Is it a cold, asthma or allergy? How to tell the difference in kids.

By Associate Professor Alberto Pinzon Charry

Paediatric allergist and immunologist in Woolloongabba, Brisbane

Runny noses, coughing, sneezing and wheezing are all incredibly common in children, especially during the colder months or after starting childcare or school.

But when symptoms keep coming back, many parents start asking the same question:

Is this just another cold… or could it be allergies or asthma?

The tricky part is that these conditions can look very similar, particularly in younger children. Understanding a few key differences can help you know what to watch for and when it might be time to seek further advice.

The common cold

Children can catch a lot of colds, sometimes more than 10 a year, especially in the early years.

Colds are caused by viruses and usually improve on their own within a week or two.

Common signs of a cold include:

• runny or blocked nose
• sore throat
• cough
• fever
• tiredness
• symptoms that gradually improve over time.

With a cold, children often feel generally unwell for a few days before recovering.

Allergies

Allergies happen when the immune system reacts to something in the environment, such as pollen, dust mites, mould or pet dander.

Unlike colds, allergies are not caused by viruses, so they are not contagious.

Allergy symptoms often include:

• sneezing
• itchy nose or eyes
• clear runny nose
• nasal congestion
• symptoms that keep returning or linger for weeks.

One clue that allergies may be involved is that children often otherwise seem well – they’re still active and energetic, despite the constant sniffing or sneezing.

Symptoms may also worsen:

• during certain seasons
• around pets
• outdoors
• overnight or first thing in the morning.

Asthma

Asthma affects the airways and can make breathing difficult when the airways become inflamed or narrowed.

In children, asthma symptoms can sometimes be subtle.

Signs of asthma may include:

• wheezing
• shortness of breath
• tightness in the chest
• ongoing cough, especially at night
• cough or wheeze during exercise
• symptoms that flare up with colds or allergies.

Some children mainly experience coughing rather than obvious wheezing.

Can children have more than one?

Yes, and this is very common.

Many children with asthma also have allergies or eczema. These conditions are linked through the immune system and often occur together.

For example:

• allergies can trigger asthma symptoms
• asthma may worsen during viral illnesses
• eczema and allergies often occur together in childhood.

This overlap is one reason symptoms can sometimes feel confusing for families.

A few practical clues

While only a healthcare professional can make a diagnosis, these patterns can sometimes help:

When should you seek help?

It’s worth speaking to your GP or paediatric specialist if your child:

• has symptoms that keep returning
• coughs frequently at night
• wheezes or becomes short of breath
• misses school or activities because of symptoms
• has ongoing nasal congestion or sneezing
• isn’t improving as expected.

Keeping track of when symptoms occur can also be helpful. For example, noting whether symptoms worsen during pollen season, after exercise, or around pets may help identify patterns.

Why getting the right diagnosis matters

Colds, allergies and asthma are managed differently.

If symptoms are allergy-related, identifying triggers can make a big difference. If asthma is involved, appropriate treatment can help children breathe more comfortably and stay active and confident.

Most importantly, the right diagnosis helps families feel more in control and less uncertain about what’s happening.

The reassuring news

Many childhood respiratory and allergy symptoms can be managed very effectively once the cause becomes clearer.

If you’re unsure whether your child’s symptoms are ‘just another cold’ or something more ongoing, seeking advice early can help provide clarity, reassurance and a plan moving forward.