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You are seeing a 3-year-old who is having symptoms of seasonal allergic rhinitis. The patient was recently tested for IgE to a variety of allergens and tested positive against some airborne pollens.
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April 22, 2025 at 7:49 pm
C) Diphenhydramine
It usually takes a couple of seasons of exposure to pollens to develop seasonal allergic rhinitis, so it is uncommon in children < 2 years old. Pharmacological therapies approved for use in age 2 years and up include: non-sedating antihistamines, nasal steroids, and nasal antihistamines. Diphenhydramine is a sedating antihistamine and is not recommended. Non-pharmacological management includes use of air purifiers, masks if tolerated when in a high pollen location, following online pollen forecasts and staying indoors when counts are high, close windows in the car and at home, change clothes when coming in from outdoors, and bathing before bed to wash off any allergens and reduce bedding contamination.