Not sure whether your child’s persistent runny nose is due to a cold or allergies? With respiratory illnesses constantly on the rise and seasonal allergies seemingly lasting year round (About 1 in 5 U.S. children are affected by seasonal allergies; boys slightly more than girls.), it can be difficult to distinguish between the two. We asked Natasha Burgert, M.D., a board-certified pediatrician, to give us some insight on the differences between colds and allergies, tips on how parents can identify allergic symptoms, and how to manage their little one’s seasonal allergies.

BabyCenter: At what age do allergies typically start to appear in children? How can a parent tell if their child has them?

Natasha Burgert: Babies don’t tend to suffer from seasonal allergies. During the first few years of life, kids need to be repeatedly exposed to trees, grasses, and flowers before they will develop a reaction to pollen. If a baby has a persistent runny nose, cold viruses are the most likely cause. By the preschool years, children have experienced multiple pollen seasons, gradually developing an allergic response. Parents often first notice itchy eyes and runny noses in the spring, when tree and grass pollen levels peak. As children grow, allergy symptoms follow a more predictable seasonal pattern, appearing each spring and fall.

By the age of 3, kids with seasonal allergies have identifiable allergic symptoms that repeat at predictable times of the year. If they suffer from seasonal allergies, don’t be discouraged or alarmed — seasonal allergies and other allergic conditions are highly treatable in kids. 

BC: How can a parent tell if their child has an allergy versus a cold or another illness?

NB: The main difference between allergies and viral illnesses is that allergies typically do not cause a fever, while itchiness is a common symptom. But with viral illnesses, fever is often a primary symptom, but not itchiness. Seasonal allergy symptoms in kids, which can last for weeks to months, include:

• nose, throat, or eyes itching
• sneezing
• runny or stuffy nose (watery mucus)
• red, watery eyes
• coughing
• fatigue or irritability 

Symptoms of the common cold, which typically lasts 7 to 10 days, can include:

• fever
• thick mucus
• body aches
• coughing
• sneezing

When it comes to allergies, some kids will get a sore throat or cough when pollen counts get high. To help your child with seasonal allergies, use simple modifications at home and over-the-counter medications.

BC: Let’s talk a little more about OTC medications. How can they help with allergies?

NB: You can safely and effectively manage seasonal allergies with over-the-counter medications and antihistamines, like Children’s Claritin^®, which offers kids 2 and older, 24-hour relief from allergy symptoms. It’s available without a prescription, and Children’s Claritin® syrup is free of dye, alcohol, and sugar while still offering a great, kid-approved taste. Some antihistamines cause drowsiness, but Children’s Claritin, doesn’t cause unwanted drowsiness – so kids can be kids. Nasal steroid sprays can effectively reduce nasal congestion, but they can take up to a week to work and can be challenging to administer to an active toddler.

Your child’s doctor can recommend the best treatment plan. They can also determine if a referral to an allergist is necessary, which is usually only needed if symptoms remain bothersome despite trying multiple options.

BC: Are allergies hereditary? Will a child develop allergies if one or both of their parents have them?

NB: Seasonal allergies have a strong genetic component. Most kids with seasonal allergies have at least one parent with the familiar and nagging symptoms. In fact, if one parent suffers from allergies, there’s a 30 to 50% likelihood their child will also experience the symptoms. This heritability climbs to 80% if both parents have seasonal allergies. Other allergic conditions, like asthma, eczema, and food allergies also can be inherited.

BC: When should a parent consider allergy testing for their child?

NB: Pediatric allergists, who specialize in diagnosing and managing allergic conditions, can perform allergy testing with skin prick tests, blood tests, oral challenges, or patch tests to identify allergens affecting your child. This type of testing is valuable when allergic symptoms are significant and identification of the specific allergen can help decrease exposure. I recommend allergy testing when a child’s allergic symptoms are severe, persistent, or unexplained. Most children with mild, occasional symptoms don’t need testing, especially since safe and effective over-the-counter treatments are readily available. But talk to your pediatrician to decide what’s best for your child. 

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BC: What can you do to minimize exposure to pollen, dust mites, or pet dander at home?

NB: It’s important to keep pollen outside of your house. When local pollen counts are high, a few changes to your daily routine can prevent it from getting into the places children sleep and play. So be sure to:

• Change your child’s clothes after spending time outside
• Wash their face and hair every night
• Keep the window closed, especially on windy days

To reduce indoor allergens like dust and pet dander, you should start with good cleaning practices:

• Regularly dust with damp microfiber cloths to trap and remove particles
• Use a vacuum with a HEPA filter to clean floors and upholstery
• Wash bedding frequently and use allergen-proof covers on pillows and mattresses
• Keep living areas well-ventilated, and use a dehumidifier to maintain humidity levels below 50%; use a high-quality air purifier to help limit allergens circulating in the air

BC: How can a parent manage their child’s allergies if they’re triggered at daycare or school?

NB: Parents often underestimate the impact of untreated seasonal allergies in kids. Uncontrolled allergies can lead to inattention at home and school, poor academic performance, difficulty participating in their favorite activities, and poorer sleep quality. If your child seems more fatigued or appears distracted due to their symptoms at home, school, or on the field, allergies could be the cause. 

And if your child’s symptoms are triggered by something in the daycare or school environment, the best defense is to give allergy medication at the first sign of symptoms. Common over-the-counter medications, like Children’s Claritin, provide 24-hour, non-drowsy control of the sneezing, runny nose, itchy, watery eyes, and itchy throat or nose and can provide relief throughout the entire school day.

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BC: Can a child grow out of allergies or can their allergies get better over time?

NB: Interestingly, allergies can change over time. This change is because a child’s immune system becomes more reactive as they grow. Symptoms are usually mild until early school age, when immune reactivity is especially high. Symptoms typically decrease in late adolescence but can resurge in adulthood. Managing allergies with lifestyle changes and OTC products can help reduce their impact throughout life.

The bottom line is, decreasing allergic symptoms over time depends on your child’s genetics, environmental exposures, and immune system development. Kids are most likely to outgrow seasonal allergies if mild symptoms started early in childhood and there’s no family history of allergic conditions.