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Allergy Or Cold: How Can I Tell?
Allergy symptoms and cold symptoms are very similar and may be present at the same time. The following will help differentiate an allergy from a cold:
Allergy
- The symptoms include runny nose (thin, clear nasal discharge), watery eyes, repeated attacks of sneezing and itching of the nose, eyes or skin.
- Allergies do not cause a fever and children may be more uncomfortable than sick.
- Severity of allergy symptoms may vary on a daily basis depending on the pollen count.
Colds
- The symptoms of a cold begin with a clear, yellow. or green nasal discharge’
- A cold may last up to 3 weeks from beginning to end
- Fever (over 101 degrees) may be present for 1-4 days.
- Coughing may be present and may last up to 10 days.
- Ear infections, sinus infections, and pneumonia are more common with a cold than with allergies.
What is an allergy?
When the human body's natural defense system wrongly identifies an otherwise harmless substance (like pollen) as harmful and then overreacts in an attempt to protect the body, the result is called an allergy.
What causes allergies?
Some children have a more active natural-defense that makes them very allergic. This is often passed on in families. For example, if a parent has hay fever (seasonal allergic rhinitis), there is a 50 percent chance that his/her child also will be allergic to pollen: this increases to 70 percent if both parents are allergic.
Allergens are substances that cause the body to overact when defending itself. Allergens may be inhaled, eaten, or they can come in contact with the skin. Some of the more common allergens are pollens, molds, house dust mites, animal dander and saliva (cat, dog, horse, rabbit), chemicals used in industry, some foods and medicines and venom from insect stings.
When do allergies first appear in children?
During infancy, some children show signs of allergic reactions to certain foods, such as cow's milk. Other children experience their first problems during adolescence. However, most children show the first signs of asthma or hayfever while in elementary school.
Some children who have severe eczema or dermititis during infancy also will develop hay fever and asthma later in life. For many children, these problems will not continue into adulthood.
Allergy symptoms will probably reoccur every year, perhaps for a lifetime. However, not everyone is bothered by their allergies.
When does my child need to see an allergist?
In some cases, even prescription medicines may not be able to control the allergy symptoms. In some cases, your child may have difficulty with side effects of medications. An allergist is a specialist who will evaluate your child and help determine what he/she is allergic to. Medicines or "allergy shots" may be recommended. These "allergy shots" contain small, but gradually increasing amounts of the pollens, molds, dust, etc. to which your child is allergic. This "fools" the body's defenses and makes your child less sensitive, so there are fewer (or no) problems when your child comes into contact with these things. Allergy shots, however, are not effective for food allergies. It is important to understand that only a small number of children require allergy shots. Allergy testing is not painful.
What are the most common allergic conditions, their causes and problems?
Asthma
Causes: Possible triggers of an attack of asthma include: pollen, dust mites, cigarette smoke, furry animals, viral infections (colds), changing weather conditions, exercise, and emotional stress.
Symptoms: Coughing; wheezing; difficulty in breathing; shortness of breath; chest tightness; coughing with activity or exertion.
Hay Fever (Allergic Rhinitis)
Causes: Pollen from trees, grasses or weeds. Molds, house dust mites, and furry animals.
Symptoms: Stuffy nose, sneezing and a runny nose; mouth breathing because of stuffy nose; discoloration and swelling under eyes; watery eyes; rubbing or wrinkling nose and facial grimacing to relieve nasal itching.
Season: April/May-trees: May/July-grass: Late August-ragweed: Winter-dust and mold.
Food Allergies
Causes: Any foods, but among the common ones are eggs, peanuts, milk, nuts, soy, fish, wheat, peas, and shellfish.
Symptoms: Vomiting, diarrhea, hives, and wheezing.
Eczema (Atopic Dermititis)
Causes: Food allergy, contact with allergens (pollens, dust mites, furry animals).
Symptoms: A patchy, dry, red, itchy rash that often occurs in the creases of the arms, legs and neck, but can occur anywhere on the body.
Hives
Causes: Food allergies, drugs (such as aspirin, penicillin or sulfa), and viruses. Cause is often unknown.
Symptoms: Itchy, slightly raised patches on the skin that are redder or paler than the surrounding skin and may be found on different parts of the body at the same time. Hives will blanch when pressed (color of hive turns white when pressed and turns back to red when the skin pressure is released).
Contact Dermititis
Causes: Contact with any substance that results in a reaction on the skin surface. Common causes include: poison ivy, oak, and sumac; household detergents and cleaners; and chemicals in some cosmetics and perfumes. Some children are more susceptible.
Symptoms: Itchy, red and raised patches in clusters, which may blister. These rashes are not contagious, unless they are scratched and become secondarily infected.
What treatment is recommended for allergic children?
Treatment with the following medicines is aimed at providing relief from allergy and cold symptoms. The treatments recommended below should provide some relief for most children.
Antihistamines
Antihistamines are the best treatment for hay fever allergy. Antihistamines work by blocking the allergy symptoms caused by pollens.
