In Hong Kong, 1 in 4 children suffers from allergic rhinitis. Many new parents lack experience and mistake symptoms like persistent sneezing, runny nose, and nasal congestion in their children for a common cold, when in fact it is allergic rhinitis. This delays treatment, allowing intermittent symptoms to develop into chronic allergic rhinitis, sinusitis, or middle ear effusion, and even sleep apnoea. What are the differences between allergic rhinitis and the common cold? How can we trace the source of a child's allergies? Can pregnant mothers prevent allergies in their infants by restricting their diet? This month, our editor has invited Dr. Chan Yik-chun, a paediatric specialist, to answer parents' questions.
Nasal allergy symptoms resemble the flu. If ignored, could your nose become crooked?
Rhinitis and the common cold are very similar, with symptoms such as itchy nose, blocked nose, and sneezing, but there are certain differences between the two. Dr. Chan suggests that parents can distinguish between them using the following simple symptoms of rhinitis:
1. Runny nose: Nasal discharge from allergies is typically thin and clear, whereas discharge from a cold gradually becomes thicker and turns yellow or green.
2. Eyes: Nasal allergies can cause itchy eyes, red eyes, and even watery eyes, symptoms not present with a cold.
3. Physical condition: Nasal allergies will not show symptoms of a sore throat or fever. Conversely, having a cold will present these kinds of symptoms.
Children suffering from nasal allergies frequently experience a runny nose and sneezing, with symptoms being most severe in the early morning or at dusk. Parents inevitably worry that their children constantly rubbing their noses will lead to enlarged nasal cavities and deform the nose, affecting their appearance in the long run. Dr. Chan stated that parents can rest assured: "There is currently no clinical scientific evidence to support this claim. If parents are concerned about their child having nasal allergies to varying degrees, they should seek professional paediatrician help as soon as possible. What is more noteworthy is whether the nasal allergy issues are affecting the child's quality of life, including sleep and learning." As over-the-counter nasal allergy medications can cause varying degrees of drowsiness, long-term use may lead to a decline in the child's mental state, affecting their performance in class during the day, so parents must consider this carefully.
In early childhood, a child's development is not yet mature in all aspects. If the source of sensitivities can be identified early and appropriate treatment is received promptly, future sequelae can be avoided, allowing the child to get a head start, and their quality of life, sleep, and learning can be improved.
Blood tests for skin to identify allergens
When parents suspect their child may have allergic rhinitis, doctors can recommend allergen testing, including blood tests and skin prick tests. Dr. Chan explains: “We generally suggest that children undergo a simple blood test, identifying different allergens through Immunoglobulin E (IgE) in the blood. Another method is the skin prick test, which provides results in approximately 15 minutes, allowing parents to understand the situation immediately.” Currently, skin prick testing is a highly accurate allergen test, but its scope is limited. It primarily tests a restricted range of allergens on the child's arms or back, and diagnosis is made in conjunction with clinical observations.
Every child's allergen is different, and possibilities include dust mites, mould, cat and dog hair, pollen, and food. Therefore, identifying your child's allergens is an important step towards desensitisation. Parents can make changes to their living environment and diet, and gradually gain control of allergic conditions over time, alleviating their child's sensitive symptoms. Dr. Chan reminds parents: "If a child has allergic rhinitis, parents should identify the allergen as soon as possible. If a child is found to be allergic to dust mites, they should frequently change bed linen and vacuum, purchase anti-mite bedding, and install an air purifier, which can greatly improve the child's allergic rhinitis." Allergic rhinitis is a chronic allergic condition that is not easily cured. By avoiding contact with allergens as much as possible, children can still grow up happily.
