Question:
Recently, my son, age 4 yrs, 10 mo., was diagnosed by a doctor
substituting for our pediatrician. He has had a cough and nasal
congestion for several months. A 21 day course of antibiotics did not
seem to make any difference in his condition. She diagnosed him with
allergies and prescribed Claritin ReadiTabs 10 mg and the full adult
dose of 50 mcg of Nasonex nasal spray. My concern with these
medications is that they are not proven as acceptable in children my
son's age. Claritin is recommended for ages 6+ and Nasonex for ages
12+. My question to you is of confirmation. Are these medications safe for a 4-5 year old child? What are the long term effects? Are there other
medications available which are proven safe and effective for this age
group? Would you administer these medications to your child at this
age?
Answer:
The first thing I would do is request allergy testing. When my son was
five (he's now 9), our family doctor didn't want to send him to an
allergist (costs the HMO money, don'tcha know). I didn't see how I would
know what to avoid and treat for unless we did. I found it very helpful!
Once I knew we needed to avoid dogs, cats, horses, mold, and dust mites,
I was able to make environmental changes. We covered mattresses and
pillows with mite-proof covers, moved stuffed animals out of the bedroom
(they now live in hampers in the living room), removed curtains, washed
bedding in hot water every week, banned all animals from our home, etc.
Eventually, we even tore the carpeting out of the bedrooms and installed
hardwood floors. I do think these environmental changes made a
difference. I can't stress how helpful it was to know what he was
allergic to, and how severely (his allergies were rated from 1 to 4+). As far as medication, I wouldn't feel comfortable giving the adult dose
of Claritin to a 4-yr-old. My 9-year-old was given the Claritin Reditabs
last year. I didn't notice it helping him at all, and he started getting
stomach pains. I stopped the Claritin and his stomach pains stopped. I
started him back on half the dose (cut a RediTab in half) and the
stomach pain started again. I read the details about side effects and
found it was a common complaint. And yes, we made sure he took the
medication with food. Needless to say, we stopped the Claritin. For the last 4 years he has been using a corticosteroid nasal spray (we
started with Vancenase, but when he started getting nosebleeds from it
we switched to Rhinocort) and regular antihistimines (we like chewable
Extendryl tablets because they taste like rootbeer). This combination
has worked well for him -- particularly the nasal spray. If I let his
nasal spray run out, he is guaranteed a sinus infection. If coughing continues once you have the sinus congestion cleared up, you
may need to investigate further. We thought we had everything figured
out and working well, but my son was just diagnosed with asthma. He
doesn't have obvious symptoms like his little brother, just coughing and
tightness in his chest. Two puffs of albuterol clears him right up.
