Learning to tell the difference, plus treatment options.
The question of whether a child is suffering from the flu or an allergy resonates with parents. Given the similarities between colds and allergies, health care providers always start with taking a good history.
Distinguishing Between the Common Cold and Allergies
Colds usually begin with a child not feeling well, having a sore throat and maybe a low-grade fever, then will progress to nasal congestion, a thick clear to greenish runny nose and a cough.
Kids may feel great when leaving for school. Then the school nurse calls to report that your child has been sent to the infirmary for coughing and may have a low-grade fever. Your child may also display these signs: fussiness, a lack of appetite, nasal congestion, a sore throat, wanting to rest or sleep more.
Even though appetite may be down a bit, good fluid intake is a must. If children are healthy, they should be feeling better by day six, not getting worse. Many parents believe that if the nasal mucous is green, their child must need an antibiotic. Multiple studies have shown that green/yellow/brown mucous does NOT equal a bacterial infection that would improve from antibiotics. The color means a child’s immune system is healthy and working through the normal process. Antibiotics don’t work for viruses. The overuse of antibiotics in inappropriate situations may lead to resistance. Bacteria are smart and are learning how to beat antibiotics faster than researchers can create new ones.
Common colds/URI (upper respiratory infection) are inevitable. Healthy children will have as many as eight to ten colds a year. The number may rise when in daycare. Colds are not always preventable, but there are a number of measures to take to help relieve some of the symptoms and help with prevention.
Infants will need a little nasal saline prior to eating and sleeping to help them breathe and not cough as much. A cool mist humidifier is also recommended to help with hydration and to help them breathe better. Over-the-counter (OTC) medications should be limited and even avoided in children under four. The American Academy of Pediatrics (AAP) has shown that the risks far outweigh the benefits of these medications. It has been determined that a few teaspoons of honey (locally grown is best) a day for children over one year of age will help with coughs. If administering OTC medication, parents should pick those with a single ingredient. It’s too easy to give too much of a particular medication if using multi-symptom relief. Treat the symptom that bothers your child the most.
Other strategies that will help keep your child healthy include: eating healthfully, limiting sweet drinks, eating at home more, avoiding processed foods, limiting portion sizes, filling half the plate with colorful veggies and fruit, and getting enough sleep and lots of outdoor play. Teach your children the importance of rest to stay healthy and let them know they do more growing when they sleep well and drink plenty of fluids. All family members should get the flu vaccine annually.
Other important tips for staying healthy include knowing viruses or germs are everywhere. Good hand-washing is a must. When that’s not possible, use a portable hand sanitizer for a great backup. Set an example for your children early on as they are watching you and will most likely repeat your behavior. Teaching your child to cough or sneeze into the bend of the arm is also very helpful.
Above all, if your child has a high fever, is not acting normally, is refusing fluids or has vomiting/diarrhea, you need to seek help from your provider.
Allergies may be seasonal and last for weeks or months depending on the allergy trigger. A child can also have multiple triggers and be bothered year round. Typically a child who has allergies will have one or several signs and symptoms. These will vary depending on the trigger (pollens from grasses and trees, dust, mold, smoke and animal dander) and the individual child’s response. Symptoms may include: stuffy, watery runny nose; itchiness in the nose, eyes and skin; sneezing and even a sore throat or cough from the constant drip.
Allergy problems can occur on their own, or along with other conditions such as eczema and asthma. Seventy to eighty percent of children with asthma have some type of allergy, and it is very common for them to run in the family. If your child has asthma, request from your provider a referral to an allergist for evaluation and periodically make a follow-up appointment with your provider to review your Asthma Action Plan and technique. Bring your child’s medications and devices to all your visits so your provider can ensure the medications are being used correctly. Don’t be shy — constant education is essential for getting allergies and/or asthma under control. Remember, your child should have a normal childhood with the appropriate management.
Treatment for allergies can prevent or lessen the symptoms. It can be as simple as taking over the medications. More advanced treatment may include immunotherapy and possible prescription medications such as steroid nasal sprays and antihistamines for the eyes. Children who have asthma as well as allergies will need their rescue medications and perhaps a maintenance (everyday) inhaled corticosteroid for months.
Be sure to check out your home environment as well as your child’s school or daycare, which may trigger symptoms that can be remedied easily. There are guidelines for doing a home or a school check to help identify possible triggers. Studies by the Environmental Protection Agency (EPA) and Allergy & Asthma Network/Mothers of Asthmatics show that your child’s school performance can be affected if allergies are not taken care of. A little preparation before the school year begins can go a long way. Contact the school nurse so the school has an action plan on hand and the appropriate medications to dispense as needed.
Remember, treatment focuses on controlling triggers as much as possible. Simple home remedies include removing carpets, if possible, and encasing pillows and the mattress in protective covering.
Rhonda Hertwig, PNP, AE-C, is a PNP at Pediatric Evening Clinic, Spartanburg, SC. She is an active member of NAPNAP Asthma and Allergy SIG.