mild symptoms, like hives. But some children have life-threatening allergic reactions to foods.
Antihistamines can treat food allergies that aren’t life-threatening, such as mild hives. Children with a mild reaction to a food should be watched closely to make sure their symptoms don’t get worse.
When a food allergy could be life-threatening, children should keep an epinephrine self-injector (Auvi-Q or EpiPen) on hand. Children should be taught, in an age-appropriate way, to avoid their problem foods. And caregivers should be carefully instructed in signs of allergy.
When people think about “seasonal allergies” — or allergic rhinitis — they typically think of outdoor triggers, like pollen. But indoor triggers can cause allergies, too.
While outdoor allergies change by the season, indoor allergies are a problem all year, and they can be worse in the winter when windows and doors are kept tightly shut. That means children with indoor allergies can experience allergy symptoms all year.
Some of the most common causes of indoor allergies in kids are:
Dust
Mold
House mites
Smoke from fireplaces, stoves, and cigarettes
Chemicals in soaps, perfumes, and cosmetics
Pet dander
Children with indoor environmental allergies usually develop symptoms like:
Runny or stuffy nose
Red, itchy eyes
Cough
Rash or hives
If you think your child has an indoor allergy, keep track of when the allergy symptoms come and go. If possible, remove the items from your home and see if your child’s symptoms get better.
In general, treatment for these types of allergies is the same as for seasonal allergies. The biggest difference is that indoor allergies happen year round, so treatment has to go on for a long time.
Outdoor allergies are often called “seasonal allergies” or “hay fever.” Outdoor allergies usually come from plant chemicals, like pollen or molds. Any type of plant, tree, or grass can trigger an outdoor allergy.
Symptoms of seasonal allergies in kids can include:
Runny, stuffy nose
Red and itchy eyes
Eyelid swelling
Sneezing
Congestion and postnasal drip
Cough
Children usually begin to get seasonal allergies after their second birthday. Infants don’t get seasonal allergies because it takes time for the reactions to develop, and the type of pollen in the air changes every month or so.
Seasonal allergies range from mild to severe, but usually they’re not life-threatening.
Treatments for seasonal allergies include over-the-counter and prescription medications. These medications come in liquids, pills, nasal sprays, and eye drops.
Children can develop allergies to stings from insects like bees and wasps. A child who is allergic to bees will develop full-body symptoms quickly after getting stung. These might include severe swelling or breathing problems, which can happen within minutes of the sting.
Children with insect-sting allergies should carry an emergency allergy medication, such as an epinephrine auto-injector, or EpiPen. Read more about the epinephrine auto-injector below.
Children with bee sting allergies might also benefit from allergy shots.
Kids can develop medication allergies. The most common medication allergies in children include penicillin allergies and sulfa allergies. These are antibiotics that are prescribed to treat common childhood problems like ear and skin infections.
Medication allergy usually shows up as a rash on the skin after a child has been taking antibiotics for a few days. This can be confusing to parents because the antibiotic didn’t seem to cause a problem at first. But medication allergies, like all allergies, take time to develop and can change over time.
If you think your child has an allergic reaction to a medication, stop giving the medication and let their healthcare provider know right away. The provider will start a different medication that won’t cause an allergic reaction. They may also recommend allergy testing to figure out which medications may trigger an allergic reaction in your child.
What are common allergy treatments for children?
The best treatment for childhood allergies depends on the allergy — both the cause and reaction.
For all allergies, the best treatment is to avoid the trigger. But that’s not always possible, and medications may be needed to help with symptoms.
Here are some treatments commonly prescribed for childhood allergies.
Antihistamines for children come as syrups or tablets. These medications stop the body from developing an allergic reaction. They’re very effective.
It’s important to remember that antihistamines are not meant to cure a runny nose or suppress a cough — their job is to stop the reaction before it develops. Some common antihistamines are:
Diphenhydramine (Benadryl)
Chlorpheniramine (Chlor-Trimeton)
Cetirizine (Zyrtec)
Loratadine (Claritin)
Fexofenadine (Allegra)
When seasonal allergies cause a stuffy nose, it can be useful to treat it directly by squirting the inside of the nose with a medication. Some of these medications are safe for children, including:
Saline rinses and sprays
Fluticasone (Flonase)
Triamcinolone (NasaCort)
Olopatadine (Patanase)
Azelastine (Astelin)
Red, itchy eyes are a common problem for children with seasonal allergies. While antihistamine syrups or tablets can help, sometimes it is most effective to treat the eyes directly. A few different types of allergy eye drops are available:
Ketotifen (Alaway or Zaditor)
Bepotastine (Bepreve)
Olopatadine (Patanol or Pataday)
These devices contain a medication called epinephrine. Epinephrine is the only medication that can reverse anaphylaxis.
