A change of seasons can cause sniffles, coughing and congestion that keep your child home from school or child care. How can you figure out whether they have a nasal allergy or the common cold?

It's not always easy to tell the difference between a cold and allergies, including seasonal allergic rhinitis or "hay fever." But knowing the key symptoms can help. And since most kids -- including those with allergies -- will catch at least six colds every year, knowing how to "read" your child's symptoms is key.

Colds are caused by viruses. Rhinovirus is most commonly responsible, but there are many strains out there. If your child has a cold, you may notice them having a stuffy, runny nose, coughing, sore throat, fever occasionally, body aches and low energy.

Colds tend to go away, but allergies might not. Generally, kids with colds will begin to feel better within 5 days and recover fully within 14 days. Allergy symptoms tend to stick around longer (generally more than 3 weeks), since they're caused by a specific allergen in the air. Common allergens include mold, dust, pollen and animal dander.

While nasal allergies can be uncomfortable, they typically don’t cause high temperatures or body aches like viral infections like colds often do. Keep in mind, though, that kids with allergies may have dull headaches caused by sinus congestion.

Kids with nasal allergies are vulnerable to airborne triggers that may not affect everyone exposed. Signs that your child is experiencing allergies might include red, itchy, watery eyes; runny, itchy nose; persistent sneezing, sore throat, tightness in the chest, skin rash or irritation.

Itching is a red flag for allergies. When reacting to an allergen like pollen, the body releases a chemical called histamine. Histamine can lead to inflammation and itching. If your child has a cold instead, you will probably not see the itchy, reddened eyes, nose and throat tickles or skin reactions common with allergies.

Sneezing is also less common with a cold, with longer pauses between each sneeze. With allergies, sneezing can be more frequent and come in rapid bursts.

Both colds and allergies can cause runny noses. But nasal drainage caused by allergies tends to be thinner and more watery, compared with nasal mucus from a cold.

Now that you know whether your child is sick or has allergies, how do you help them feel better?

Colds are contagious and may affect the whole family. Having a seasonal toolkit with safe, nonprescription remedies can help you feel prepared.

After a cold, make sure your child stays home until they're fever-free for 24 hours. If no fever is present, wait until the symptoms are manageable. Make sure your child has enough energy to get through the day before returning to usual routines. If you're giving your child a fever reducer such as acetaminophen or ibuprofen, wait until they're fever-free without medication before sending them to school, day care, special events or play dates.

Keep in mind that antibiotics don't treat colds. They're only good for bacterial infections, not viral infections like the common cold. However, if your child develops a secondary infection such as walking pneumonia or an ear infection, antibiotics may be needed. If you see new or worsening symptoms that won't go away, consult with your child's doctor.

Allergies are not contagious. Management includes using saline spray/sinus rinses to clean up the nasal passages, removing allergens and excess mucus. Over the counter medications such as fluticasone nasal spray or Azelastine nasal spray may help with nasal congestion.

Over-the-counter antihistamines can also help with itching and other allergy symptoms. Nonsedating antihistamines including certirizine, fexofenadine and loratadine -- such as Zyrtec, Allegra and Claritin -- are preferable over diphenhydramine commonly known as Benadryl.

Kids may need allergy testing to pinpoint specific triggers. This may be the case if symptoms do not improve with over-the-counter medicines or if there is a prolonged need for these medications. Your child may need to see a specialist who can determine the source of their symptoms and suggest how to treat them.

Whatever is causing your child's sniffles, sneezes and coughs, your pediatrician is ready to help. Your child's doctor understands the daily worries that affect you as a parent or caregiver. Both allergies and colds can affect the quality of life and overall health of the child and family.

Keeping a growing child healthy and safe is a full-time job! Our role is to support you through it all, so don't hesitate to reach out for the support you need.

____

Christina Johns, MD, MEd, FAAP is a pediatrician and pediatric emergency physician who has served as the Senior Medical Advisor and Vice President of Communications for PM Pediatric Care, the largest urgent care network in the US. Her clinical practice is in Annapolis, Maryland. A TEDx speaker and official spokesperson for the American Academy of Pediatrics, Dr. Johns has extensive media experience, from digital and print to radio and TV, local and national. She has been a medical contributor to ABC News’ "Good Morning America" and has had multiple appearances on CNN and a variety of local news and parenting outlets.

©2025 Tribune Content Agency, LLC.