With allergy season approaching, many parents are thinking about keeping antihistamines for children on hand at all times. However, choosing a medicine may not be so simple - much depends on the age of the child and specific situations in which help may be needed. Often parents come to the pharmacy and start asking the mayor what is the best thing to do. In order to help our readers in this situation, allergist-immunologist Yegor Batorov answers the most pressing questions from parents about this group of drugs.
What are the best, safest and most effective antiallergenic drugs for children under one year of age?
The choice of antiallergic drugs for children under one year old, unfortunately or fortunately, is small. After the first month of life, you can give dimetindene drops. If an antihistamine is used in the treatment of dermatosis, then this property is unnecessary, if bronchitis, then it is harmful, and if, for example, rhinitis, then in some cases it may be useful, but this is up to the doctor to decide. The drug belongs to the first generation and can have a sedative effect. In addition, when taken for more than 1-2 weeks, a decrease in effect may be observed.
From six months you can start using the second generation drug - cetirizine drops. It is less likely to develop side effects, in particular those affecting the central nervous system, so in general it is preferable for children.
In addition, from the second month, parenteral - intramuscular or intravenous - administration of chloropyramine is possible - strictly as prescribed by a doctor and in a hospital setting.
List of recommended antihistamines before vaccination
The list of antihistamines offered by the modern pharmaceutical industry is truly enormous and depends only on the age of the child, the health status and financial capabilities of the parents.
Fenistil drops and gel
For children under one year old
Usually, during vaccination of infants, the use of antihistamines is not required, since the child has enough antibodies that he receives from mother's milk.
If you have predispositions or there is an urgent need for vaccination, you can use the following medications:
- Fenistil is one of the most effective drugs in this group, used to treat infants. It has a pleasant taste and a minimum of contraindications. To make it easier to take, it is added to milk. The maximum daily dose is ten drops of the medicine, the frequency of administration is three times;
- Suprastin is quite effective and has a considerable number of side effects, so it can only be given to a child under one year of age if there is no other choice. The maximum daily dose is one tablet, the frequency of administration is three times;
- Zyrtec is an antihistamine of the latest generation, characterized by a convenient form of use (nasal drops). It is used no earlier than the child reaches six months of age. Once a day. At the moment, this is the most powerful drug in this group, approved for use by children under one year of age.
From one year and older
The list of drugs approved for use within this age group is incomparably larger; we list the most effective:
- Claritin. Used in the form of syrup or tablets, no more than once a day;
- Kestin . Easy to use, has a pleasant taste. Daily dosage – one teaspoon;
- Lordestin . The maximum daily dose is one tablet;
- Diazolin. A classic medicine, used once a day.
Claritin tablets
Which drug is best for a child over one year old?
The list continues to grow with age. In general, it is considered preferable to use second-generation antihistamines, unless there are some nuances that the doctor can judge. In addition to the already mentioned cetirizine, desloratadine can be used from the age of one year, and levocetirizine from the age of two. The mentioned drug is unlikely to have a sedative effect (or stimulating - more often in young children), its effect does not weaken depending on the duration of use, that is, if necessary, its long-term use is possible.
The choice of first generation antihistamines is also expanding, but their use, due to the peculiarities of their effect on the body, is very specific and should be carried out as prescribed by a doctor. From the age of one it is possible to take hydroxyzine (rec.!), from the age of two - cyproheptadine. Both drugs have pronounced antipruritic and sedative effects, which can be very useful in the treatment of allergic dermatoses, but, unfortunately, these effects weaken when taken for more than two weeks. Hydroxyzine is generally more often used as a sedative, so do not forget about its “antiallergic” effects when combined with other antihistamines.
This pharmacological celebration of life is belatedly joined by tablet forms of clemastine (from the age of six, rec.!), diphenhydramine (from the age of seven) and fexofenadine (from the age of 12).
Preparation rules
Although you can often hear that you should not prepare for a flu shot, some formalities are still worth following. Thus, it is recommended to refuse vaccination if you feel the first signs of illness: sore throat, slight nasal congestion, sneezing frequently, etc. A contraindication to vaccination is also an exacerbation of a chronic disease. Before vaccination, an examination by a therapist or pediatrician is also required. After it, you should take care, because you may experience slight malaise, expressed in chills, weakness, and sweating. Therefore, you should not sit in a hot bath (showering is not contraindicated), go for long walks, and you should also postpone going to public places (cafes, cinemas, etc.).
Those who suffer from an allergy to chicken protein (it is part of vaccines) should avoid subunit (containing individual components of pathogenic microorganisms) and split vaccines. Vaccination is prescribed to them individually and is carried out only under the supervision of a doctor and under the cover of antiallergic drugs.
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Is it possible to calm the child down a little with an antihistamine?
The desire is understandable, but it is impossible. Firstly, the sedative effect of these drugs - most often the first generation - is very non-selective. When the effect is achieved, you will “turn off” not only motor activity, including “vocal” activity, but also thought processes, and in case of an overdose, there is a danger of developing hallucinations, convulsions, tachycardia, urinary retention, fever, and coma. Secondly, you can achieve the exact opposite result: in children - the younger, the more often - antihistamines (usually the first generation, but potentially any) can have an stimulating rather than a sedative effect.
How many days before vaccination should you take an antihistamine “to avoid a reaction”?
