Allergies vs. Colds

ACHOO! “Please, not another cold!” thinks every parent everywhere. But is it? Or could it be allergies? It’s that time of the year here in Jacksonville, FL, where a thick yellow/green layer of pollen is on EVERYTHING outside. And when the symptoms start, it’s not always easy to tell the difference between a cold and allergies. But there are some key differences to help you differentiate between the two. Think you can tell the difference? Read the symptoms below and take a guess!

• • Runny or stuffy nose
  • Coughing
  • Sneezing
  • Itchy, watery eyes
  • Sore throat
  • Dull headache

If you said allergies, you’re right! Several symptoms of colds and allergies overlap but the tell-tale sign was the itchy, watery eyes. Itching is not usually present with colds.

Allergies

Some children are susceptible to airborne allergens such as pollen, dust, mold, animal dander, etc. When the immune system is reacting to an allergen, it releases a chemical called histamine which can lead to inflammation and itching. Allergies are less likely to affect babies and toddlers than older children and are more common during certain times of the year like spring and fall. A child will exhibit symptoms as long as they are exposed to the allergen; some will follow a seasonal pattern, and some will have year-long allergies.

Common cold

Children will often catch 5-8 colds per year and since it can be contagious, it’s important to recognize the symptoms quickly to prevent further spread. Colds are caused by a virus, most often by rhinovirus, and are passed person to person via direct contact (i.e. shaking hands), airborne droplets (i.e. coughing, sneezing) or surface contamination (i.e. touching a doorknob). This is why we stress regular hand washing and covering sneezes/coughs! It helps limits the spread of germs.

Symptom Comparison: Allergies vs Cold

There are several steps you can take to help relieve symptoms in your child.

Treating Allergy Symptoms

• • Minimize allergens at home by keeping windows closed, frequent dusting and vacuuming, removing and washing clothes after being outside, washing hands after pet exposure and using an air purifier.
  • Oral antihistamines block the release of histamines which decreases/eliminates symptoms. There are several options on the market so choosing one can be confusing.

• • A steroid nasal spray might also help with symptoms. These medications are available over the counter (i.e. Flonase, for children 2 years & older) and can also reduce inflammation and congestion.
  • Some children respond to oral medications, some to a nasal spray and others need a combination of the two. Always start with the lowest, appropriate dose of a single medication and give it a few days to fully take effect before changing or adding a second-line treatment. And, as always, consult your medical provider before starting any medications.

Treating Cold Symptoms

Because colds are caused by a virus, antibiotics will not help relieve symptoms or cure the illness. And taking them when not indicated can lead to bacteria antibiotic resistance for future bacterial illnesses making them more difficult to treat. Symptom management while allowing the virus to run its course is the best treatment.

• • Rest and hydration are essential for healing. Children need plenty fluid (and rest if you can get them to sit still long enough!) to help thin mucus, prevent dehydration and combats fatigue.
  • Saline nasal spray can help moisten nasal passages providing some relief from discomfort as well as congestion (and it may help children blow their nose more completely and/or improved bulb syringe suctioning).
  • A cool-mist humidifier while sleeping can help with congestion and sore throats. It is not recommended to add any product (i.e. menthol, essential oils, etc.) to the humidifier.
  • Menthol chest rubs can be used for children 2 years and older to relieve congestion and cough.
  • Take acetaminophen or ibuprofen as needed as prescribed by your medical provider for fever, aches and pains.
  • Cough and cold medications are not recommended for children under the age of 6 and if possible, try to go without them due to risk of side effects.

When to Call the Doctor

It can be hard to know when to call your medical professional, especially if you’re a first-time parent. But don’t fret, here are some quick guidelines for when you should reach out for more help.

• • Infants less than 3 months of age: call immediately for a fever of 100.4F (38C) or higher
  • Infants 3-6 months of age: a fever of 101F (38.3C) or higher
  • Infants older than 6 months of age: a fever of 103F (39.4C) or any fever that lasts longer than three days
  • Kids: a fever of 104F (40C) or higher that is unrelieved by taking over-the-counter medications
  • Ear pain especially if it’s several days into a cold and/or accompanied by any discharge
  • Eye redness and drainage (yellow/green or if eyes are stuck together after sleeping)
  • Severe lethargy or irritability
  • Sore throat with difficulty swallowing
  • Any symptoms lasting longer than 7-10 days

When to See Emergency Care

• • Inability to eat or drink anything (especially in infants) and/or signs of dehydration (no tears when crying, low urine output or dry diapers for 8 hours or more, sunken eyes and/or fontanel (soft spot-on top of infant’s head))
  • Trouble breathing (wheezing, grunting, retractions, nasal flaring, blue lips)
  • Altered mental status or unresponsiveness
  • Seizures- some kids are prone to febrile seizures; most are typically brief and not dangerous. But first-time seizures or any seizure that lasts longer than five minutes warrants evaluation.

At First Call Pediatrics, we’re here for you 24/7 through our secure, HIPAA-compliant portal, ready to answer any questions you may have about your child’s health. We believe in bringing Direct Primary Care right to your home! Our in-home pediatric care is focused on preventative care, ensuring you and your children have educational resources and direct access to your provider so no question goes unanswerd. Whether your little one is feeling under the weather or you simply need guidance and reassurance, our team is here to provide trusted concierge pediatric medical advice and compassionate support. We’re honored to care for your family in both times of illness and wellness and aim to provide family-centered care right to your door!

References

Allergies vs. colds in children. Children’s Health (2026). https://www.childrens.com/health-wellness/allergies-vs-colds-in-children. or here!

Is It a Cold or Allergies? How to Tell the Difference. HealthChildren.org (2025). https://www.healthychildren.org/English/health-issues/conditions/allergies-asthma/Pages/Is-It-Allergies-or-a-Cold-How-to-Tell-the-Difference.aspx.or here!