Kids’ allergies has been always a big question mark for me as a parent. While Eeshaa has always shown symptoms of milk and peanut allergies, Shrihaan keeps sneezing and getting runny nose, rashes whenever the weather changes or when he is exposed to dusty environments. Surprisingly, all these years, I never tried to decode the allergies and what I can do as a parent to keep them at bay for my kids. All I used to do was give some usual runny nose medicines. But kids still used to keep coughing and having runny and blocked nose very frequently. It started affecting their daily routine. Enough was enough and we decided to consult Dr Mohana Rajukulendran of Parkway East Paediatric Clinic. The consultation proved to be such an insightful and enlightening one and it made so many factors about kids’ allergies clearer for me as a parent.
Did you know? Parkway East Paediatric Clinic is conveniently located in the East at Parkway East Hospital and Dr Mohana specialises in the treatment of paediatric allergic conditions and respiratory allergies. She also offers dust mite immunotherapy as treatment for allergic rhinitis.
Covid-19 Safety Precautions by the Clinic
Unfortunately, in the current times, no topic starts without the mention of COVID-19. I was a bit apprehensive about the safety protocols at the clinic but safety was the priority right from the moment we entered. Safe distancing, SafeEntry and temperature checks were all perfectly in place. In fact, Dr Mohana and her staff were masked up and the clinic looked extremely clean with all the necessary safety measures.
What to Expect During Your Visit to Dr Mohana of Parkway East Paediatric Clinic?
The first thing my kids noticed was the lovely, soothing and kid-friendly ambience of the clinic. Flowers, teddies and beautiful wall decals are sure to win little hearts.
Next step is filling up the registration form. After getting our queue number, we waited for a while before Dr Mohana called us in.
Dr Mohana has a very pleasant personality and she instantly connected with the kids. My elder daughter loved her! My son was also comfortable and didn’t throw any tantrums as he would sometimes throw when he was at a paed’s clinic.
Personally, for me as a parent, it really matters how the paed befriends the kids. I really like Dr Mohana because she put my kids at ease and is very approachable. She was also able to simplify jargon and scientific terms easily allergies such that my children were able to understand. That makes every parent’s job easier.
Dr Mohana is a qualified paediatrician and she specialises in managing food and drug allergies. She also offers skin prick tests, blood tests and food and drugs challenges for diagnosis and management.
I was advised to get the skin prick test for allergies done before for Eeshaa and Shrihaan but somehow the words “prick test” left me feeling uneasy and I avoided bringing my kids for one. But after consulting Dr Mohana and learning more about the science behind the test, we decided to get it done for Eeshaa and it was seriously such a breeze. In fact, Dr Mohana made it so simple. She is very gentle and the procedure was almost painless.
Typically, this test takes about 15 – 30 minutes. The test detects immediate allergic reactions, which develop within minutes of exposure to an allergen.
With only a short 10 – 15 minute wait, here are the results of Eeshaa’s skin prick test. It was found that she is NOT allergic to common allergens like milk, peanut, dust mites, cockroach and grass. What a relief!
I had lot of doubts, queries and worries about kids’ allergies and Dr Mohana was very patient to answer all of my questions. I have compiled all my questions and the elaborate explanations provided by Dr Mohana for you of my readers. Thank you for this, Dr Mohana! The FAQs will benefit many parents and kids immensely.
Q: What can parents expect when it comes to allergies in kids? What are the common allergies and which specific symptoms to watch out for?
Dr Mohana: An allergy is an abnormal response of the body’s immune system to normally harmless substances (allergen) found in the environment. In children, common allergic conditions include eczema, food allergy, allergic rhinitis and asthma. The natural history of the progression of allergic symptoms is as listed in the above order from infancy to preschool ages. This is also known as the allergic march. A child with one type of allergy is at increased risk of developing other allergic conditions. Hence, it is important to be vigilant for the symptoms of allergies.
The symptoms of allergies vary according to the type of allergic condition.
