As a paediatric pulmonologist seeing children every day with allergic and respiratory conditions, World Allergy Week is a reminder to pause and talk about what often gets under-discussed in routine consultations. This year's theme, Allergy Care is Essential Care, resonates with something I see in practice constantly. Allergies are not minor inconveniences to be managed with the nearest antihistamine. They affect how children sleep, learn, play, and grow. One of the most important examples of this is paediatric allergic rhinitis and its impact on quality of life.
Allergic rhinitis is more than a blocked nose
Allergic rhinitis in children is one of the most underestimated conditions in paediatric care. The classic picture of sneezing, a runny or blocked nose, and itchy eyes is easy to dismiss as a recurring cold or seasonal nuisance. What is less visible is the downstream effect: disrupted sleep from nasal obstruction, daytime fatigue that reduces concentration in school, irritability, and missed school days. Children with poorly controlled allergic rhinitis score lower on quality of life assessments not because of the nasal symptoms alone, but because of what those symptoms do to every other part of their day. Treating allergic rhinitis properly, with targeted allergen identification and an appropriate management plan, is not optional. It is foundational.
Exercise and asthma: the misconception that limits children
One of the most common things I hear from parents is that their child has been told to avoid sports or physical activity because of asthma. In most cases, this advice is not appropriate. Exercise and paediatric asthma do not have to be in conflict. Exercise-induced bronchoconstriction is a real phenomenon where airways narrow during physical exertion, and it does need to be identified and managed. But the goal of that management is not to restrict activity. It is to make activity possible.
A child with well-controlled asthma can and should be encouraged to exercise. Physical activity strengthens the respiratory system, improves cardiovascular fitness, and supports healthy weight, all of which improve asthma control over the long term. The practical steps involve ensuring adequate pre-exercise bronchodilator use where prescribed, identifying and avoiding specific triggers such as cold air or high-pollen environments, and building activity tolerance gradually. Blanket restriction of exercise is one of the most quality-of-life-limiting interventions we can apply to a child with asthma.
Obesity and asthma: a relationship parents need to understand
The connection between obesity and paediatric asthma is well established and clinically important. Children with obesity are more likely to develop asthma, and children who already have asthma tend to have more severe and harder-to-control disease when they also have obesity. The mechanisms involve reduced lung volumes due to excess weight on the chest wall, increased systemic inflammation that worsens airway inflammation, and a higher likelihood of gastroesophageal reflux and sleep-disordered breathing, both of which can mimic or worsen asthma.
What this means in practice is that weight management is not separate from asthma management. It is part of it. Encouraging physical activity, addressing dietary patterns, and supporting families in sustainable lifestyle changes are all legitimate parts of the asthma consultation for a child with obesity. Inhaler technique, trigger avoidance, and medication are still important, but they work better in the context of a healthy weight.
This World Allergy Week: one question to ask
If your child has been managing allergy or asthma symptoms for more than a few months and has never had a formal evaluation, this week is the right time to change that. A proper assessment of the allergen drivers, a review of how symptoms are affecting daily life, sleep, and activity, and a structured management plan are the things that separate allergy care from allergy coping.
To book a consultation with Dr Neha Mohan Rao at Allergy Central, Indiranagar, Bangalore Baptist Hospital or Manipal Hospitals, Sarjapur Road, call +91 9731642860.
Written by Dr Neha Mohan Rao, MBBS, D.Ch, DNB Paediatrics, MRCPCH, European Diplomate in Paediatric Respiratory Medicine, Paediatric Pulmonologist and Sleep Medicine Expert, Allergy Central Indiranagar / Bangalore Baptist Hospital / Manipal Hospitals Sarjapur Road, Bengaluru.
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