Cold or allergy? Identifying sneezes


Q: It seems like my daughter, who is 6, has had sneezes and a runny nose all spring. How can I tell is she has allergies or just a cold?

A: Sneezing and runny nose, as well as other symptoms of seasonal allergies such as eye irritation and cough, can also be caused by viral infections. At the beginning of a viral infection, however, a child usually seems somewhat ill -- she may have a fever, a poor appetite and less energy than usual. Symptoms of a viral infection would not last "all spring" unless the child had several different infections in a row.

By contrast, allergic symptoms last as long as the child is around the offending material, called the allergen. Pollen, grass and trees can all be allergens. A child with allergies often rubs her eyes and nose and complains they itch. The lining of her nose gets pale and puffy. She may breathe through her mouth,because her nose is always blocked.

Her symptoms will get worse when she has extended contact with the allergen -- after you have cut the grass or after she's been playing outdoors, for instance.

Your doctor should be able to help you sort this out after hearing the details of your child's story and examining her. Together you can decide if her symptoms are troublesome enough to warrant medication or further evaluation.

Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.

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