Does My Child Have a Cold or Allergies?

If your child is coughing, sneezing, and has a runny nose for several weeks, but doesn't have a fever and otherwise seems well, do they just have a cold or could it be allergies?

If you're more likely to think allergies in the spring and cold during those back-to-school months, you might be wrong. Although most people think of spring as allergy season, depending on what your child's allergic to, autumn can be just as bad.

Symptom Overlap

Allergies and a cold are not treated the same, so it's important to know exactly what's behind your child's symptoms. The problem is that the two conditions have similar symptoms, making them easy to confuse.

Symptoms of both a cold and allergies include:

• A runny nose
• Cough
• Itchy throat
• Sneezing
• Watery eyes

That said, the causes of cold and allergies are very different. Allergies are a result of the immune system overreacting to something it is sensitive to (i.e., pollen, certain foods, etc.). Colds are caused by a viral infection that is spread from one infected person to another.

How to Tell the Difference

While both a cold and allergies can cause similar symptoms, a cold typically starts mild and peaks one to three days after infection. Typically, a child with a cold will also exhibit symptoms uncommon with allergies, including body aches, fever (although this is rare), and sore throat.

If the onset of symptoms occurs suddenly, it is likely allergies—especially if it occurs around the same time every year.

Paying attention to the following characteristics of these symptoms, as well as what accompanies them, can help you differentiate whether they are due to a cold virus or allergies.

Color of Nasal Discharge

Although a​ runny nose from a cold will start off being clear, it often turns yellow or green after three to five days. Children with allergies will continue to have just a clear runny nose.

Effect of Weather Changes

If your child's symptoms change with the weather, it's probably allergies. For example, ragweed counts usually decrease after heavy rain. If your child's symptoms improve after it rains, they might be allergic to ragweed.

If their symptoms are worse on days that are windy, that might also indicate an allergy. Pollen counts are often higher on windy days.

How Others Feel

A cold virus can hitch a ride in saliva and mucus that gets expelled when someone sneezes, coughs, or even just talks. It can also land on surfaces and live there for several hours, meaning touching things like door knobs or remote controls (and then touching the nose, eyes, or mouth) can get someone sick.

Given this and the close contact that is inevitable when sharing a home, it's likely that if your child has a cold, other family members are sick too.

If no one else at home is ill, that is a good sign allergies are to blame. However, it's also possible that everyone with symptoms has allergies and is allergic to the same things (e.g., dust or pet dander).

Facial Changes

Children with allergies often have dark circles under their eyes. This is due to congestion of small blood vessels below the skin in that area, which is very thin and, therefore, more translucent than other skin. While this can also occur with a cold, it's very common with allergies—so much so that this discoloration has been called an "allergic shiner."

A child with allergies might also push their nose up so frequently when itching it that they develop a small crease near the bottom of their nose. Inside, the nasal tissue will often be pale and swollen. In contrast, the inside of the nose of a child with a cold will usually be red and inflamed.

How to Prevent Allergy Symptoms

If your child does have seasonal allergies, you can take precautions to try to limit allergy symptoms. Since pollen count peaks in the late morning and early afternoon (10 a.m. to 4 p.m.), keep your child indoors at this time.

Keep the windows of your house and car closed to minimize your child's exposure to allergens (things they are allergic to). Check pollen counts and keep your child inside when there is a lot of pollen in the air. Don't let your child outside when people are mowing their lawns.

Allergy testing might also help if you aren't sure what is triggering your child's allergy symptoms. If the test reveals an allergy to ragweed, then you won't be surprised when they begin getting allergy symptoms when ragweed counts are high.

Treatment

Seeing your child struggle with a cold or allergies can be tough! Thankfully, no matter which one you are dealing with, there are a few treatment options that may help, depending on the symptoms your child is experiencing.

Pain Relievers

Some over-the-counter (OTC) pain medications can help treat symptoms such as headache, sore throat, and fever, depending on your child's age.

It is important to keep these guidelines in mind when choosing a pain reliever for your child:

• Children younger than six months should only be given acetaminophen (Tylenol).
• Children six months or older can be given acetaminophen or ibuprofen.
• Ask your child's doctor about dosage, which should be based on weight (not age).
• Children should never be given aspirin due to the risk of Reye’s syndrome, which is a very serious, but rare illness that can harm the liver and brain.

It is also important to read medication labels carefully before administering doses to your child. Of course, your child's pediatrician should give the okay to use OTC medications, regardless of age.

Nasal Congestion, Sneezing, and Cough

Medications that target cold and cough specifically should only be used for children over 4 years old unless directed by a doctor. Instead, you can try saline spray or drops for nasal problems (or a suction bulb for younger children), or use a humidifier or cool mist vaporizer.

The best way to combat a cold or allergies? Lots of rest! Drink plenty of fluids, monitor symptoms, and always reach out to your child's pediatrician if you have questions or concerns.

When to Call the Doctor

It can be difficult to see your child struggle with a cold or allergies, especially if the symptoms become more severe. It's important to keep an eye on how they are feeling and contact their pediatrician if you notice anything out of the ordinary.

That said, you know your child best! If you are concerned with a symptom not listed here, always reach out to your medical provider. They may recommend further testing, especially if you are unsure whether allergies are the culprit. This can include either blood or skin allergy tests that help determine a proper diagnosis.