Diagnosis follows an orderly process that starts with a careful medical history. Your pediatrician or allergy specialist will ask a lot of questions about your child’s symptoms and medical background, and about your family’s medical history as well.
- Does your child cough, wheeze, or get extra short of breath when she’s running or playing hard?
- Does your child cough a lot? Is the coughing worse at night? Is she wheezing? Does she have trouble breathing? Does her chest feel tight sometimes?
- What happens when she laughs or becomes upset?
- Does your child sneeze frequently? Does she rub her nose often?
- Does she blow her nose or wipe it a lot? Is the nasal discharge clear and runny? (A clear discharge is typical of allergic rhinitis, also called hay fever, the most common form of allergy) Or is it thick and greenish or yellowish? (A yellow or green color suggests that your child may have an infection, separate or possibly in addition to allergy symptoms.)
- Are her eyes itchy and watery?
- Does she have more than her share of colds? Do they last longer than a week?
- Does she ever have a rash or itchy bumps on the skin?
- How often does she have symptoms? How long do they last?
- Do particular events or exposures seem to bring on symptoms, or make them better or worse?
- Have the symptoms ever gotten better after your child has taken medicine? What kind of medication helped?
Your pediatrician will ask whether your child’s symptoms often appear during a particular season of the year, at a certain location, or when your child is around animals, such as cats. Your pediatrician will also ask whether symptoms come on after your child has eaten a particular food.
Your pediatrician will ask whether other members of the family have hay fever, asthma, or eczema because allergy and asthma run in families. However, even if you can’t recall a single relative who sneezes and wheezes, your doctor will not discount allergy and asthma in your child because, like many disorders, they can appear with no prior family history.
Parents sometimes try over-the-counter medications before asking their pediatricians about a persistent cough, a rash, or respiratory symptoms. Although it’s recommended that you talk with your pediatrician before giving medications to your child, it’s helpful to tell the doctor whether a medication had any effect because this can give clues about the possible cause of symptoms. For example, if a runny nose and itchiness bothered your child less and she stopped sneezing for a while after taking an antihistamine, chances are she has an allergy and not an infection. Conversely, if her coughing and wheezing did not change after she took a dose of an over-the-counter medication, your pediatrician may decide to test or even go ahead and treat for asthma before looking for other underlying conditions.
Symptoms: All in the Timing
Allergy symptoms that come and go with the seasons may be caused by seasonal plants such as trees, grasses, and weeds. Coughing, sneezing, or other chest and nose symptoms that get much better when your child is away from home may indicate that your child is sensitive to substances normally found indoors, such as pets. By contrast, symptoms that always clear up on weekends and school vacations suggest that there may be a problem with something in the environment at school.
Coughing at night with hoarseness and frequent throat clearing may be caused by postnasal drip from allergic rhinitis or sinusitis. But coughing, wheezing, and related symptoms that get worse at night may also raise suspicions about asthma because asthma symptoms are often worse at night. Your pediatrician may suspect exercise-induced asthma if your child frequently coughs or wheezes when running or playing energetically.
Allergies Tend to Run in Families
Many types of allergy problems, including hay fever, asthma, and eczema, tend to run in families. If both parents have allergies, each child has about a 60% to 70% chance of being allergic.
However, allergic responses to insect venom, medications, and latex are the exceptions to the rule. Having a parent with one of these allergies does not increase the chance a child will be allergic.