Does Your Child Have a Cold, or Is it Allergies?
It may not be easy to tell what's making your child sneeze and cough.
If your child seems to get a cold every April, when everything in your neighborhood starts blooming, it's likely that he has seasonal allergies.
“A mother can do a pretty good job on her own of making a quick distinction,” Tringale says. “If it happens every spring with clear nasal discharge and no fever, it's most likely allergies.”
There's one time of year when an annual cold may actually be a cold, though, says Chiu: Back-to-school time in September.
“At the start of school season, everyone always seems to get an upper respiratory infection, with all the exposures from classmates,” she says, “so it may be hard to distinguish between viral cold and fall allergy.”
The younger your child, the less likely she is to have a seasonal environmental allergy.
“No one is born with an allergy,” says Johnson, who notes that most children under age 3 don't have allergies yet. “It takes 2 to 3 seasons, even in a highly allergic person, to develop the immunologic response [to pollen, which causes allergic reactions].”
Allergies tend to run in families, so a child with a family history of allergies whose parents notice that she gets sneezy every May can ask the pediatrician to recommend an allergist, Chiu says. “The best, most cost-effective way [to be diagnosed] is to see an allergist for allergy skin testing, [when an allergen is placed onto the child's skin to check for a reaction],” she says.
If your child has allergies, ask the pediatrician whether over-the-counter antihistamines or eyedrops are appropriate for your child, or if she'll need prescription nasal spray. Older children may be cured of their allergies by getting regular allergy shots over the course of several years. Although the occasional 3-year-old with severe allergies does get allergy shots, Johnson says, it's easier for a 7-year-old to rationalize the benefits of getting a painful jab each week.
If your child begins a course of allergy shots but decides to quit before it's finished, the partial treatment may have a protective effect. A recent study published in the Journal of Allergy and Clinical Immunology\ found that children who only received a fraction of an allergy shot regimen needed less allergy medication and visited the doctor less often than they had before.
Sometimes, when a child's so-called cold or allergies endure for weeks or months, the parents bring her to the pediatrician's office and learn that a third, unconsidered condition is to blame.
“If symptoms 'always' persist, especially in preschoolers, that usually means something else is going on, like asthma, sinus infections or reflux,” Johnson says. “These are three things that can cause an ongoing cough that people don't think of. And some kids have non-allergic rhinitis, which is excess mucus production.”
Asthma that isn't diagnosed can be a serious problem for children, so parents should talk to their pediatricians about constant nighttime coughing in children.
“More than half of asthma attacks occur at night when children are sleeping,” Tringale says. “The worst asthma triggers are in the bedroom, and the nature of lying down makes it harder to get air. When parents hear children coughing at night, when there are no nasal symptoms and no fever, it can be an early sign of asthma. These are things that pediatricians and allergists are really skilled at diagnosing."