Your child is back from overnight camp with a bad cough. You assume it’s a cold, because they have got a fever and say they caught it a few days before they came home. So you do all you can to help them fight it off.
A few days later, their fever is gone and they are back in action. But they are still coughing, and it goes on for weeks.
So why is this cold hanging on? Or is it something else, like allergies or asthma?
Your doctor can find out. Before you ask them though, try to notice these things to help them figure out what’s going on.
Is There a Fever?
Allergies can bring on sneezing, watery eyes, itchiness of the eyes, nose, and roof of the mouth, and sometimes a sore throat.
But “you don’t get fever with allergies,” even though they're often called “hay fever,” says Marc McMorris, MD. He's a pediatric allergist and immunologist with C.S. Mott Children’s Hospital.
“Usually, colds will come on gradually and you get runny nose, itchy eyes, and a low-grade fever (up to 101 F).”
What’s Up With Their Buddies?
Your child’s friends could be a big clue. Have you noticed any of them sniffling lately? Kids tend to pass colds and other illnesses back and forth.
“Most parents know who their kids have been around. We know what’s going through the community,” McMorris says.
If other children aren't sick around your child, then you may have to think of other issues that might be causing their symptoms.
How Long Have the Symptoms Lasted?
Colds tend to go away in 2 weeks or less. Allergies stick around longer. “It’s not going to be 3 days and you’re done,” McMorris says.
Nasal allergies can hang around for much of the year, especially in the plant-growing months, if you’re allergic to some kind of pollen.
Your child could also be allergic to something that’s indoors, such as dust mites, pet dander, indoor mold, or cockroaches. Those are year-round triggers.
What Time of Year Is It?
In the spring, pollens from trees and flowers are everywhere. If your child is sneezing, wheezing and dripping, blame the pollens.
In the summer, mold and insect bites can also trigger allergic reactions. The hot months are also marked by “food pollen syndrome.” That’s when fruits and vegetables carry allergens that can set off symptoms in your mouth.
Also, if your child is having symptoms at different times of the day, "it’s consistent with allergies,” McMorris says. “I always try to relate it to what kids are doing.”
Say your little one wakes up congested, for instance -- they may be reacting to dust mites, dander from the family dog or cat, or indoor molds. If they don’t want to eat for a few hours after waking up, it may be allergy-related nasal drainage dampening their appetite. If the itchy eyes and sneeziness tend to come on when they are at soccer practice in the morning, keep in mind that that's when plants tend to pollinate.
When it’s winter time and your child’s eyes are fine, though, it's more likely that a virus is to blame for their symptoms, McMorris says. Still, you’ll need to ask your pediatrician to find out for sure. You may also need a referral to a doctor who specializes in allergies.
How Old Is Your Child?
Most people's asthma starts by age 6, says Fernando Martinez, MD, a pediatric pulmonologist who leads the University of Arizona’s Asthma and Airway Disease Research Center.
“It is rare you will develop asthma [after 6]. Nothing is impossible, but it’s much more unlikely,” he says.
You can get allergies at any point in your life. But outdoor allergies tend to arrive between ages 4 and 6, McMorris says. Indoor allergies can start as early as age 3, but not always. For instance, “a child can take a while to develop allergies to a pet,” he says.
It may be time for an allergy test if the symptoms seem to be worse when your kid is at home and you have a furry pet.
Also, does your child have eczema? This itchy skin condition often goes hand in hand with allergies. And if your child has eczema and allergies, and they are younger than 6, “there’s a high probability” they will get asthma, Martinez says.
What's Coming Out of Their Nose?
The kind of stuff clogging up your child’s nose is another possible clue.
If it’s clear and watery, it’s more likely to be allergies. If it’s green and thick, think infection or virus.
You can try to un-stuff their nasal passages with a saltwater or saline solution. If you have an infant, use a suction bulb. You could also try an over-the-counter nasal steroid, like fluticasone (Flonase) or triamcinolone acetonide (Nasacort), for older children, McMorris says.
Do Allergies Run in Your Family?
If either parent has allergies, there’s a higher chance your child will, too. The odds go up even more if both of you do.
“It’s very much a genetic condition,” McMorris says.
Likewise, if both of you have asthma, your children are also likely to get it. About 25% to 30% of children with one parent who has asthma will have the disease.
Many people who have asthma also have allergies. Doctors call this “allergic asthma.” They can share triggers, such as pollen, pet dander, and mold spores.
Could It Be Asthma?
This question is “priority No. 1 for people with allergies,” Martinez says. That's because untreated asthma is dangerous and can be life-threatening.
You child's symptoms may point to this breathing problem if they also:
- Coughs at night, during exercise, or when they laugh
- Has chest tightness
- Is short of breath
- Gets colds that always seem to end up in the chest
- Becomes tired while doing normal activities
Although asthma lasts all year, it tends to peak in early autumn and the winter, Martinez says. Unlike allergies, viruses and stress can also trigger asthma. And of course, someone who has asthma or allergies could also catch a cold.
Give your pediatrician a call if you think your child may have asthma. Together, you and the doctor can get your little one feeling better.