Advice given was too conservative

EDITOR—We agree with Pollard et al that infants and children below the age of 2 who are on treks should not sleep above 2000 m.1 But we question their concluding remark that children aged 2-10 who are trekking should not sleep higher than 3000 m. In the absence of any firm data on acute mountain sickness in children, we believe that this advice is too conservative for children who can express themselves clearly—for instance, those aged 7 and older.

Firstly, in our experience the ability of the child to describe a problem clearly in words (so that, if necessary, descent can be planned promptly) is key in the decision whether children should accompany adults to high altitude. We believe that this was not emphasised enough in the editorial.

Secondly, most leaders of trekking groups in the Himalayas believe that dehydration is unhealthy at high altitude and that it …