Protecting Children During the Haze: Advice for Parents

Recent haze conditions across parts of Malaysia have raised concerns among parents, especially after Bernama reported that a nine-year-old child required hospital treatment following worsening cough, breathing difficulty and chest discomfort during the haze.

Ministry of Health surveillance also recorded an increase in upper respiratory tract infections and conjunctivitis at selected healthcare facilities during the period. Although these illnesses cannot all be attributed directly to haze, the figures are a timely reminder to monitor children closely when air quality deteriorates.

Why are children more vulnerable?

Children breathe more air relative to their body size than adults, and their lungs and immune systems are still developing. Fine particles such as PM2.5 can travel deep into the lungs, irritating the airways and worsening existing respiratory conditions.

Children with asthma, allergies, chronic lung disease or a recent respiratory infection may be especially sensitive. Some may experience symptoms even when the Air Pollutant Index (API) remains within the “moderate” range.

Symptoms parents should watch for

Haze exposure may cause or worsen:

• Coughing or throat irritation

• Runny or blocked nose

• Red, watery or irritated eyes

• Wheezing or noisy breathing

• Chest tightness

• Shortness of breath

• Headache or unusual tiredness

• Worsening asthma symptoms

Haze does not directly cause every respiratory infection. However, polluted air can irritate a child’s airways and make symptoms from asthma, allergies or an existing infection more difficult to manage.

Advice from the MyLittle team

1. Check the API before outdoor activities

Monitor the official local API, particularly before school, sports or playground activities. Air quality can change throughout the day.

When the API reaches unhealthy levels, reduce your child’s time outdoors and postpone strenuous activities. If your child develops symptoms at a lower API reading, bring them indoors and allow them to rest.

2. Keep indoor air as clean as possible

Close windows and doors when outdoor air quality is poor. Use your vehicle’s air-recirculation setting when travelling.

Avoid adding more pollutants indoors, including cigarette or vape smoke, incense, candles and heavy cooking fumes. A properly maintained air purifier with a HEPA filter may help reduce indoor fine particles.

3. Continue prescribed asthma treatment

Children with asthma should continue their controller medication exactly as prescribed. Keep their reliever inhaler and spacer nearby, and follow their personalised asthma action plan.

Do not increase, stop or change your child’s medication without medical advice. Arrange an assessment if the reliever is required more frequently than usual or does not provide adequate relief.

4. Be careful when choosing a mask

Avoidance of outdoor haze remains the most important protection. Ordinary surgical masks do not reliably filter fine haze particles.

Malaysia’s Ministry of Health advises that standard N95 respirators are generally unsuitable for children because an adult-sized mask may not fit properly and can make breathing more difficult. Parents should consult a healthcare professional before considering respiratory protection for a child.

5. Encourage fluids and adequate rest

Offer water regularly and ensure your child gets sufficient rest. Drinking water helps prevent dehydration and may soothe throat discomfort, but it does not remove inhaled particles from the lungs.

When should your child see a paediatrician?

Arrange a medical assessment if your child has:

• A persistent or worsening cough

• Wheezing, chest tightness or breathlessness

• Fever or reduced activity

• Difficulty sleeping because of coughing

• Poor feeding or reduced fluid intake

• Asthma symptoms requiring more frequent reliever medication

• Symptoms that are not improving after returning indoors

Seek urgent medical attention if your child is breathing very quickly or struggling to breathe, the ribs are pulling in with each breath, the lips or face appear blue or grey, the child cannot speak or drink normally, becomes unusually drowsy, or prescribed reliever medication is not helping.

A reassuring reminder for parents

Most mild irritation caused by haze improves after exposure is reduced. However, every child responds differently, and a concerning change in breathing should never be ignored—even when the reported API has not reached the unhealthy range.

MyLittle Child Specialist Clinic is here to assess children experiencing persistent cough, wheezing, breathing difficulty or worsening asthma symptoms and to provide personalised advice for your family.

This article provides general health information and does not replace an individual medical consultation.

Sources: Bernama, Ministry of Health Malaysia, World Health Organization, CDC