Eczema affects 20% of school-going children in Singapore. It presents with red, dry, scaly and very itchy skin. Common triggers for eczema include detergents or harsh soaps which are irritants to the skin, synthetic clothing material, an increased bacterial skin load. In very young children, certain foods allergies may be involved in eczema while in older children dust mite allergies are a common trigger.
About 5% of children in Singapore under the age of 12 have food allergies. These present as acute reaction soon after the ingestion of food. Reactions usually occur within 30min and can last up to 24 hours. The commonest presentation in food allergies is the development of a skin rash such as hives or red patches. There can also be vomiting, diarrhea and abdominal discomfort. Less common reactions include wheezing, nasal symptoms (runny nose, itching, sneezing or blocked nose). Food allergies can also present with anaphylaxis or an acute life-threatening reaction. These are reactions where there are more severe symptoms such as throat or tongue swelling, difficulty breathing, giddiness or fainting due to low blood pressure or severe abdominal symptoms.
It is estimated that 40% of Singaporean children have allergic rhinitis. This presents with symptoms of sneezing, runny nose, itchy nose and/or congestion of the nose and a cough which could be worse at night.
Asthma can present with chronic coughing, especially at night and after exercise. Children with asthma also have repeated episodes of wheezing or breathlessness. About 20% of Singaporean children have asthma.
Q: In Singapore, are there particular allergies that are more likely in kids?
Dr Mohana: Living in a tropical country like Singapore with high humidity makes dust mite allergies very prevalent. Dust mites are microscopic creatures that are found everywhere in our environment – in mattresses, pillows, bedsheets, soft toys, sofas and carpets. A lot of children who have allergic rhinitis, asthma or eczema are also likely to have dust mite allergies. For example, about 90% of children with allergic rhinitis are also dust mite allergic!
Q: Are kids born with allergies or do they develop them later? Also, will kids grow out of allergies?
Dr Mohana: Children don’t manifest with symptoms of allergies at birth. Most children develop symptoms in infancy or the early preschool years. Some babies with eczema present in the first few weeks of life. It is also not uncommon for allergic conditions to present later in life in adulthood.
Some children do outgrow their allergies as they grow older. Common examples include food allergies such as cow’s milk or egg allergies where 80% of children would outgrow their food allergies by age 16. However, for other foods such as peanut or shellfish, the likelihood of outgrowing is much lower at 5 – 15%.
For other allergies, about 60% of children may outgrow eczema as they approach adulthood, 40% for allergic rhinitis and 20% for asthma.
Q: What are the symptoms of respiratory allergies and how are they different from common cold and flu symptoms?
Dr Mohana: Symptoms of respiratory allergies are more persistent and occur for longer durations than common cold and flu symptoms. Children with respiratory allergies experience runny nose, sneezing, itchy nose or eyes, blocked nose symptoms and cough for several days of the week over the duration of months. Parents may also notice that these symptoms may be worsened in certain environments for example when exposed to dust or while playing with pets.
Q: Which are the effective treatment options for paediatric allergic conditions and respiratory allergies?
Dr Mohana: Treatment for respiratory allergies and other paediatric allergic conditions firstly involves identifying the allergen trigger so that there can be appropriate environmental control measures put in place for allergen avoidance. We also rely on certain medications such as antihistamines or local nasal or airway steroid medications to bring active inflammation under control. For more severe or chronic allergies, we also have the option of allergen immunotherapy to increase the body’s tolerance to allergens.
Q: Any precautions and regular care that parents and kids need to take when it comes to combating allergies?
Dr Mohana: The key is for allergy prevention and control. If there is a strong family history of allergies (allergic rhinitis, asthma, eczema or food allergies), this predisposes children to a higher chance of developing allergies. Common strategies for allergy prevention include perinatal probiotics and early moisturising of this skin from birth to prevent eczema, and early weaning by 4 – 6 months of age to reduce the risk of food allergies. In families where children already demonstrate symptoms of allergies, it is important to get allergy testing done to identify causative allergens so that these can be avoided for symptom control.
