Allergy or cold? Take your child to the doctor or wait? Here’s what you should know

Does your child have a fever, cough or congestion? Is it a cold or an allergy? A trip to the doctor’s office isn’t always necessary. Dr. Matthew Bradshaw and Nurse Practitioner Taylor Scarborough of AnMed Pediatrics explain.

Is it an allergy or a virus? Our experts have the answers.


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Colds are common year-round, but when springtime arrives and brings prime allergy season, cold-like symptoms can seem as prevalent as the pollen in the air across Upstate South Carolina and North Georgia. And congestion, coughs and fevers are typically even more widespread in children, who are more likely than adults to suffer infections.

So what is a parent to do? When should you take your child to the doctor? Dr. Matthew Bradshaw and Nurse Practitioner Taylor Scarborough of AnMed Pediatrics share their expertise, guidance and answers to common questions below.

“Respiratory illnesses are always a concern for parents,” said Scarborough, herself a parent and a former patient of the medical practice where she now serves others. “From my experience, it’s important to get some education to know if something is OK to watch at home. We want to give parents reassurance on what’s normal and to be expected with viral illnesses and what’s something that they definitely need to bring into the office to have evaluated.”

Dr. Bradshaw is also a parent himself and a former patient of the practice where he now serves others. He knows perhaps better than anyone what it’s like for symptoms of respiratory illness to emerge amid allergy season.

“I feel like Anderson is the allergy capital of the world sometimes because there are so many different kinds of plants and trees,” Dr. Bradshaw said. “We’ve got a lot of different plants that bloom and hit in the March-April timeframe. That’s the time you see those allergies kick up.

“You have grass pollens blooming by March and April, and then trees are blooming, too. With that, the dust and pollen blow, and everybody just seems to flare. For some people, other allergies are worse at different times. Then, of course, there are illnesses that feel similar to allergies but aren’t actually allergies. It’s important to treat everything appropriately.”


Q) My child feels sick. Should I take them to the doctor?


A) From Dr. Bradshaw:

I’m always happy to see people if they feel like they need to be seen, but sometimes advice is all parents are actually looking for. Sometimes learning to be able to manage some of those things at home is good. Just the existence of a slight fever is not an automatic indication that your 3-year-old child needs to be taken to the doctor.

The biggest concern for any kid with a respiratory illness is going to be their breathing. Breathing rates vary age-wise, but in general if you’re seeing rapid breathing, the skin in between the ribs sucking in, nostrils flaring out – just struggling to breathe in general – that’s an emergent situation. If there are concerns about dehydration, that should be addressed quickly, too. And a fever in a baby under 2 months of age should be seen by a doctor. Those are things that should be addressed emergently. In the event of any situation like that, call 911, go to an emergency department or go to a place like AnMed Kids Care, which is open even on holidays.

But in general, if it’s just cough, cold symptoms, snotty congestion but no breathing concerns, no fevers, then that is something that’s fine to give a few days. For most cold viruses, days five to seven are going to bring their peak symptoms, and then it gets better from there. It’s when it keeps lingering that you need to come in to make sure it’s not something else that’s developing.


Q) My child has a fever. Should I take them to the doctor?


A) From Dr. Bradshaw:

If your child is younger than 2 months old, yes, take them to see their doctor. But for older kids, without an urgent concern like with their breathing, if you come in immediately with a fever, it’s sometimes hard to say how it’s going to go. Is it something that’s going to take a day to get better? Is it going to take three days to get better? Sometimes with viruses you don’t know that exactly. Sometimes with fever we may suggest giving it a couple days to see if it gets better on its own, with acetaminophen or ibuprofen. Sometimes it just takes time.

My rule of thumb is 72-ish hours. If the fever persists over that period of time, I think it’s reasonable to come in, especially for younger kids. They can’t tell you their ears are hurting. They can’t tell you, ‘Hey, it hurts here.’ Those kids are the ones who we especially might want to take a look at – to make sure their ears aren’t infected, to listen to their lungs closely. Older kids are more able to voice their concerns and call for special attention when it’s needed. In general, 48 to 72 hours with fever is not uncommon to see with colds. It’s when symptoms keep lingering beyond that things could be evaluated more. 


