How to Identify if My Child Has Allergies or a Cold?

While allergy and cold symptoms are often similar, they're different diseases. See how to tell them if your child has allergies or a cold.

Written and verified by the dermatologist Maria del Carmen Hernandez.

Last update: 08 June, 2023

Upper respiratory infections, such as allergies and colds, are often confused in children. In fact, the symptoms of both overlap quite often, but there are also strong differences that can help you know how to recognize and treat them in the best way. To find out if your child has allergies or a cold, here’s everything you need to know.

First of all, it’s important to understand that both allergies and colds are common conditions in children and can manifest with similar symptoms, such as nasal congestion, sneezing, and a runny nose. However, there are some distinguishing features that can help you tell the difference between the two.

What are the differences between allergies and a cold?

The American Academy of Pediatrics lists the following as initial symptoms of allergies or hay fever:

• Itching of the eyes, nose, ears, or mouth
• Clear and watery nasal discharge
• Spasmodic sneezing

On the other hand, colds are caused by different types of viruses. While symptoms and severity may vary, different types of colds may share certain characteristics. The Centers for Disease Control and Prevention (CDC) suggests that the average healthy adult has 2 to 3 colds per year.

A cold doesn’t usually cause a rash or itchy eyes, which allows it to be quickly differentiated from allergies. The duration time of both conditions is also different, as the recovery of a cold is usually faster, between 7 to 10 days. On the contrary, allergies won’t disappear unless the triggering factor is eliminated or treatment is received. They then tend to cause symptoms for 2 to 3 weeks.

How can allergies be prevented?

Allergies occur when the immune system reacts adversely to certain substances, called “seasonal allergens”. The most common include the following:

• Tree pollen
• Dust mites
• Molds
• Pet dander
• Foods (peanuts, tree nuts, milk, and eggs)

Allergies aren’t contagious, as you must be sensitive to a substance to develop a reaction. Whereas colds are transmitted by droplets of the virus that the child sheds when sneezing or coughing during a cold.

Symptoms and treatment of allergies and colds

Colds and allergies share some common symptoms, such as the following:

• Sneezing
• Coughing
• Sore throat
• Watery eyes
• Runny nose
• Nasal congestion

Colds are most likely to cause fatigue, sore throat, body aches, and a stuffy nose. Even more severe cases can also cause headaches and fever. Meanwhile, allergies also cause itchy eyes, wheezing, and skin rashes, such as hives or eczema.

Are there therapeutic options?

Colds resolve over time. In this case, antibiotics won’t help, as they kill bacteria and not viruses. Therefore, in most cases, the only therapeutic option is to drink plenty of fluids and rest.

However, some drugs can help alleviate symptoms while the symptoms continue to progress. Ibuprofen, paracetamol, decongestant nasal sprays, and cough syrups can be great allies, as long as they’re administered under a pediatrician’s prescription.

In the case of allergies, an effective way to prevent symptoms is to avoid the triggering factors. If this isn’t possible, medications can be taken upon the recommendation of the pediatrician to reduce symptoms.

Antihistamines and children

Always consult your doctor before administering any over-the-counter cold medicine. In addition, the use of cold medications for prolonged periods of time isn’t advised.

Antihistamines work by blocking the effects of histamine. Although they’re considered over-the-counter, it should be noted that the FDA doesn’t recommend their use in children under the age of two (especially newborns), at least without a pediatrician’s authorization. In fact, according to a publication in Pediatric Allergy and Immunology, there’s a lack of studies regarding the safety of antihistamines in children under 2 years of age.

Also, babies have an immune system that’s not yet fully developed, so they’re more prone to side effects.

When is it advisable to go to the doctor?

In general, it’s not necessary to go to the doctor for a cold. However, when cold symptoms last more than 10 days, it’s advisable to do so, as it can lead to a more serious infection, such as pneumonia, sinusitis, or bronchitis.

Both allergies and colds can cause bacteria and viruses to build up in the lower respiratory tract and sinuses, causing more severe infections.

The Centers for Disease Control and Prevention recommends seeing a specialist in the following cases:

• Symptoms last more than 10 days.
• A child 3 months or younger has a cold with lethargy, fever, or both.
• Severe or unusual symptoms.
• There’s a high risk of complications (heart disease or compromised immune system).

Cold and allergies: So different and yet so similar

While some of the symptoms of cold and allergy are very similar, they are two very different health conditions. This is why determining which condition your child has can help with indicating the right treatment to help them feel better faster.

If symptoms don’t improve with treatment, or if a fever or rash develops, it’s recommended to consult a specialist to rule out a serious medical condition.