Q: Will the medication for allergies cause any side-effects?
Dr Mohana: As allergies are chronic conditions, the medications which are used are chosen specifically to reduce any long-term side effects. For example, non-sedating antihistamines are used instead of sedating antihistamines for children. Also low dose nasal or lung steroids are used for focal control of inflammation without the risk of systemic absorption and side effects. It is important to control allergies adequately as they can adversely affect growth and quality of life. Poorly controlled allergic rhinitis is known to cause poor sleep and poor concentration in school while poorly controlled asthma can affect both lung and physical growth.
Q: When it comes to food allergies, what are the dangers to note? How can parents handle emergencies?
Dr Mohana: Firstly, it is important for parents to recognise the symptoms of an allergic reaction. They usually present almost immediately or up to 4 hours from ingestion of a food allergen. Mild symptoms include itch and swelling of the lips, face or eyes, hives, itchy rashes, mouth tingling or vomiting or diarrhea. For mild symptoms, immediately administer an oral antihistamine and watch closely for any progression of symptoms for which medical help should be sought.
Anaphylaxis or severe allergic reactions can present with the following:
- swelling of the tongue
- throat tightness or swelling
- difficulty talking or a hoarse voice
- wheezing or a persistent hacking cough
- difficult noisy breathing
- loss of consciousness
- pallor or floppiness in a child
- severe persistent abdominal pain
Immediate and urgent medical attention should be sought for any of the following symptoms. Call an ambulance to take your child to the nearest Accident & Emergency department. If your child has had known food allergies or a previous anaphylactic reaction, he/she might have been prescribed an Epipen (adrenaline autoinjector). This should be administered while waiting for help.
Q: Dr Mohana, please tell us more about the services provided by the clinic.
Dr Mohana: Our clinic caters to the needs of families with children with allergies.
- I help diagnose, manage and treat conditions such as allergic rhinitis, eczema, hives, food allergy and drug allergies in children.
- I provide in-clinic skin prick tests to air and food allergens to help identify allergic triggers and give advice on how to better manage and control allergies.
- Together with families, I help formulate and provide action plans for asthma, eczema and food allergies so that parents are involved in better managing their child’s allergic condition.
- I also give advice and plan oral food or drug challenges for children where appropriate, and offer dust mite sublingual immunotherapy for children with dust mite allergies.
- Care extends to the inpatient setting for any children who require acute management and treatment of their conditions. This includes management of acute exacerbation or asthma, intensive skincare and management for eczema flares and management of anaphylaxis.
- To further support children with allergies, we also offer school visits for education of staff on management of our patient’s allergic conditions and Epipen training visits.
Parkway East Paediatric Clinic also offers general paediatric and adolescent medicine services that provide the highest quality care for children. My kids are already telling me that we should go to Dr Mohana for our flu jabs.
Planning your visit to consult Parkway East Paediatric Clinic’s Dr Mohana? Please refer to below information about the clinic’s address, phone and operating hours.
Parkway East Paediatric Clinic
#03-07 Parkway East Medical Centre
319 Joo Chiat Place
Tel: 6229 5849
If your child requires a routine health assessment (for growth and development) or vaccinations, bring them to Parkway East Paediatric Clinic at the following hours:
Monday – Saturday
8:30am – 10.30am
For children with other conditions, visit the clinic at the following timings:
Monday – Friday
10.30am – 1pm
2pm – 4.30pm
10.30am – 1pm (closed on Sundays and public holidays)
The Seletar Mall Clinic – Shenton Medical Group
33 Sengkang West Avenue, The Seletar Mall, #01-55/56, Singapore 797653
Paediatric Specialist Services
Tuesday and Thursday:
02:00 PM – 04:30 PM
*For appointments only, contact 6214 0363 or visit bit.ly/2OfBP0h
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