Respiratory immunologist Constanze Jakwerth: Cold or serious illness - how parents can tell the difference

The most common respiratory diseases in childhood are:

1. Infectious cough and runny nose (colds)

On average, children experience 8–12 infections per year – especially in the first years of life.

Typical: runny nose, slight cough, often accompanied by fever.

Important: These infections are usually harmless and part of the natural immune development.

2. Pseudocroup (viral laryngitis)

Especially with small children.

Typical: barking cough, hoarseness, shortness of breath at night with wheezing when inhaling.

Warning signs: If the child has difficulty breathing or turns pale, please see a doctor immediately.

Often caused by viruses, it can be persistent in young children.

Typical: deep, mucous cough, often lasting several weeks.

Caution: Repeated episodes may be an indication of incipient asthma.

Often diagnosed too late – first symptoms can appear as early as preschool age.

Typical: wheezing, coughing during exertion or at night, shortness of breath, especially during infections.

Tip: If the child does not recover properly after an infection or coughs repeatedly, it is worth visiting a pediatrician or pulmonologist.

My personal advice: Parents know their child best. If the cough sounds "different," the child is breathing unusually, or is visibly straining, this is a warning sign. It's better to seek medical attention early – especially if there are wheezing noises or recurring breathing problems.

Allergies are a significant risk factor for the development of chronic respiratory diseases in childhood – especially bronchial asthma .

Many children react early on to environmental allergens such as dust mites, pollen, or pet dander – often initially with an allergic rhinitis or cough . What many don't realize is that these symptoms not only affect the nose, but also the lower respiratory tract . There, they can promote chronic inflammation , which in the long term leads to respiratory problems.

In addition, allergies weaken the protective function of the respiratory epithelium. The mucous membrane becomes more permeable to pollutants and pathogens, and the immune system is more easily disrupted . If a viral infection then occurs, it can overwhelm the lungs – triggering coughing, wheezing, or even shortness of breath .

Allergies alone do not cause asthma – but they create conditions under which respiratory diseases develop more easily and become more severe .

Therefore, it's important to pay attention to recurring symptoms early on : If a child coughs regularly, reacts to pollen , or takes a long time to recover after infections, this should be checked by a doctor. With a good diagnosis and targeted treatment, many long-term consequences can be avoided.

Dr. Constanze Jakwerth, Principal Investigator at the Center for Allergy and Environment (ZAUM) of the Technical University of Munich and the Helmholtz Center Munich, completed her studies in molecular medicine in Freiburg, Providence, RI, USA, and Boston, MA, USA (Harvard Medical School). She earned her doctorate from the Technical University of Munich. As an expert in respiratory immunology, she researches crosstalk at the airway epithelial barrier, specializing in asthma and allergies at the German Center for Lung Research (DZL). Her research focuses on identifying local disease mechanisms in asthma and allergies.

Parents can actually do a lot to reduce the risk of allergies and chronic respiratory diseases in their children – especially in early childhood when the immune system is still developing.

Secondhand smoke is one of the biggest risk factors for childhood asthma and allergies – even during pregnancy. A smoke-free home is therefore essential.

2. Breast milk – if possible

Breastfeeding strengthens the immune system and has been proven to reduce the risk of respiratory illnesses and allergic symptoms – especially in the first few months of life. If breastfeeding isn't possible, don't worry – if there's a family history of allergies, especially in mom or dad, you should consider using a suitable HA (hypoallergenic) baby formula.

3. Multiple germ contacts instead of a sterile environment

Over-hygiene can irritate the immune system rather than protect it. Children who regularly play outside, grow up with animals, or have contact with other children often develop a more robust immune system.

4. Early treatment of allergic symptoms

If children react to pollen, pet dander, or house dust, it should be checked by a doctor early on. Untreated allergies can spread to the respiratory tract and become chronic.

5. Healthy indoor air & few pollutants

Ventilation, no scented candles, little fabric softener, low-pollutant materials in the children's room – all this protects the sensitive respiratory tract.

6. Listen to your gut feeling

If an infection "feels different," a cough lasts an unusually long time, or the child is noticeably ill often, it's better to see a doctor once too often than not enough. Especially in young children, respiratory illnesses can sometimes be silent but have serious consequences.

Conclusion: Parents can strengthen their child's immune system – not by shielding them, but by striking a wise balance between protection and stimulation. Fresh air, exercise, early attention, and loving care are the best prerequisites for children to grow up healthy.

Chronic respiratory diseases and allergies can affect children's health and development on multiple levels – physical, emotional and social.

1. Impaired physical resilience

Children with untreated asthma or allergic respiratory diseases cough frequently, become breathless more quickly, and often unconsciously avoid physical activity. This can lead to poor fitness, muscle loss, and obesity in the long term.

Nighttime coughing, nasal congestion, or shortness of breath disrupt sleep – and thus also concentration, learning ability, and mood during the day. Many affected children are tired, irritable, or lacking concentration during the day.

If children regularly miss kindergarten or school due to frequent infections or allergy symptoms, this can affect their social integration and academic development.

4. Long-term inflammatory processes

Untreated chronic inflammation in the airways – e.g., due to allergic asthma – can inhibit lung growth and increase the risk of permanent lung damage in adulthood.

Constant restrictions, fears of seizures, or the feeling of being “different” can affect self-esteem and emotional well-being – not only in the child but also in the parents.

Conclusion: Allergies and respiratory diseases are more than just a "bothersome cough" or "a runny nose." They affect the overall quality of life and should be taken seriously, detected early, and treated properly – so that children can grow and develop without worry.

This article is from the EXPERTS Circle – a network of selected experts with in-depth knowledge and many years of experience. The content is based on individual assessments and is aligned with the current state of science and practice.