Prevention and management strategies for childhood allergies

An increase in childhood allergies in Malaysia has become a significant health concern, with triggers ranging from dust mites to severe food reactions. This underscores the urgent need for parents to understand, manage, and prevent these conditions.

“Allergies are more than just sneezes or skin rashes, they can deeply affect a child’s quality of life,” said Dr Noor Zehan Abdul Rahim, Consultant Paediatrician and Paediatric Respiratory Specialist. She noted that urban environments increase children’s exposure to allergens such as dust mites’ excretion, smoke, and pollution. Although parents cannot control all factors, they can take measures to create safer, healthier homes.

Dust mites’ excretion are the most common triggers for respiratory allergies in Malaysia. They thrive in humid conditions and hide in bedding, carpets, and soft furnishings. Pet dander is another major culprit, as even hypoallergenic pets can still trigger reactions in sensitive children, Noor Zehan said. Though less common than in Western countries, food allergies can include reactions to peanuts, shellfish, and milk. Pollen and mould also pose challenges, particularly in damp urban areas, she added.

Allergy symptoms can vary and typically appear from 2 to 3 years of age. Although food allergies may develop in children as young as 6 months old, respiratory allergies such as allergic rhinitis, often emerge around 5 or 6 years old. Respiratory triggers can cause sneezing, coughing, wheezing, or nasal congestion. Allergic rhinitis is the most common childhood allergy. It is characterised by sneezing, runny nose, and nasal congestion. Skin reactions like rashes or eczema may signal environmental or dietary causes, while vomiting or diarrhoea can indicate food allergies.

Parents should be advised to watch for recurring symptoms. If a child frequently reacts after eating certain foods or being in specific environments, the cause/s should be investigated further, she said. Thus, it is recommended that parents record their child’s symptoms to help identify patterns and triggers.

While allergies may cause some discomfort, persistent symptoms have long-term consequences. For example, allergic rhinitis can lead to chronic sinusitis or asthma, which disrupt a child’s sleep, focus, and everyday activities. When asthma is triggered by untreated allergies, the resulting symptoms can be life-altering if asthma is not properly managed, said Noor Zehan. “It’s heartbreaking to see children struggle with something that can often be prevented or controlled,” she added.

While allergies can feel overwhelming, Noor Zehan outlined simple but effective steps parents can be advised to take to reduce allergen exposure and manage symptoms effectively so that it makes a big difference for their child, including:
●        Cleaning and decluttering: Using dust-mite-proof covers and vacuuming regularly with HEPA filters.
●        Eliminating smoke exposure: Even particles on clothes can aggravate allergies.
●        Managing pet allergens: Keeping pets out of bedrooms, and in severe cases, considering relocating pets.
●        Introducing allergenic foods carefully: Under medical guidance, introducing foods that contain peanut or egg components between 4 and 6 months, but avoiding whole peanuts to prevent choking.
●        Choosing air purifiers wisely: Avoiding fragrances or chemicals that irritate sensitive airways.

Allergy trends and myths
Misconceptions about allergies persist, including the belief that children will naturally outgrow them. Although some allergies resolve over time, many allergies persist into adulthood and impact the patient’s quality of life if not managed properly, explained Noor Zehan. Another myth is that avoiding triggers like cold drinks can prevent respiratory issues. However, she reassured that with proper management, children with asthma or allergic rhinitis can enjoy normal activities without unnecessary restrictions.

Parents may also worry about inhaler dependency, but Noor Zehan said doctors should dispel this fear among parents because inhalers are not addictive. In fact, they are life-changing tools that help children breathe freely and thrive. When their conditions improve, reliance on medication can be gradually reduced, she explained.

The pandemic has also influenced allergy trends. Lockdowns temporarily reduced children’s exposure to infections, easing respiratory symptoms, but there were limited opportunities for immunity-building. Reduced exposure meant children missed out on essential immunity-building, leaving them more vulnerable post pandemic, she said.

She also encourages parents to strike a balance by advising parents to slowly reintroduce their child to diverse environments while maintaining good hygiene. This helps the child to rebuild their defences and at the same time allows for parents to identify potential allergens.

In conclusion, managing childhood allergies requires teamwork between parents and healthcare providers. Regular check-ups with a paediatrician are essential for early detection and treatment. “The early years are crucial for long-term health,” emphasised Noor Zehan. She said that parents should be advised to stay informed, take action, and readily seek medical advice when necessary. Every step taken by parents presently will help their child live a healthier, happier life, she said.