The powerful effect of epinephrine can keep swelling from interfering with breathing, and it helps support blood pressure if it starts to drop.
The effect of injected epinephrine is very fast, so it can be lifesaving in an emergency. But it’s important to know that the effect only lasts for about 15 to 20 minutes before it starts to wear off.
For that reason, a child who receives epinephrine should be taken to an emergency room right away. If the ER is more than a few minutes away, be ready to give a second dose of epinephrine before they get there.
Steroids are very effective at treating allergy symptoms of all types. These medications come in many different forms and often require a prescription. The downside of steroids is that they can cause side effects, especially if they’re used frequently. Common steroids include:
Can you prevent allergies in kids?
You can’t stop your child from developing allergies, but there are a few things you can do to help reduce their risk. Here’s what research shows:
Breastfeeding: Breast milk is very unlikely to trigger an allergic reaction, and it can help reduce the risk of cow’s milk protein allergy. Wheezing and eczema — common medical problems that are often linked to allergies — are also less likely when a baby breastfeeds for at least 6 months.
Solid foods: It’s a good idea to include a broad variety — including egg, dairy, peanut, tree nut, fish, shellfish, and sesame — because delaying these foods can make allergies more likely.
Dust mites: Exposure to dust and mold in early life can trigger allergies. Take steps to reduce dust in bedding, furniture, and carpets.
Cigarette smoke: The irritants in cigarette smoke cause inflammation in babies’ respiratory systems and may increase their risk of developing asthma and other lung problems.
Pets: The effect is very small, but some research suggests that children who grow up with a pet are less likely to develop allergies to pet dander.
Does every child with allergies need to see an allergist?
Not all kids with allergies need to see an allergist. But it’s a good idea for your child to see an allergist if:
Your child needs an allergy test: If you’re not sure what’s causing your child’s allergies, an allergy test can help figure out what’s really going on. Allergy tests can help you narrow down what your child really needs to avoid to stay symptom free.
Your child isn’t getting better: If your child isn’t getting better with regular allergy medication, it’s time to see an allergist. They may recommend newer allergy medication or allergy shots.
Your child has a life-threatening allergy: If your child has a life-threatening allergy, an allergist may recommend desensitization therapy.
The bottom line
Children, toddlers, and babies can develop allergies. The most common causes of allergies in kids include indoor allergens, outdoor allergens (hay fever), foods, and medications. Symptoms of allergies in kids include rashes, hives, runny nose, itchy or watery eyes, and sneezing. Some children develop unusual allergy symptoms like vomiting, poor weight gain, and bloody stool. Some children can develop anaphylaxis, a more serious allergic reaction.
Why trust our experts?
References
American College of Allergy, Asthma & Immunology. (2017). Seasonal allergies.
American College of Allergy, Asthma & Immunology. (2019). Food protein-induced enterocolitis syndrome (FPIES).
American Academy of Allergy, Asthma & Immunology. (2020). Food protein-induced enterocolitis syndrome (FPIES).
American Academy of Allergy, Asthma & Immunology. (2020). Prevention of allergies and asthma in children.
Healthychildren.org. (2020). Seasonal allergies in children.
Lodge, C. J., et al. (2012). Pets at birth do not increase allergic disease in at-risk children. Clinical & Experimental Allergy.
McEvoy, C. T., et al. (2017). Pulmonary effects of maternal smoking on the fetus and child: Effects on lung development, respiratory morbidities, and life long lung health. Paediatric Respiratory Reviews.
Meek, J. Y., et al. (2022). Technical report: Breastfeeding and the use of human milk. Pediatrics.
National Center for Health Statistics. (2023). More than a quarter of U.S. adults and children have at least one allergy. Centers for Disease Control and Prevention.
Nemours KidsHealth. (2022). Seasonal allergies (hay fever).
Shargorodsky, J., et al. (2015). Allergic sensitization, rhinitis and tobacco smoke exposure in US adults. PLoS One.
