Haze and Children: How to Protect Your Child's Lungs
In short: Haze is harder on children than on adults because they breathe more air for their body size and their lungs are still growing. Check the Air Pollutant Index (API) each morning, keep children indoors with windows shut once it passes 100, run a properly sized HEPA air purifier in the room they use most, and get medical help the same day if your child is working hard to breathe.
Key takeaways
Malaysia's API bands are Good (0 to 50), Moderate (51 to 100), Unhealthy (101 to 200), Very Unhealthy (201 to 300) and Hazardous (above 300).
Under the National Haze Action Plan, schools stop outdoor activities when the API goes above 100 and close when it reaches 200.
Children inhale more air per kilogram of body weight than adults, so the same haze gives them a bigger dose of fine particles.
Babies and children under 2 should not wear face masks. For them, protection means clean indoor air, not a mask.
Fast breathing, the skin sucking in between the ribs, or a wheeze that the reliever inhaler does not settle needs a doctor the same day.
Why is haze worse for children than for adults?
Children breathe faster, take in more air for their weight, and have lungs and immune systems that are still developing, so fine haze particles reach deeper and do more harm.
The haze over Malaysia from regional forest and peat fires is mostly fine particles (PM2.5), small enough to pass the nose and throat and settle in the small airways. The World Health Organization notes that children inhale more pollutant per unit of body weight, spend more time outside and play more vigorously than adults. All three push their dose up.
Which children are most at risk?
Babies, especially those under 1, who breathe quickly and cannot tell you they feel unwell.
Children with asthma or a history of wheezing with colds.
Children born early, particularly those who needed breathing support as newborns.
Children with heart conditions, chronic lung disease or neuromuscular conditions that weaken the cough.
I see this pattern every haze season in clinic. The healthy school-age child gets itchy eyes and a scratchy throat. The child with asthma is the one who ends up needing extra treatment.
What do the API numbers mean for my child?
Treat 100 as the line for outdoor play, 200 as the line for staying home, and act earlier if your child has asthma or is a baby.
The Department of Environment (DOE) publishes API readings every hour for stations across the country. Check the reading for the station nearest your home and your child's school or taska, not the national headline, and recheck it before afternoon play because readings can change within an hour or two. A practical way to use the bands:
0 to 50 (Good): normal life, including outdoor sport.
51 to 100 (Moderate): fine for most children. If your child has asthma, keep the reliever inhaler with them and cut long, hard outdoor exercise.
101 to 200 (Unhealthy): move play, sport and swimming indoors. Keep babies indoors. Short trips, such as from the car to the clinic, are fine.
201 to 300 (Very Unhealthy): keep children indoors with windows closed. This is where a clean room at home matters most.
Above 300 (Hazardous): stay indoors and follow official advice closely. If your child has a lung or heart condition, plan with your doctor in advance.
Should my child go to school or taska during haze?
Schools follow the National Haze Action Plan: outdoor activities stop above API 100 and schools close at 200, and parents may keep a child home if they are worried, as long as they inform the school.
In mid-October 2026 the Ministry of Education confirmed it had returned to these National Haze Action Plan thresholds. For childcare, the Ministry of Women, Family and Community Development directed registered operators to halt outdoor activities and keep indoor spaces clean, with any change to opening hours tied to local API readings. Rules can be revised as the situation changes, so check the latest notice from your school or centre.
When does keeping my child at home make sense?
Your child has asthma and has needed the reliever inhaler more than usual in the last few days.
Your child is recovering from a chest infection or still coughing at night.
The local reading is close to 200 and the classroom has open windows or fans pulling in outside air.
How do I make the air at home safer?
Choose one room, keep its windows and doors shut, run a HEPA air purifier sized for that room, and stop anything that adds smoke or fumes indoors.
You do not need to clean the air in the whole house. One clean room where the children sleep and play does most of the work.
How do I choose and use an air purifier?
Pick a unit with a true HEPA filter and a clean air delivery rate (CADR) suited to the size of the room. Undersized units barely help.
Avoid ozone generators and "ioniser only" devices. Ozone irritates the airways.
Place it where your child spends the most time and run it on a high setting with the door closed.
Check and replace the filter as the maker advises. Haze season loads filters quickly.
What about air-conditioning?
A split-unit air-conditioner recirculates room air rather than drawing haze in, so it lets you keep windows shut in comfort. Clean its filter more often during haze. In the car, switch to recirculate mode.
What adds to indoor pollution?
Smoking or vaping anywhere in the home, including the balcony.
Burning candles, incense, mosquito coils or scented oils.
Frying or grilling with the kitchen door open to the rest of the house.
Vacuuming without a HEPA filter, which throws settled dust back into the air.
Aerosol sprays and strong cleaning products.
Should my child wear a face mask?
Children under 2 should not wear masks at all; older children can wear a well-fitted mask for short trips outdoors, but staying indoors protects them far more than any mask.
A mask only filters haze if it seals around the face. That is the problem with children. Adult N95 masks are too big for most children's faces, so air leaks around the edges, and a tight seal makes breathing harder work for a small child.
What is reasonable by age?
Under 2: no mask. Babies cannot remove a mask if they struggle to breathe. Keep them indoors in clean air instead.
2 to 6: a child-sized mask for short outdoor trips only, with an adult watching. Take it off if your child is uncomfortable or breathing hard.
7 and older: a well-fitting child-size respirator style mask gives better protection than a loose surgical mask, as long as your child can wear it comfortably.
Children with asthma, heart conditions or breathing difficulty should check with their doctor before wearing a tight-fitting mask.
