At age 3, Cheyenne Madden seemed to be sick more than the average preschooler. For much of the year, she dealt with a constant dry cough, painful sinus congestion, and endless rounds of pediatrician visits and antibiotics. "We were always at the doctor," says her mother, Lynn, of Hartly, Delaware. "I thought, 'It can't be normal for a 3-year-old to cough all the time.'"
When one of Cheyenne's sinus infections persisted for weeks despite three rounds of antibiotics, her pediatrician started to suspect the little girl was not suffering from an illness, but allergies. It made sense: Lynn herself had seasonal allergies, and Cheyenne's symptoms seemed to worsen with the arrival of spring. Finally, after more than a year of symptoms, Cheyenne saw an allergist, who confirmed she was allergic to several types of trees and grasses, as well as certain pets. Now that she takes an antihistamine and a nasal steroid spray daily, and steers clear of freshly mown lawns and neighborhood dogs, Cheyenne is coughing less -- and enjoying the outdoors much more.
Solving a stubborn case of the sniffles has never been trickier, for parents or doctors. It's not unusual for kids to have six to eight upper-respiratory illnesses a year, especially in early childhood, when they're most vulnerable to infections. But more and more children get a stuffy nose, a nagging cough, and watery, itchy eyes just from breathing the outside air, particularly during the spring and fall. These seasonal allergies -- which docs call allergic rhinitis -- are caused by an overreaction of the immune system to certain things outdoors, like molds and pollens from grasses, trees, and other plants such as ragweed. "Up to 40 percent of kids now have allergic rhinitis -- a percentage that's doubled over the past two decades," explains Parents advisor William E. Berger, M.D., an allergist in Mission Viejo, California.
No one knows exactly what's behind the rise in seasonal allergies, but many scientists say that our increasingly sanitized environment is diminishing kids' exposure to everyday microbes that bolster their immune system. When it isn't busy fighting germs and viruses, a child's body may perceive harmless things in the environment as a threat, and cells release chemicals such as histamine -- which causes sniffling, sneezing, and itching -- in defense. A newer theory relates to global warming, which is leading to longer pollen seasons. Because people often develop allergies only after being exposed to a trigger for a couple of seasons, consistently higher pollen counts might be leading to earlier and peskier symptoms. (Kids don't typically develop seasonal allergies before age 4, though they may have "perennial allergies" to indoor irritants like dust, mites, and pets at an earlier age.)
Thankfully, as allergy rates grow, so has awareness, and doctors are getting better at diagnosing kids. Making the distinction between colds and allergies can be difficult; a clue is often the duration of symptoms. "A typical cold lasts only seven to ten days," says Fuad Baroody, M.D., director of pediatric otolaryngology at The University of Chicago Medical Center. "Children with allergies might suffer for weeks or months, with no break in their symptoms." Also, allergic kids often just look different from sick kids, says Dr. Berger. Many have "allergic shiners," dark circles that form under the eyes due to chronic congestion, or rub their drippy noses upward in what docs call an "allergic salute."