Pregnancy dietary restrictions for allergy prevention: excessive worry about nutrient deficiency
Many mothers restrict their diet during pregnancy, believing that less exposure to allergens will help prevent allergies in their babies. However, Dr. Chan says, "Mothers do not need to avoid specific foods. Excessive worry, on the other hand, can lead to too many dietary concerns before childbirth and a lack of nutrition." In recent years, there has been an increase in
Few clinical science studies have shown that children who are exposed to a wider range of foods can help boost their immunity and may also reduce their sensitivity to certain foods. Dr. Chan emphasised: "Pregnant mothers should first pay attention to a balanced diet, ensuring adequate nutritional intake for themselves to guarantee the baby's health. Eating too many allergenic foods is the wrong approach and will not stimulate the baby to produce antibodies. In fact, the most important thing for pregnant mothers is to get plenty of rest, creating a good environment for the fetus to grow." The most important things during pregnancy are to stay relaxed, eat a balanced diet, and get enough rest. Being overly picky with food can have the opposite effect; do not let pregnancy become a burden, as this will ensure a healthy future for your baby.
Children's face masks should not be worn carelessly; ear dislocation can have significant consequences.
During this period, citizens must wear masks when going out. Parents are worried that their children will get infected and will urge their children not to take off their masks casually. Although valuing personal hygiene is the correct concept, Dr. Chan pointed out: "It is not recommended for young children (i.e., under 1 year old) to wear masks, mainly concern about affecting the children's breathing. Choosing a mask that is too tight, overlooking the covering of the child's nose or mouth, may also cause suffocation by obstructing normal breathing." Dr. Chan also advised parents to pay more attention when choosing masks for their children, such as the age guidelines indicated on the mask box, the tightness of the ear straps, and the suitability of the nose strip, so that children can wear comfortable masks.
When the epidemic is unstable, the safest way to protect children, especially infants, is to stay at home more and go out less: "If parents must take infants out, holding them in their arms already provides a degree of protection, but they should be careful to notice if any droplets are being sprayed nearby. At the same time, they should try to shorten travel distances and times, and reduce the child's time spent in public places." The bones of newborns are not fully developed, and there have been reports of infants' ear cartilage becoming misaligned due to wearing masks. When parents consider external protection for children, they should carefully observe the child's own condition and avoid masks causing danger.
Doctors wish to protect children's smiles
In recent years, with the development of paediatrics and the establishment of children's hospitals in Hong Kong, the Hong Kong College of Paediatricians has also added various paediatric subspecialties, including paediatric neurology, paediatric respiratory medicine, and paediatric infectious diseases. Currently, only a small number of doctors in Hong Kong possess qualifications in paediatric respiratory medicine, and Dr. Chan is among the very first doctors in Hong Kong to obtain specialist qualifications in paediatric respiratory medicine. When asked why he chose the challenging field of paediatrics, Dr. Chan recalled, "I grew up in church and loved playing with the children there. I really enjoyed my time with them. Their innocence and smiles were infectious, so I wanted to do my best for children, allowing them to grow up healthy and happy and fulfil their potential." In addition to caring for children's physical health, Dr. Chan understands that their well-being is, to some extent, a determinant of a family's happiness: "When a child is ill, parents are under immense pressure. As a paediatric specialist, I hope to use my expertise to help more children. Beyond treating their illnesses, I can also alleviate parents' worries, hoping that the entire family can enjoy a healthy and happy life and savour their children's precious childhood." Dr. Chan's journey in medicine is not only about safeguarding the innocent smiles of children but also about safeguarding the happiness of entire families.
Author Introduction
Dr. Chan Yik Chun, Paediatric Specialist, Fellow of the Hong Kong Paediatric Pulmonology Society, Member of the World Sleep Society, and former Board Member of the Hong Kong Paediatric Society for Respiratory and Allergy. Previously Assistant Professor at The Chinese University of Hong Kong's School of Public Health and Primary Care, Honorary Assistant Professor in the Department of Paediatrics and Adolescent Medicine at The University of Hong Kong's Li Ka Shing Faculty of Medicine, and Visiting Consultant Paediatrician at Hong Kong Baptist Hospital.
Original link: https://primarycare.org.hk/%E7%82%BA%E5%AD%A9%E5%AD%90%E6%97%A9%E6%BA%96%E5%82%99-%E8%84%AB%E6%95%8F%E6%88%90%E9%95%B7%E8%B7%AF/
