Children ENT Problems

Children often have a significant level of Ear, Nose, Throat and Upper Respiratory problems. Because of their inability to vocalise , often the symptoms are neglected till they flare up into severe infections. While these are treated at the time, failure to address the underlying conditions may, lead to persistent or frequent recurences of the problems.

My child is having a flu all the time” or “My child needs to visit the doctor every other week
These may be common comments made by parents in the play-group and kindergarten age. Hearing difficulty may be undiagnosed leading to learning impairment in this age group. Asthma cases are also higher when the recurring allergies and infections are not controlled.
At our centre, we are experienced with dealing with children and their needs.


Allergies are fairly common. Both genes and environmental factors play a role in its development.

The immune system normally protects the body against harmful substances, such as bacteria and viruses. It also reacts to foreign substances called allergens, which are generally harmless and in most people do not cause a problem.

In an individual with an allergy, the body over reacts to a specific allergen and symptoms occur. They include

  • Breathing problems (coughing, shortness of breath)
  • Burning, tearing, or itchy eyes
  • Coughing
  • Diarrhea
  • Headache
  • Hives
  • Itching of the nose, mouth, throat, skin, or any other area
  • Runny nose
  • Skin Rashes
  • Stomach cramps
  • Vomiting
  • Wheezing

Amongst the diseases that affect children, allergies is one of the commonest. It may manifest as eczema when they are in infancy and progress on to rhinitis (nose), asthma (lungs) to conjunctivitis (eyes). Because of its myriad manifestation, allergies may be missed.

If left untreated, allergic rhinitis (runny nose) can lead to increased risk of asthma. Studies have shown that children with allergies are poorer performers in their academic and school work. In our highly competitive society this may have a profound effect. Typically, allergies leads to poor quality of sleep and concentration.

Symptoms of Allergic Rhinitis (“Sinus”)

Rhinitis means inflammation of the nose. Allergic rhinitis denotes inflammation caused by allergies. It is often referred to as “Sinus” by the public. This is typically caused by environmental factors such as house dust mites, pollens, dogs and cats danders.

Symptoms include

  • Sneezing
  • Runny Nose or Watery Nose
  • Blocked Nose
  • Mouth Breathing, Snoring, Noisy Breathing, Poor Sleep, Poor Concentration
  • Itch Nose, Twitching of the nose and eyes due to itch
  • Asthma
  • Chronic Cough

Many have the impression that allergies cannot be treated. This is not true. With appropriate management, Allergies can be well controlled and even cured.

Allergy Development

The development of allergies is influenced by genes and the environment.

If one parent has allergies, the risk to their child is 25%. If both parents have allergies, the risk is 50%.

Environment and diet plays a significant part in allergy development. The prevalence of allergies has risen over the centuries with industrialisation. Look around us, more children you know of today has allergies compared to our parents’ and grandparents’ time.

Food and exposure to pollutants, dust mites, pets’ dander (the dry skin and saliva that remains on the pet after it licks itself) and pollens can trigger allergy. It has been shown that people living near major highways has a higher occurrence of allergies compared to those living several streets away from the highway suggesting fossil fuel pollution has an influence. Similarly the same has been observed with cigarette smoke.

It is important to try and identify the source of the allergy. A skin or blood test can help us identify the source of the allergy.

Diagnosis of Allergies

Blood tests testing for IgE to specific allergens are used to determine if an individual is allergic to dust mites, dogs, cats, pollens and others. About 2 ml of the blood is required.

These test determine immediate type allergy. Medications do not affect the result of the blood tests. Blood tests testing for IgE to specific allergens are used to determine if an individual is allergic to dust mites, dogs, cats, pollens and others. About 2 ml of the blood is required.

Skin Prick Test

A small drop of allergens is introduced onto the skin usually in the forearm or back (in infants). A sharp plastic stillet is used to introduce a small amount of the allergen into the skin. No blood is drawn with this techique and is suitable in adults and children. The test can be read in 2 minutes.

Patch Test

This is used to determine contact type allergy. The suspected contact allergen is introduced onto the skin and an adhesive is placed over this and left for 48 hours. The result is read at that time.

Food Allergy Test (Intradermal Allergy Test)

Food allergy can be immediate or delayed. Immediate Allergy is easy to diagnose as it manifest within minutes to hours of food ingestion. Delayed allergy may take up to days before it manifest. Hence one may not link a particular food to the symptoms that the individual exhibits.

Intradermal Food Test is used to determine delayed food allergy. A small amount of the suspected food is introduced into the skin and its reaction is observed.

Allergies Treatment

Most allergies can be treated for Adults and Children.

Some of the best ways to treat allergies are:


If one is allergic to say shellfish, then abstinence from that food will prevent symptoms from occurring. If the allergens are found in the environment like dust mites, pet danders or pollens, then measures to avoid exposure will decrease symptoms


If avoidance cannot eliminate the symptoms or is not possible, then medications can help minimise symptoms. Common medications include antihistamines, nasal sprays, asthma medications, steroid creams and oral steroids.

  • Medications, however, control the symptoms but do not cure the allergy.


Immunotherapy, a targeted treatment for boosting the immunity against specific allergens, can reduce or eliminate the allergic symptoms.