When to see a doctor, and when not to worry
Mild eye and throat irritation can be handled at home, but any sign that your child is struggling to breathe needs medical care the same day.
Usually fine to manage at home
Itchy eyes, sneezing or a mild dry cough in a child who is eating, playing and sleeping normally.
Symptoms that ease when your child is in the clean room.
A slight increase in reliever inhaler use that settles with the usual dose plan in your child's asthma action plan.
Book an appointment soon
A cough that keeps your child awake at night or lasts more than a week after the air clears.
Your child with asthma needs the reliever more than twice a week, or is waking at night with cough or wheeze.
Your child does not yet have a written asthma action plan, or the current one is more than a year old.
Recurrent nosebleeds, worsening eczema or eye symptoms that do not settle with rinsing.
See a doctor the same day
Fast breathing, the skin pulling in between or under the ribs, or nostrils flaring.
A wheeze or cough that does not improve after the reliever inhaler, or relief that lasts less than four hours.
Your child is too breathless to speak in full sentences, or a baby is too breathless to feed.
Lips or tongue turning blue or grey, unusual drowsiness or floppiness. Call 999 for these.
A baby under 3 months with any breathing difficulty or a fever of 38°C or above.
Chest pain, or a fever with a worsening cough.
What can I do at home during haze?
Plan each day around the API reading, keep your child well hydrated, and make sure any asthma medicines are ready before the haze gets worse.
Babies under 1
Keep your baby in the clean room as much as possible.
Continue breastfeeding or formula feeding as usual. Feeds provide the fluid they need.
Saline nasal drops can ease a blocked nose before feeds.
Toddlers and preschoolers
Swap the playground for indoor play: building blocks, dancing, obstacle courses with cushions.
Offer water often. Children forget to drink when they are busy.
Wipe sticky eyes with clean, cooled boiled water on cotton wool.
Talk to the taska about their indoor plan and whether doors and windows stay shut.
School-age children
Move sports training indoors or postpone it.
If they have asthma, make sure the school has a copy of the asthma action plan and that the reliever is in their school bag.
What not to do
Do not rely on a cloth mask or tissue held over the face. They do not filter fine particles.
Do not put any mask on a baby or child under 2.
Do not stop your child's preventer inhaler because they seem well. Haze is the time it matters most.
Do not burn incense, mosquito coils or rubbish at home.
Do not use cough syrups in children under 6 to "treat" a haze cough.
From Dr Nisa's clinic: Every haze season, the children I worry about most are the ones with asthma whose preventer inhaler has quietly run out or been stopped. The haze arrives, the cough starts at night, and within a few days they are struggling. If your child has asthma, check now that the preventer is being used every day, the reliever is not expired, and the school knows the plan. Ten minutes of preparation often saves a difficult week.
Worried about haze and your child's breathing?
I am Dr Nisa Khalil, a consultant paediatrician with more than 18 years of experience caring for children, based at ParkCity Medical Centre in Kuala Lumpur. If your child has asthma, keeps coughing during haze season, or you are not sure whether their breathing is normal, I can assess them and help you put a clear plan in place.
Book an appointment at ParkCity Medical Centre, or start with an online eConsult if you would like advice first.
You may also find these helpful:
Frequently asked questions
Is haze dangerous for babies?
Haze is more harmful for babies than for older children because they breathe faster and their lungs are still developing. Most babies who stay indoors in a clean room with windows closed cope well. Watch for fast breathing, chest drawing in, poor feeding or unusual sleepiness, and see a doctor the same day if any of these appear. Babies under 3 months with breathing difficulty should always be checked promptly.
Should my child wear an N95 mask during haze?
Not if your child is under 2, and adult N95 masks rarely fit young children properly. For children over 2, a well-fitted child-size mask can help for short outdoor trips, with an adult watching. A mask is a backup, not the main protection. Keeping your child indoors in filtered air reduces their exposure far more than a mask worn outside.
At what API should I keep my child indoors?
Move outdoor play indoors once the API goes above 100, and keep children inside with windows closed once it passes 200. If your child has asthma or is a baby, act a little earlier, around the upper end of the moderate range. Always use the reading from the station closest to you, and recheck it during the day because levels change quickly.
Do air purifiers help during haze?
Yes, a HEPA air purifier that is the right size for the room can lower fine particle levels indoors considerably. It works best in one closed room where your child sleeps and plays. Check the clean air delivery rate against your room size, avoid ozone-producing devices, and change the filter as recommended, because haze season clogs filters faster than usual.
Can my child with asthma go to school during haze?
Usually yes, if their asthma is well controlled, outdoor activities are cancelled and the classroom is closed and air-conditioned. Make sure the reliever inhaler is in their bag and the school has their asthma action plan. Keep them home if they have needed the reliever more than usual recently or if local readings approach 200.
Medically reviewed by Dr Nisa Khalil on 19 October 2026. This article is general information and does not replace a consultation with your own doctor.
References
World Health Organization. Wildfires and health, fact sheet. who.int
World Health Organization. Ambient (outdoor) air quality and health, fact sheet. who.int
Department of Environment Malaysia. Air Pollutant Index status categories. doe.gov.my
US Environmental Protection Agency. Wildfires and indoor air quality. epa.gov
Malay Mail (Bernama). MOE reverts to haze plan: schools shut at API 200, outdoor classes at 100, 15 October 2026. malaymail.com
Worried about your child?
Book an appointment with Dr Nisa Khalil for calm, evidence-based paediatric care when your child is unwell.
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