Congestion Triggered By Changes In The Weather

Question of the Week

Q. My daughter is almost 2 1/2 yrs old. When the weather changes, that is, if it gets cold and when she takes a nap or sleeps in the night it appears as if she has cold and her nose is congested. She breathes loudly and sometimes she wakes up because of this. Last winter we tested for all allergies - foods, indoor and outdoor, and everything was negative. Spring, summer and fall she did not have this problem and again for the past one week she has the same problem. What could be the reason. Should I ask her pediatrician to do some test? He says she seems to be fine. Sangeetha, Santa Barbara, CA

A. Well, it isn't really possible to test for 'all allergies.' You can test for common ones, like mold, dust mites, pet dander, etc., but you can't test for everything. So it is still possible to be allergic to something, even though you have negative allergy tests.

For example, the ImmunoCAP Childhood Allergy Profile is a blood test that can test for:

• Cat dander
• Cockroach
• Dog dander
• Egg white
• Fish, cod
• House dust mite (Dermatophagoides farinae)
• Milk
• Outdoor mold (Alternaria alternata)
• Peanut
• Soybean
• Wheat
• Total IgE

If you add on a ImmunoCAP Regional Profile, like for Southern California, you can also test for common outdoor allergy triggers, like bermuda grass, common pigweed, false ragweed, Japanese cedar, maple leaf sycamore, oak, olive, Russian thistle, scale, and walnut.

Although it still isn't 'everything' that you could be allergic to, if your child didn't have this kind of testing, then you might ask if it would be helpful.

And keep in mind that seasonal allergies as a cause of your child's congestion is more likely if other family members have allergies too.

It is also possible that she is just more likely to catch colds that are caused by viruses, since they are more common during the late fall and winter. This is especially likely if she is in daycare or around a lot of other children who are sick right now.

Another possibility is that during the winter, especially if you have begun using your indoor heater already, the air in the house is likely to be dry and irritate her nose. This can make her sound congested and it might be better with a saline nasal moisturizing spray and/or a cool mist humidifier.

If she coughs a lot when she has these episodes, then it could also be that she has asthma, which can be triggered by changes in the weather. And asthma symptoms are often worse at night.

There isn't necessarily a good test that your Pediatrician can do now to sort this out, but if you think it is allergies, you might ask about trying an allergy medication, like Claritin, Zyrtec, or Singulair, and/or a nasal steroid spray.

It may also help to see a Pediatric Allergy specialist, who can evaluate her to see if they think that it is allergies, asthma, or just a cold.

With her loud breathing and waking up at night, it may also help to see a Pediatric ENT specialist to make sure that she doesn't have obstructive sleep apnea.

Related Questions and Answers

• Do Babies have Sinuses?
• Is it a Cold or Allergies?
• Is It A Sinus Infection?
• Where are my antibiotics?
• Why Don't Antibiotics Work Anymore?

And review our symptom checker guide to nasal congestion for more information.