Not at all. Prophylactic use of H1-histamine receptor blockers before vaccination is widespread, mainly as a sedative for parents, especially if the child is “allergic to everything.” A true allergy to vaccine components is extremely rare, and its detection - after administration of the drug - will most likely lead to the cancellation of revaccination. More often (but also rarely) there are pseudo-allergic reactions. In both cases, processes are launched in the body during which, in addition to histamine—the receptors to which are blocked by “antihistamines”—many other biologically active substances with a similar mechanism of action are released. Prophylactic use of, for example, dimethindene (or cetirizine) can reduce - until completely disappearing - "mild" symptoms, such as urticaria, which would not cause much discomfort, but could serve as an alarming signal for the future. You can drink the same dimethindene (or cetirizine) and relieve such symptoms “after the fact.” For severe reactions, such as extensive skin lesions, bronchospasm or drop in blood pressure, taking antihistamines will not help either before or after vaccination. Most of the drugs discussed have little effect on fever and other “non-allergic” side effects (if you do not take into account the parenteral administration of diphenhydramine). By the way, the frequency of the same fever is statistically significantly reduced by preliminary intake of certain NSAIDs, but it can also reduce the effectiveness of antibody production.
What actions should parents take after vaccination? Are there any restrictions?
I repeat, vaccination is a completely standard procedure, so you should not put your child to bed and be “overprotective” of him. The family can live their normal lives, but, of course, remember that the child was vaccinated, and maybe be a little more attentive to the child.
When administering DPT and other serious vaccines in the next three days, try to adhere to a more or less gentle regimen for the child, that is, it is advisable to avoid unnecessary visits, limit contacts and the overall burden on the child. At this time, the baby is shown a calm home regime. Walking is not prohibited. Just try to cover the grafting site with clothing to prevent dirt from getting on it. And, of course, the walk should be of a reasonable length.
It is also recommended not to experiment with nutrition, that is, not to introduce new foods into the child’s diet, in the period a week before vaccination and a week after. If a child is prone to allergic reactions, during this period he should receive food that excludes those foods that can cause allergies.
If your child has had an injection (and almost all vaccines are injectable), try not to bathe him or her for a day after the shot. The next day, you can take a bath as usual, again, if the child does not have a temperature reaction.
After vaccination against polio, which is dripped into the mouth, it is recommended to limit food and drink for an hour, since the live polio vaccine can be washed off from the mucous membranes and not give the expected effect. This restriction does not apply to other vaccines that are administered by injection.
Thus, as you can see, the recommendations are the simplest. Strict restrictions are introduced in special cases related to vaccination of groups of children with severe chronic diseases, severe allergies, and so on.
The sanitary rules establish a recommendation regarding the post-vaccination period, according to which, after vaccination, a child should stay in a medical facility for 20-30 minutes. It is during this time period that the first manifestation of a possible allergic reaction is most likely. However, such situations in children, fortunately, are extremely rare. Parents who are concerned about the child's condition after vaccination can always stay and spend this time under the supervision of a doctor in a medical facility. If a child is prone to an allergic reaction, this condition must be met.
And one last thing. Before going for vaccination, it is advisable to have an antipyretic drug at home in case the child develops a fever in the evening. For babies under 1 year of age, it is better to take suppositories; for older children, a tablet preparation or in the form of syrup is suitable. The threshold at which it is necessary to reduce the temperature is different for each child. Parents can determine for themselves based on the child’s condition whether he needs to be given an antipyretic,
We give antihistamine in syrup. It seems that the child’s rash has appeared/increased...
Is it possible. Stop the antihistamine syrup for children and start giving the drug in drops or tablets, ideally a different one, but you can try the same one. A true allergy to antihistamines is rare - a little more than a hundred confirmed cases have been described in the literature over the past 60 years, although, of course, not every case is published and not every case even requires a visit to a doctor. An allergic or pseudo-allergic reaction to the numerous components of the syrup, designed to make its use pleasant, is more likely. By the way, manufacturers indicate “individual intolerance to components” in “contraindications”, but this intolerance is revealed only experimentally.
Note from the editor: mark “rec.!” means a drug of which all or most of the trade names are available with a prescription. Other drugs may be prescription drugs depending on the form and brand name.
Side effects. Do I need to take medications before and after vaccination?
Evgeny Komarovsky
Pediatrician, author of several popular books for parents, TV presenter
June 1, 10:28
This material is also available in Ukrainian
Any options for drug preparation for vaccination are complete nonsense
I consider such actions (and advice!) simply banditry. Well, imagine how you take a blood thinner for five days, and then, God forbid, of course, you fall, break your leg and die from bleeding. Introduced?
Any options for drug preparation for vaccination are complete nonsense. Don't listen to anyone or do anything like that. Nonsense.
Does the amount of antibodies produced depend on the reaction to the vaccine?
I have not seen any scientific work indicating that such a dependence clearly exists. Neither for coronavirus, nor for other vaccines against other diseases.
These are fundamentally two different parts of immunity: the body’s universal response with a high temperature to any infection and the body’s specific response to the introduction of a specific vaccine.
Younger people may have a stronger response to immunization, which is why, for example, in the United States, the United States produces a flu vaccine for older people with an increased dose of antigen to stimulate the immune response. But in general, it is possible to determine the average dose, which will not cause too strong a reaction to the vaccine in anyone.
Can a nursing mother be vaccinated against Covid?
You see, what’s the matter: there is not yet enough research on the effect of vaccinations against coronavirus infection on a nursing mother and her child, so legally a doctor really cannot write “you can be vaccinated.” But practically nowhere is it written that this cannot be done.
