Paediatrician says Delhi-NCR’s severe AQI is affecting babies before they are born; Here’s what doctors want parents to know

As Delhi-NCR slips back into the ‘severe’ air quality zone, doctors caution that the health impact of pollution does not begin when a child steps outdoors — it begins much earlier, inside the womb itself. Experts warn that polluted air is now affecting infant immunity and long-term lung development in ways India can no longer afford to ignore.

Damage begins during pregnancy, not childhood

“Air pollution can start affecting a baby as early as the first trimester,” says Dr Lalita Kanojiya, Additional Director – Paediatrics, CK Birla Hospitals, Jaipur. Fine particulate matter like PM2.5 and PM10 — small enough to travel deep into the mother’s lungs — can enter her bloodstream and reach the placenta. Once there, they disrupt the supply of oxygen and nutrients, interfere with organ formation and even cause placental hypervascularisation, a change now linked to poor foetal growth.

Dr Manish Malik, Director of Paediatrics and Head of Neonatal Services at Max Smart Super Speciality Hospital, Saket, adds that the threat is not limited to particles alone. “Ultrafine particulate matter such as PM2.5 and PM10, along with toxic gases like carbon monoxide, can cross the placental barrier. This early exposure is linked to poor weight gain, preterm birth, and placental inflammation. It can even contribute to gestational hypertension in mothers.”

Also Read: Rising AQI levels are harming more than lungs; doctor warns children, seniors and pregnant women most at risk

Research over the last decade has reinforced this early impact. Children exposed to toxic air in utero show higher risks of low birth weight, preterm birth, wheezing disorders and asthma. Dr Kanojiya notes that parents often observe early warning signs in infancy — persistent cough, noisy breathing, rapid breaths or recurrent infections — all signals that the respiratory system never got the chance to develop fully.

The threat amplifies after birth

Pollution doesn’t stop harming a child once they’re born — it worsens. According to Dr Arup Halder, Pulmonologist, CMRI Kolkata, pollution is a “double-hit”: it disrupts foetal development, and then continues to damage the lungs throughout early childhood.

“The latest State of Global Air (SOGA) report shows that chronic exposure to particulate pollution in pregnant women significantly increases the risk of babies being born too small or too early,” he says. In 2019, nearly 4,76,000 babies worldwide died due to air pollution exposure, with one in five newborn deaths now linked to prematurity or low birth weight.

Even more alarming, nearly two-thirds of these deaths come from indoor air pollution — caused by cooking smoke, incense, poor ventilation, and household dust.

These early exposures contribute to what experts describe as the foetal origins of adult disease. Babies born underweight or preterm due to pollution face higher lifetime risks of chronic respiratory illness, cardiovascular disease, poor immunity, and even cancers. “A predisposing factor in the womb, when combined with ongoing exposure, becomes a lifelong threat,” says Dr Halder.

Dr Malik explains why infants deteriorate faster than adults during pollution spikes, says, “Their airways are smaller, their lung capacity is lower, and their immune defences are still developing. Even mild inflammation or infection can trigger wheezing, breathlessness and recurrent infections. Many children end up needing nebulisers or antibiotics early on.”

Parents should also be alert to behavioural signs. “Irritability, restlessness or hyperactivity can sometimes indicate pollution-related stress on the body,” he adds.

What practical steps can parents take?

Since infants and toddlers breathe faster than adults and inhale more air per kilogram of body weight, they fall into an extremely vulnerable category. Masks are not recommended for very young children, so the focus must shift to reducing exposure.

Doctors highlight immediate steps families can take to protect pregnant women and young children:

Inside the home

• Use HEPA air purifiers during high-pollution periods.
• Improve ventilation when AQI improves; otherwise, keep windows shut.
• Wet mop floors and use a vacuum cleaner to reduce indoor dust.
• Avoid incense sticks, agarbattis, scented candles, and strictly avoid smoking indoors.
• Keep infants and toddlers indoors during peak pollution hours.

For pregnant women

• Wear N95 masks when stepping outdoors.
• Avoid high-traffic zones and peak pollution times.
• Hydrate well and include vitamin C and antioxidant-rich foods to counter oxidative stress.

 

Also Read: Poor air quality can trigger whooping cough in infants, paediatrician suggests tips to protect newborns from pollution

For infants and young children

• Avoid outdoor play near traffic or congested areas.
• On severe pollution days, shift all exercise or play indoors.
• Watch for early symptoms — cough, noisy breathing, fast breathing or recurrent colds — and consult a paediatrician early.
• Air-purifying plants, while not a primary solution, may help support cleaner indoor air along with other measures.

 

FAQs on air pollution and children's health

How does air pollution affect children's health?

Air pollution starts affecting children as early as the first trimester of pregnancy. Fine particulate matter and toxic gases can enter the mother's bloodstream and reach the placenta, disrupting oxygen and nutrient supply, and impacting organ formation. Post-birth, pollution continues to damage the lungs and immune system, leading to higher risks of respiratory illnesses, cardiovascular diseases, and other long-term health issues.

What are the early signs of pollution-related health issues in children?

Early signs include persistent cough, noisy breathing, rapid breaths, recurrent infections, irritability, restlessness, and hyperactivity. These symptoms indicate that the respiratory system may not have fully developed due to early exposure to polluted air.

What can parents do to protect their children from air pollution?

Parents can use HEPA air purifiers, improve ventilation when AQI is better, wet mop floors, avoid burning incense and scented candles, and keep children indoors during peak pollution hours. Pregnant women should wear N95 masks outdoors, avoid high-traffic zones, and stay hydrated with vitamin C and antioxidant-rich foods. For infants and young children, it's essential to avoid outdoor play near traffic, shift exercise indoors on severe pollution days, and monitor for early symptoms.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.