This works like a vaccine and over a period of time, the individual develops a protection against the allergens.

This is effective against environmental allergens such as dust mites, pet danders and pollens. It is effective in allergies of the nose, eyes, allergic asthma and some eczema.

Preventing Food Allergies in Children

Food allergies can be mild, like eczema, to life threatening allergic reactions. To decrease the chances of developing a food allergy, it is recommended that babies are breast fed for four to six months. If this is not possible, then use a hypoallergenic milk formula.

For weaning, use single-ingredient infant foods and introduce one at a time. This allows the caregiver or parent to identify problem food.

Certain foods that are known to cause allergies such as cow’s milk, soy, egg, fish, shellfish, peanuts and tree nuts are best avoided till the child is one year old.

Maternal diet during pregnancy and lactation is not effective in minimising the child’s development of allergies.

Preventing Environmental Allergies

Reducing exposure in early life may delay or prevent the development of allergies and asthma symptoms. Keeping the environment clean, using high efficiency particulate absorbing (HEPA) type air filters, removing carpets and stuffed toys from your kid’s room can help lower exposure and symptoms.

Pets should not be allowed in the child’s room.

Reduce exposure to tobacco smoke.

If your child is frequently sick, do consider that an allergy may be one of the underlying causes. Consult a doctor that has an interest in allergies, such as an Ear, Nose and Throat (ENT) specialist or paediatrician, to further assess your child.

Centre For Ear Nose Throat Allergy & Snoring

3 Mt Elizabeth
#16-11 Mt Elizabeth Medical Centre
Singapore 228510

Tel: +65 65860988
What’sApp: 6598277186

Pang Xin Yi
Pang Xin Yi
15 April 2024
I consult Dr Pang for various issues - from nose bleed to chronic hives to ear block. He is always very thorough in his work. Dr Pang is very easy to talk to, and always tries to understand not just your condition, but your medical history and the environment you live and work in. He asked thorough questions about my medical and lifestyle history, carried out allergen tests to narrow down possible causes and gave very detailed advice on how to manage my hives condition. Appointment times are also adhered to (give and take 10-15min allowance which I find totally acceptable). Dr Pang also shares treatment options openly but always left it to my own discretion to pick the one I am most comfortable with. I also appreciate his staff for always being friendly and patient, and giving clear instructions when I had tests to take. It’s hard to find a clinic these days where you could have a comfortable and relaxed visit so I am glad that I found them.
Vijesh Kishore
Vijesh Kishore
15 April 2024
Dr. Pang Yoke Teen with his pleasing personality and quick diagnosis and great advise thinking always the best for the patient . One of the few doctors who believe in giving less medicines the minimal required and the clinic staff is very helpful, efficient and caring and accommodative
Oriana De Saint Priest
Oriana De Saint Priest
1 April 2024
I had a very good experience with Dr Pang YT and can highly recommend him for his professionalism
Poh Wee Koon
Poh Wee Koon
22 March 2024
Been visiting Dr Pang for allergy-related issues for a year and counting. The service is always prompt and friendly, and treatment as well as symptom management has been great. Appointments are not too hard to get, and picking up of medication is easy too. All good and a nice, friendly place to seek help at.
Stefan Andersson
Stefan Andersson
22 March 2024
I’ve had a very good experience at Dr Pang’s clinic. I had concerns around sleep apnea and Dr Pang identified that I was suffering from a lot of different allergies and food sensitivities. Now I’m getting treated for some of these allergies and it has improved my life quality a lot which I’m so grateful for. Him and his team of nurses are also super friendly and down to earth so it’s always a nice experience visiting the clinic as well! Highly recommended.
Elizabeth Lee
Elizabeth Lee
21 March 2024
First visit to Dr Pang was almost 10 years ago where he treated my extremely severe allergic rhinitis. My allergies were so bad that I would get attacks triggered every single day in normal environments. Ever since the treatment I have probably only experienced allergy attacks less than 5 times in the past 10 years, and those times I can pinpoint were in dusty conditions. Thank you Dr Pang for changing my life for the better!! Will always be grateful to you and your clinic :)
Aditi Mann
Aditi Mann
19 March 2024
Thank you Dr Pang Yoke Teen for helping me to cope with my allergies! I went to Dr Pang after suffering from severe allergies for several years. My nose congestion and eye irritation would completely ruin my quality of life. At the first consultation Dr Pang was able to diagnose the problem and prescribed the necessary medication. I started to feel better after taking the medication for just a couple of days. I have been under Dr Pang’s care for more than 6 months now and I have almost forgotten what it is to have an allergy! A special mention for Sheila and the other staff who also make the experience to the clinic an easy and comfortable one - thank you too!
Shao Wei Tan
Shao Wei Tan
13 March 2024
I’ve had a sensitive nose and sinus issues since childhood. After consulting Dr Pang, I went for a surgery and on a course of immunotherapy. It just works — I almost never get runny / blocked nose anymore unless I’m actually sick!
Derrick Tan
Derrick Tan
6 March 2024
Had issues with allergies for a really long time and Dr Pang came up with an effective treatment plan which includes immunotherapy. Feeling better now