A) From Nurse Scarborough:

A fever is not always a bad thing, in terms of being what bodies need at certain points in time. Seeing how your child is responding to that fever is important. Are they managing that fever well? Are they still eating? Are they still drinking? Are they stay well hydrated? Those are some things to look for.

Encourage your child to drink fluids. It’s not uncommon for us to see with viral illnesses these fevers lasting three, four, sometimes five days. If we start to push past that benchmark with the fever, then we want to have them evaluated in the office, make sure there’s nothing underlying going on. That’s kind of the typical expectation, the typical bell curve we’ve been seeing with some of these respiratory viral illnesses.


Q) How can I tell if my child has an allergy or a cold?


A) From Dr. Bradshaw:

It’s hard to say sometimes if something is allergies or if it’s viral, especially if there’s no fever with it. The symptoms could be the same. Under age 2, the chance for true environmental allergy is pretty low, though that’s not to say they can’t have it.

The tricky part of this is that a 6-month-old, 9-month-old, 12-month-old, they’re going to be getting cold viruses all the time. Is it colds that they’re getting and they just happen to get better because the colds run their course, or is it actually the allergy that’s getting better? Some older kids are a little more predictable. You can look back at their charts and say, ‘OK, I see you every March for cough, sneezing, snot. There’s no fever. It lingers for a few weeks, and it gets better. And they seem to improve with allergy medicine.’ Those kids are more predictable with a seasonal allergy.

Some kids are affected by indoor allergens year-round. They’re a little easier to predict. Some older kids with allergies will have almost black eyes where they have dark circles. When you look in their nose it’s pale looking instead of a vibrant color. Sometimes they’re sneezing more frequently, have itchy or watery eyes – those are more of your allergy symptoms. 


A) From Nurse Scarborough:

Sometimes you’ll even have kids who have both allergies and colds, and they’re overlapping. That’s not uncommon to see in childhood.


Q) Are the treatments different if my child has an allergy or a cold?


A) From Dr. Bradshaw:

An allergy or a virus could be treated with over-the-counter medications, but those medications would be different. If you suspect an allergy, you should message your primary care provider for advice. Every kid is different. As a parent, you’ll do best to lean on your relationship with your child’s doctor to determine the best course of treatment.

It could be that if we’re treating an allergy, we might try different allergy medicines to see if we can get relief. But if those symptoms just keep lingering and lingering, that’s when we need to get you in and take a look to make sure it’s not something else. 

If we’re treating a viral infection, depending on age, sometimes we recommend over-the-counter cough and cold medicines, doing saline nasal sprays to flush out the nose, honey for a cough or sore throat. If it’s viral, it’s going to run its course. It may take seven to 10 days for the symptoms to fully improve, and sometimes even longer. I’ve seen coughs with viral infections that can last for weeks – and it’s not a new viral illness, just that same one that just keeps lingering. But it will eventually run its course. 


A) From Nurse Scarborough:

Certain medications are different for different age groups in the pediatric population. It’s very tailored to that specific patient and their age group. Be sure you get advice that you can trust.


Q) What should I do to get medical advice if I don’t take my child to the doctor?


A) From Dr. Bradshaw:

Parents often just need a little advice and guidance that they can trust – advice and guidance from experts who know their families. Should you bring in your child? Could it be a cold or an allergy? What medicine should you give them? What should you monitor? We’re able to provide a lot of help through MyChart.

MyChart is an excellent way to seek help and advice. Look under the Patient Advice Request and send your message. Our nurses are prepared to assist you, and they consult with physicians as needed. We really encourage our families to take advantage of this service. We respond as quickly as possible.

If it’s more urgent than would be appropriate to wait for a day or so, it’s better to call your pediatrician. We have wonderful nurses who are ready to help over the phone. Just leave a message, and we’ll get back to you as soon as possible.