Allergy symptoms clear up faster if antihistamines are given at the first sign of sneezing or sniffing. For children with occasional symptoms, antihistamines may be used only on days when symptoms are present. For children with daily symptoms, the best control is attained if antihistamines are taken continuously throughout the allergy season.
Benedryl, chlorpheniramine, and brompheniramine are the most common over the counter antihistamines. The main side effect of over the counter antihistamines is drowsiness.
Zyrtec, Claritin, and Allergra are prescription non-sedating antihistamines that can be used if the over the counter medicines make your child drowsy. Zyrtec is available in liquid and tablet form and Claritin is available in liquid, reditabs (dissolves when placed on tongue), and tablets.
Decongestants
Decongestants work to reduce nasal congestion by reducing the swelling in your child’s nose caused by allergy or the common cold. Decongestants can increase your child's activity level and/or make it harder for your child to fall asleep.
Pseudoephedrine (Sudafed), phenylpropanolamine, and phenylephrine are the most common decongestants. Sudafed is available as a liquid (15 mg/teaspoon), drops (7.5 mg/0.8ml), 15 mg chewable tablet, 30 / 60 mg tablets (Deconsal II), and 120 mg long-acting tablets. Be careful not to mix up the liquid and drop formulations, as the drops are twice as concentrated as the liquid.
If your child becomes drowsy when using an antihistamine alone, changing to a combination product that contains an antihistamine with a decongestant (such as pseudoephedrine or phenylpropanolamine) may help offset the drowiness.
Claritin-D is Claritin and pseudoephedrine combined and is available in a 12 hour (2 times/day) and 24 hour (one time/day) formulation. Allegra-D is Allegra and pseudoephedrine combined and is used 2 times/day.
Cough Suppressant
Dextromethorphan (DM) works to relieve coughing. It can be used alone for a dry, irritating cough or in combination with an antihistamine/decongestant for relief of a post-nasal drip.
Codeine syrups can be prescribed if dextromethorphan does not relieve your child’s cough. Your child should be examined by a doctor before codeine preparations are prescribed.
Expectorants
Expectorants are present in many cold/cough preparations. They are intended to break up mucus. However, they provide little relief in children.
What formulation of over the counter medicines should I try?
Remember to always check the ingredients of any medicine you use. Many of the brand name cold medicines have generic equivalents, which are as effective.
Pediacare Cough and Cold, Dimetapp DM, and Triaminicol are brand name, over the counter, combinations of an antihistamine, decongestant, and cough suppressant.
These combinations contain chlorphenerimine or brompheniramine (1-2 mg), pseudoephedrine (10-15 mg) or phenylpropanolamine (6.25-12.5 mg) and dextromethorphan (DM) (5-10 mg), all in one teaspoon.
These medicines can be given as often as every 4 hours to relieve the symptoms of allergy or a cold.
What dose should I give my child?
The following doses are based on your child’s weight. Start with the lower dose. If your child’s symptoms are not relieved and no side effects occur, increase 1/4 teaspoon/dose up to the maximum recommended dose. Do not give more than 2 teaspoons per dose.
10-20 pounds: 1/4-1/2 teaspoons every 4 hours
20-30 pounds: 1/2-3/4 teaspoons every 4 hours
30-40 pounds: 3/4- 1 teaspoons every 4 hours
Over 40 pounds: 1-2 teaspoons every 4 hours
If your child becomes drowsy or overactive, continue the drug, but temporarily decrease the dosage. If the side effects continue despite the lower dose, stop the medicine and call our office. These medicines should not be used in infants less than 5 months of age.
What are Nasal steroids?
Nasal steroids are effective in reducing allergy symptoms when an antihistamine alone does not provide enough relief. Flonase, Nasonex, Vancenase DS, and Vancenase Pockethaler are some commonly used nasal steroids.
Nasal steroids are safe and most effective when used daily during allergy season. It may take up to a week to see relief from allergy symptoms. Nasal steroids are sprayed in your child’s nose 1-2 times per day.
What is Nasalcrom?
Nasalcrom is an over the counter nasal spray that helps relieve nasal allergy symptoms. It must be given 4-6 times per day and is most effective if started before the allergy season begins. It can be used with all other allergy medicines.
What are Nasal Decongestant Sprays?
Nasal decongestant sprays are used to provide quick relief from nasal stuffiness that interferes with nasal breathing. They should only be used for a maximum of 5 days at one time when a cold is causing significant nasal congestion. If nasal symptoms are due to allergy, use the medicines recommended above. Prolonged use will result in significant worsening of nasal congestion.
Nasal decongestants are most effective when used with an oral decongestant. Use sprays that come with pump dispenser -- they are easier to use. The dose is one squirt in each nostril 1-2 times per day as needed for relief.
Afrin, Neosynephrine, and Nostrilla are commonly used nasal decongestant sprays. They are available in pediatric or adult strengths. The active ingredient: is Oxymetazoline Hydrochloride 0.05% (adult) and 0.025% (children’s).
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